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Integrated telemedicine primary care is an excellent
health care delivery solution addressing the health disparity faced by British
Columbia’s rural and remote communities. Telemedicine has been around for some
time and research conducted in 2003 suggests that community readiness is vital to acceptance by
patients, practitioners, the public and organizations; and to the successful
implementation of technological care (Jennett, Jackson, Healy, Ho, Kazanjian,
Woollard, Haydt, and Bates, 2003).  

            More
than ten years later, a study by Terekhova et. al reveals that telemedicine use
is increasing, in fact, doubling between 2013-2014 and 2014-2015, although
virtual care use remains very small (0.01%) (Terekhova, Tabassi, Gabriel and
Jafari; 2017).  Growth in remote
primary care is highest in Northern BC, likely due to limited access to health
services in this geographical area; although other factors may affect user
distribution including internet access and social media marketing (Terekhova
et. al, 2017). With this increase in usage, it is interesting to note that
acceptance of telemedicine is higher amongst patients than health care
providers (Terekhova et. al, 2017).  In 2014, then BC Minister of Health, Terry Lake, ordered a
review of telemedicine services citing the concerns of provincial doctors and
increased health care cost burden. Online doctors, the government argues,
garner higher fees than their office counterparts and therefore, add costs to
the health care system. Therefore, virtual care “could deplete the already
fragile supply of family doctors providing cradle to grave, comprehensive
medical care, an effect similar to that created by walk-in clinics” (Fayerman,
2014). 

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            In
response to concern over the erosion of physician/patient encounters, which
doctors see as integral to patient-centred care, the Doctors of BC outline their
position in their Policy Statement on Telemedicine in Primary Care as a
‘complimentary tool’ for rural primary care physicians (Doctors of BC, 2014).  Northern Health Physicians (NH) also calls
for integration between telemedicine and ‘on the ground’ services accessing
local, regional and provincial medical resources (Pelletier, 2018; NH, accessed
2018). Culturally sensitive care and focussed intervention based on northern
communities’ unique needs are also laid out in Northern Health’s Policy
Statement (NH, accessed 2018).

            Let’s
look at a specific example of a community’s response to an identified barrier
to Ehealthcare: Research shows that a majority of telemedicine patients are
under the age of 50, suggesting that seniors do not access telemedicine
services (Terekhova et.al, 2017). My stepsister is the community liaison
officer with Columbia Basin Alliance for Literacy (CBAL) in Castlegar, BC. One
of her duties is to help improve technology literacy for community seniors. It
is through these kinds of community initiatives that this identified
demographic—particularly remote/rural seniors—may confidently accept and access
IT-based health care services such as Telehomecare or remote patient monitoring
in the near future.

            Telemedicine
can lead to improved health outcomes for rural and remote areas of BC. I
believe that community measures can be taken to instil readiness amongst users
and providers; and provide personal, effective and integrated health services
for vulnerable British Columbians.   

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