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<h4>Fort Severn is the most northernly <br>community in the province <br>of Ontario.</h4>

Fort Severn is the most northernly
community in the province
of Ontario.

The View from CRC

Telehealth in Canada: Cutting through communications barriers

The quiet, remote community of Fort Severn is probably the last place one would expect to find leading-edge telecommunications technology at work. But it is in this small town in northern Ontario, with a population of just 460, that the Communications Research Centre Canada (CRC) installed a satellite connection on behalf of K-net, the Industry Canada funded Aboriginal Smart Community. K-net is currently demonstrating the many benefits offered by telehealth.

Based in Ottawa, Ontario, CRC is the federal government’s primary laboratory for advanced communications research and development (R&D). Thanks to CRC’s leading satellite communications program, Fort Severn was equipped with a telehealth system in 2001, enabling citizens to access services such as remote consultation and diagnosis, health education in preventative care for the public and continuing medical education to health professionals. Previously, the community’s health care expertise was quite limited. Two Health Canada nurses worked at the nursing station, and referrals for additional medical services required a 1.5-hour flight at a cost of over $1,200 per scheduled trip. Emergency or “Medivac” trips from Fort Severn cost approximately $8,000.

The telehealth system consists of several specialty devices contained in a telemedicine suite that includes a video conferencing unit and a general patient examination camera. The camera is designed to be simple to operate, with easy focus, freeze-frame capabilities and the ability to send a still image as an e-mail attachment for physician review. The system is also flexible to accomodate additional tools – such as an otoscope, retinascope and a digital stethoscope. Teleradiology equipment is also in operation in the Fort Severn Nursing Station.

Despite the many benefits, however, some barriers still exist for the implementation of telehealth systems. Experience has shown CRC that even with relatively low-cost equipment and using narrow bandwidth, telehealth alone is not sustainable for small, remote communities. It is essential to consolidate the applications needed by the community to build a sustainable infrastructure. In Fort Severn, for example, the community’s needs were addressed by networking all organizations and services – including
<h4>Fort Severn was equipped with a telehealth <br>system in 2001, enabling citizens to access <br>services such as remote consultation and <br>diagnosis, health education in preventative <br>care for the public and continuing medical <br>education for health professionals. </h4>

Fort Severn was equipped with a telehealth
system in 2001, enabling citizens to access
services such as remote consultation and
diagnosis, health education in preventative
care for the public and continuing medical
education for health professionals.

two schools, the band office and the nursing station. The satellite system supporting Fort Severn’s telehealth system is linked to a hub station in Sioux Lookout, Ontario, which is in turn connected to a broadband terrestrial network of larger communities.

On the “Cutting” Edge

Remote communities in Canada may soon have access to another application stemming from satellite technology – telerobotic surgery.

Telerobotics allows faraway experts to assist physically in operations using a robotic device. Through electronic impulses, telerobotic surgery transmits the natural movements of a surgeon’s hand, wrist and fingers across space, to robotic devices that can perform the same operations from across the room or much farther away.

While robotic surgery is already commonplace in more than 100 hospitals around the globe, it wasn’t until 2001 that the world’s first long-distance robotic operation – telerobotic surgery – took place between New York City and Strasbourg, France. In Canada, Dr. Mehran Anvari of Hamilton, Ontario achieved the world’s first hospital-to-hospital telerobotic procedure 2003, when he used a robot to perform remote antireflux surgery over a high-speed terrestrial network. Since then, Dr. Anvari’s team has performed an additional 23 cases.

Currently, Dr. Anvari is working closely with CRC and Telesat on a project designed to further explore the use of satellite technology for sites where adequate terrestrial links are not available. The project consists of three phases. The first phase will be initial testing in Hamilton, where the latency issues – the slight time-delay over satellite – will be tested, and protocols and procedures established. In order to do this, CRC has already installed a satellite system at the St. Joseph Health Care Centre in Hamilton. Later this year, CRC will also install satellite equipment in North Bay, Ontario, to fulfill the second phase – proof-of-concept and simulation of telerobotic surgery. The project’s third phase aims to perform live telerobotic surgeries between Hamilton and North Bay on up to six patients.

This project will greatly benefit remote and rural communities by increasing the accessibility of quality healthcare and providing doctors in isolate regions with the support of skilled surgeons.

By Jim Hamilton & Michelle Mayer


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