Peter G. Rossos
M.D., F.R.C.P.(C)
Director of Medical Informatics, University Health Network Associate Professor of Medicine, University of Toronto

Alejandro (Alex) R. Jadad
M.D. D.Phil. F.R.C.P.(C)
Director, Centre for Global eHealth Innovation
Canada Research Chair in eHealth Innovation

Telehealth: Transcending traditional boundaries is an imperative

Every health system in the world should strive to ensure that the people it serves have access to the information and services required to achieve optimal levels of health, with the most efficient use of available resources. Given the shortages of health professionals in most institutions and countries in the world, telehealth is the only viable way to reach this goal.

The opportunities created by information and communication technologies remain limited due to the lack of legal and funding structures to support inter-jurisdictional exchange of services. This is hurting people, particularly in under-served areas. Licensing restrictions and the lack of reciprocal payment mechanisms remain chronically and stubbornly entrenched in most systems. Services must follow need, not jurisdictions set in the pre-Internet era.

Members of the public, health professionals, governments, licensing organizations, third party payers and industry must join forces to create a new framework for the delivery of health services across traditional geographic, institutional and funding boundaries, while addressing issues related to privacy, compensation and liability. Seamless access to knowledge and expertise is required to support distant and community based management of services.

Teleconferencing, home monitoring and virtual clinical environments can empower patients and remote healthcare providers with the ability to manage complex medical conditions without travel and hospital admission. Although personal consultation and intervention will always be a necessary component of health care, electronic interactions will prove to be more effective and efficient in many situations.

Longer-term benefits could include an emphasis on preventative health measures, and improved recruitment and retention of health professionals through support and continuing education in remote communities.

A multi-disciplinary approach is required to study and implement appropriate policy change, funding mechanisms, process of care, and technology itself. We must work together to creatively harness the technological potential to provide appropriate health services without limitations of geography and socio-economic status.