The Alberta SuperNet – Impact on Health Services Delivery Dr. Penny Jennett – Principle Investigator Co-Investigators:

1. The Alberta SuperNet – Impact on Health Services Delivery Dr. Penny Jennett – Principle Investigator Co-Investigators: Dr. M. Yeo, Dr. R. Scott www.ucalgary.ca/telehealth American Telemedicine Association 2004 Annual Meeting & Exposition Tampa, Florida May 2-5, 2004

2. Overview • Background • Purpose • Methods • Results • Impact • Readiness • Challenges • Conclusions • Next Steps PJ - ATA Tampa, Florida May 2-5, 2004

3. What is the Alberta SuperNet? • 4700 linkages • 422 communities • Federally funded • Multi-sectored • 14 multi-disciplinary researchers from 4 universities • Broadband – ISPs - 10 times dial-up - 560 kb

4. BackgroundEight sub-projects • Public consultation • Distance learning • Disaster emergency • Health • Discrete choice • Virtual clusters • In home/community • Libraries PJ - ATA Tampa, Florida May 2-5, 2004

5. Purpose To determine the Key Informant views of: • Healthcare organizations/care sites (e.g. CEOs, administrators); • Healthcare practitioners (e.g. physicians, nurses, rehabilitation therapists); and • Consumers (e.g. Patients/clients, public) on the impact of the SuperNet as a transmission mode for e-health applications/solutions. PJ - ATA Tampa, Florida May 2-5, 2004

6. Questions • What is the perceived or actual impact of using the SuperNet to deliver health services? • How will the delivery of health services affect the status quo? • How ready are the various stakeholder groups to use the SuperNet? • What indicators can be used to measure the impact of the SuperNet? • How might the delivery of health services via the SuperNet affect patient safety and confidentiality? • How do project findings impact the various strategic policy levels? PJ - ATA Tampa, Florida May 2-5, 2004

7. MethodSelection of Participants • Key Informants • Representative sample of 14 key health sector informants was selected from the participating communities, in consultation with the Provincial Telehealth Director. • 6 organizational/administrators 4 health care providers 2 patients/consumers 2 provincial telehealth program • All 14 key informants selected were interviewed (100% response rate) PJ - ATA Tampa, Florida May 2-5, 2004

8. Results Impact (Positive and Negative) on: • Usual Care • Current Telehealth Services Readiness PJ - ATA Tampa, Florida May 2-5, 2004

9. ResultsImpact on Usual Care • Positive: • Provide greater access to care, particularly for elderly and physically disabled. • Improve the quality of care; timeliness of care; and appropriateness of care. • Better use of resources; more appropriate use hospital beds and providers of care. • Capacity building for rural health care providers. • Provide greater continuity of care from tertiary level facilities to care in rural communities. PJ - ATA Tampa, Florida May 2-5, 2004

10. Results Impact on Usual Care (Cont’d) • Negative: • Fear that providers and services will be lost in rural communities. • Disruption of patient-provider relationship / Impersonal. • Change in processes and way healthcare is delivered. • Pushing the system harder at both provider and community ends. • Rural communities caring for more acute patients. • Redundancy will need to be built into the system. PJ - ATA Tampa, Florida May 2-5, 2004

11. Results (cont’d)Impact on Current Telehealth Services • Positive : • Possible to reach Alberta Communities that could not be reached before, via telehealth. • Increase in telehealth consultations. • Higher bandwidth will make more, higher quality, e-health services available. • Increased flexibility will facilitate the use of telehealth as a tool in clinical practice. • Sharing of diagnostic information will be immediate. • Can be cost-effective if done within context of all other IT requirements. PJ - ATA Tampa, Florida May 2-5, 2004

12. Results (cont’d)Impact Current Telehealth Services • Negative: • Telehealth services currently in place are ISDN and will require transition to IP. • Need for infrastructure changes – gateways, gatekeepers, bridges, etc. requires significant up front planning in collaboration with IT/IS. • Going to have to learn to do things differently. • If telehealth, via IP is not reliable, could impact patient outcomes, and telehealth services negatively. • Privacy and confidentiality issues, particularly with wireless and EHRs. • Lack of experience with providing telehealth via the SuperNet. PJ - ATA Tampa, Florida May 2-5, 2004

13. Results (Cont’d)Readiness to Use SuperNet (n=14) PJ - ATA Tampa, Florida May 2-5, 2004

14. Informed Awareness Costs Sustainability Business Case Technical Infrastructure Reliability Gateway; bridge; interface Security/Privacy People Staffing Education Support Readiness Challenges PJ - ATA Tampa, Florida May 2-5, 2004

15. Conclusions • Converging high capacity Internet health services with usual and current telehealth services has both positive and negative implications, including potential socio-economic impact (e.g. capacity building, and more efficient use of resources) across several levels. • Key Informants have varied views as to the state of readiness. PJ - ATA Tampa, Florida May 2-5, 2004

16. Next Steps NEXT STEPS: • Triangulation of results: household telephone interviews, town halls, symposium, and health questionnaire results • Dissemination of e-Health Sector Sub-Project findings. • Integration of findings of e-health sub-project with other sub-projects. PJ - ATA Tampa, Florida May 2-5, 2004

17. Summary • Background • Purpose • Methods • Results • Impact • Readiness • Challenges • Conclusions • Next Steps PJ - ATA Tampa, Florida May 2-5, 2004

18. Dr. Penny Jennett jennett@ucalgary.ca Health Telematics UnitGlobal e-Health Research and Training Program www.ucalgary.ca/telehealth Thank You!