Teleradiology: first Grand Manan, then the world
New Brunswick is taking telemedicine seriously, the head of radiology at the Saint John Regional Hospital says. "Telemedicine is a very cost-effective tool with tremendous applications in rural Canada and rural New Brunswick," says Dr. Michael Barry.
"In rural New Brunswick, it will lend itself to teleradiology very, very nicely, and the government has acknowledged that by appointing a telemedicine officer for the Department of Health."
Since the fall of 1995, Barry has been running a teleradiology project at his hospital, which receives about 100 x-rays a month from Grand Manan, an island in the Bay of Fundy.
Accessible by ferry, the island has only 1 family physician to serve 3000 residents. "Grand Manan is very vulnerable to weather in winter," Barry says. "It has very real problems getting reasonable access to health care."
Barry says that with telemedicine -- and NB's upgraded telecommunications system -- it takes less than a minute to transmit digitized x-rays, which meet guidelines established by the American College of Radiology.
"We do every x-ray imaginable -- skulls, chest, ankles, spines -- everything that plain radiography can do," Barry says of the $100 000 computer-based system, developed by TecKnowledge Healthcare Systems of Halifax.
His hospital faxes back x-ray readings within 24 to 48 hours; the turnaround time used to be 7 to 14 days. "If you're reading an x-ray that's 2 weeks old, it's not much good for acute injuries," he says. "This is the way service should be -- 24 to 48 hours like any major hospital. [Grand Manan] could just as well be across the hall as 100 km away."
Barry says the project has already started to prove its worth. In the first 8 months it saved 2 air evacuations, which cost thousands of dollars.
Still, rural radiologists fear they may pay a price when telemedicine expands. "One of the concerns in rural areas is that it will put the small, single radiologist out of business, that everything will be [sent] to bigger centres, particularly with regionalization.
"I don't think there's any replacement on the ground for those radiologists," Barry stresses. "This will not replace a radiologist -- this will [provide] support."
The next step for Saint John Regional is an imaging network in radiologists' homes so they can receive diagnostic images from emergency and intensive care departments during on-call hours. Barry, who was testing CT scans at home last, says the network will expedite admission and discharge decisions and move patients through emergency more quickly.
"We think this is the first of many applications," he says of the Grand Manan project. "We believe there is an international market here."
