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Telemedicine used to handle H1N1 in Alberta

EDMONTON – To help manage the H1N1 pandemic, Alberta has been using telehealth equipment in many of its Intensive Care Units. The telehealth gear allows doctors to communicate with their peers at tertiary care centres in Edmonton and Calgary.

Videoconferencing equipment has been deployed in or near 18 ICUs since October, allowing critical care teams throughout the province to consult each other, virtually face-to-face, at any time during the pandemic.

Each ICU in Edmonton and Calgary has been paired with an ICU in one of five other urban centres: Red Deer, Fort McMurray, Grande Prairie, Lethbridge and Medicine Hat. The Edmonton and Calgary teams dealing with the most difficult H1N1 cases are also linked by telehealth.

The technology is able to accommodate PACS (picture archiving and communication system), allowing real-time sharing of medical images.

As a result, staff and physicians at many ICUs have been able to provide better care for critically ill patients in their communities.

Dr. Noel Gibney (pictured), medical director of Critical Care, Edmonton Zone and an intensivist at the University of Alberta Hospital (UAH), says telemedicine plays an important role in treating critically ill patients at his site and at its buddy site, the Northern Lights Regional Health Centre in Fort McMurray.

“It enables us to advise physicians there on the management of many cases that, otherwise, would have been transferred to Edmonton. When possible, it’s good for critically ill patients to stay where they are, and it’s good for the system, too,” he says.

Dr. Gibney says videoconferencing is vastly superior to telephoning. “When you see the same people on a day-by-day basis, it builds trust and relationships,” he says. “Those are intangibles but they’re very real components of providing really good care.”

The UAH support is appreciated by staff at Fort McMurray, says Dale Marshall, the operational lead for Critical Care Services at Northern Lights. While the hospital can care for patients with complex needs, Marshall says, it’s not a big tertiary care centre.

“We do a great job, but sometimes we can benefit from the expertise available elsewhere in the province. That’s why the telehealth connection was vital. It gave staff here the support and confidence to care for these patients.

Caroline Hatcher, director of Cardiac Sciences, Critical Care and the neonatal intensive care unit (NICU) at the Foothills Medical Centre in Calgary, add that: “When we were planning for the pandemic, we knew we would need to rely on each other because critical care capacity in the province was going to be stressed.”

“Having all province’s ICU teams linked also allows pandemic information to be quickly shared,” adds Dr. Cheri Nijssen-Jordan, co-lead of AHS’ Pandemic Clinical Operations.

AHS staff, in both Telehealth and Critical Care, worked for two weeks to have the network running by mid-October, when the second H1N1 wave arrived. Timely delivery of the technology was the biggest of several challenges, says Jason Kettle, provincial lead, Telehealth and Multimedia Technical Services.

“We don’t throw a videoconference device in a room; there are a lot of factors that need to be considered to ensure patient safety and confidentiality,” he says.

A review of the telehealth initiative is ongoing and a report is expected in early 2010, says Sybil Young, provincial lead, Telehealth Initiatives and Services. “This was a new piece of work, so it’s important to evaluate it,” Young says.

Posted Jan. 14, 2010