Framework for Canadian telehealth guidelines: summary of the environmental scan

Abstract

A Canadian project (the National Initiative for Telehealth Guidelines) was established to develop telehealth guidelines that would be used by health professionals, by telehealth providers as benchmarks for standards of service and by accrediting agencies for accreditation criteria. An environmental scan was conducted, which focused on organizational, human resource, clinical and technological issues. A literature review, a stakeholder survey (245 mail-outs, 84 complete responses) and 48 key informant interviews were conducted. A framework of guidelines was developed and published as a preliminary step towards pan-Canadian policies. Interim recommendations were that organizations and jurisdictions might consider formal agreements to specify: (1) organizational interoperability; (2) technical interoperability; (3) personnel requirements; (4) quality and continuity-of-care responsibilities; (5) telehealth services; (6) remuneration; and (7) quality assurance processes. An additional recommendation was that flexible mechanisms were needed to ensure that accreditation criteria will be realistic and achievable in the context of rapid changes in technology, service integration and delivery, as well as in the context of operating telehealth services in remote or underserved areas.

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

“…However, there is also a potential threat that telehealth would encourage specialists to stay in urban centres while using telehealth to provide coverage to remote regions. This has been pointed out as a possible consequence of the diffusion of teleradiology services[ 34 ].…”

Diagnosis of Skin Lesions Using Photographs Taken With a Mobile Phone: An Online Survey of Primary Care Physicians

“…16,17 Although initially one might think that the use of such tools would only be of benefit to patients and professionals in rural and remote settings, they are also beneficial for urban patients who face obstacles to accessing specialized health care. 18 Unlike hospital settings, community health care provides unique conditions for the use of clinical digital photography and new challenges related to the setting, working practices and the possible absence of health care policies to support such practices.…”

Au-delà de l’évaluation des bénéfices : réflexion sur les conséquences inattendues de la télésanté

“…La télésanté peut également accentuer la concentration des services de santé et des effectifs dans les grands centres urbains. Les médecins se retrouvent plus enclin à demeurer dans les grands centres hospitaliers et à fournir des services via la télésanté, plutôt que de pratiquer directement en région [9] , [10] , [35] , [36] . On peut alors assister à l’émergence d’une concurrence entre les établissements de santé pour le statut de centre de référence dans le cadre d’un réseau de télésanté, soit un statut associé à de nombreux avantages, notamment financiers et humains [10] .…”