Video conferencing-based telehealth--its implications for health promotion and health care.

PURPOSE: To review the experience with a province-wide telehealth system in Canada, and its implications for health care and health promotion. To explore whether group support systems (GSS) based on networked computers can substitute for video conferencing technology. METHODS: Key results of the evaluation of the BC Telehealth Program are summarized. The potential of extending the successful principles through use of GSS is explored based on literature review, demonstrations, and trial use for educational applications. RESULTS: The BC Telehealth Program was designed to support health professionals at secondary care facilities, such as regional and district hospitals in two application domains: children's and women's health (C&W) and emergency room and trauma care (ER-Trauma). Successful applications extended beyond health professionals and focused on chronic conditions, the management of which is contingent on visual information, and involves established teams in regular scheduled visits or in sessions scheduled well in advance. Ad hoc applications, in particular applications under emergency conditions proved problematic. Administrative applications in support of telehealth implementation, e.g., through facilitation of management and provider education, are essential for clinical success. Savings from support of administrative applications exceeded the substantial capital investment and made educational and clinical applications available at variable cost. Educational applications were shown to have significant clinical benefits. Exploration of GSS technology showed that it may not be mature enough to substitute for video conferencing technology in support of sophisticated training and education aiming at clinical impact. CONCLUSION: The substantial clinical and efficiency gains provided by video conferencing-based telehealth may for now continue to depend on mature video-conferencing technology.

Health information science at UVic: the student perspective.

The graduates and students of the School of Health Information Science (HIS) at the University of Victoria (UVic) have pioneered the Canadian sphere in health informatics since 1982. After six years of growth this co-operative education program has matured and establishment of a research base and graduate school has become a recent focus. In this context an evaluation of the HIS curriculum and co-op work experience from the student perspective was undertaken. Eighty-five persons, including 50 upper level students were surveyed. Thirty-five graduates were tracked and queried regarding their present employment, job satisfaction, future goals and perception of their professional status. In particular, students were queried on the retrospective value and/or shortcomings of the HIS co-op program. Their perceptions on the training that they have had or that they observe as leading to successful careers is documented. The student view on the ascribed role of 'change agent' and concerns regarding the lack of professional identity are noted. The implications of these findings on the future form of the Health Information Science curriculum and the direction of its educational model are subsequently discussed.