Why investing in high-speed internet is important for good patient care
By Erin Keely, MD, FRCPC
Ten years ago, a colleague of mine, Dr. Clare Liddy, referred a patient to our centre and was told that the patient would be seen in six to nine months. During this time, the family doctor would not receive any support or guidance from the specialist. Wait times are a major barrier to effective health care. We knew that this was a problem and decided to work together to find a solution.
The result is Champlain BASETM (Building Access to Specialists through eConsultation) known as eConsult. This tool connects primary-care physicians and nurse practitioners with specialists to discuss patient needs in a more timely fashion. They can attach photos or video clips to help tell the patient’s story. Sometimes it eliminates the need for the patient to travel to the specialist’s office for a more formal referral. One family doctor sent a video of a toddler walking with their toes turned in. In a few days the family doctor had received advice from the orthopedic surgeon that it was nothing of concern and the child didn’t need any further testing or treatment. The family was spared months of worry and the need to travel two hours to a specialist appointment.
The average time it takes for the primary-care provider to get advice from the specialist through eConsult is two days and the average cost is about one-third of the cost for a traditional referral. Electronic access tools, like eConsult, have been shown to reduce specialist visits, shorten wait times and, more importantly, help patients get the care they need. But these electronic access tools only work when communities have access to reliable high-speed internet. Today, many of them don’t. So instead of electronic tools helping the most in need, there is a risk that the gap widens for the “haves” and the “have nots.”
One in six Canadians live in rural and remote communities, but only 2.3 per cent of specialist physicians live in those communities. I’m familiar with, and have even contributed to, the research that shows how technology can be used to deliver care to people in rural, remote and Indigenous communities where access to health care in general, and highly specialized care in particular, is lacking. However, one of the greatest obstacles we face in delivering technology-enabled care from a distance is spotty internet service. Far too many communities across Canada (and not just the very remote ones with very sparse population) do not have reliable high-speed internet access. The people in these communities do not benefit from technology-enabled health care in the way that people in internet-connected communities do.
This federal election, the Royal College of Physicians and Surgeons of Canada and its partners are calling on candidates to invest a minimum of $5 billion over the next 10 years to build a connected country to provide equal access to health care. Reliable, high-speed internet access facilitates the delivery of specialty medicine to those who would not otherwise have access, including populations in need such as Indigenous peoples and those living in rural and remote communities. Every person in every community in Canada deserves to have access to the best available health care using modern, proven technology. We ask federal candidates to commit to investments in high speed internet to make this a reality.
Erin Keely, MD, FRCPC, is an endocrinologist at The Ottawa Hospital and a professor in the Department of Medicine at the University of Ottawa.