Interior Health has found success using a fiber-optic platform to serve a wide, mostly rural area of British Columbia, Canada.

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Serving the medical needs of more than 700,000 people is a serious task for any healthcare organization. However, when that population is spread over a geographic region of more than 83,000 square miles, the concerns become greater than simply having the resources to care for it. CEO Murray Ramsden says this is the situation for Interior Health Authority , one of five provincial healthcare systems established in British Columbia, Canada, in 2001.

“It’s a very large geographical area encompassing about 55 municipalities,” Ramsden says. “It’s about the size of Oregon.”

The authority, which was created by the province after an amalgamation of three existing health regions, covers a mostly rural area, with often-large distances between communities. Dr. Michael Humer, who oversees all thoracic surgery in the authority, says population density averages no more than three people per square kilometer. Patients who require intensive treatment would ordinarily have to drive thousands of kilometers each year to make all the necessary office visits, he says.

“I don’t know of [another region] that serves as many sites and faces these geographic challenges,” Ramsden says.

To solve this problem, Interior Health has turned to a high-tech solution. Ramsden says it has made a significant investment in a fiber-optic infrastructure that allows it to share information between clinics, hospitals and offices faster than ever before. What’s more, Interior Health has made it possible for a doctor to consult with a patient without either of them having to meet face-to-face.

Greater Connectivity
“Our strength has been the use of technology,” Ramsden says. Within two years of being formed, Interior Health had established a network of fiber-optic cables that connected all of its sites. The technology was provided by TELUS, and all clinical services were then put on the MEDITECH platform.

“Once we had a common platform, we were in a position to roll out our integrated health record and use tools like a common picture archiving system,” Ramsden says.

With this level of connectivity, Interior Health’s practitioners can instantly call up the profile of any patient treated within the system. Not only does this provide medical professionals with immediate and up-to-date information, but it also allows them to provide care from a distance. Dr. Humer says the health authority has been able to save itself and its patients time and money by conducting some care through telehealth technologies.

“For the past four years-plus, we have conducted video consultation and follow-up clinics through [Interior Health],” he says, adding that he has helped treat more than 3,000 thoracic surgery patients through more than 500 telehealth clinics since 2003.

“At the majority of the sites there is a thoracic specialty nurse on the site with the patient, and we’re able to look directly at their X-rays and we can get many of their investigations done on-site,” he says. “They come to Kelowna for surgery and all the follow-up can be conducted at their local facility.”

Humer says the authority’s telehealth initiative saves patients the risk of traveling, in addition to time and money. In British Columbia, where roads can be treacherous during the winter months, that’s a significant advantage, he says. “The patients are universally ecstatic about the service,” he adds.

Frontier Medicine
Telehealth technology has also been a boon to Interior Health because of the difficulty in keeping medical professionals in rural areas. Ramsden says although human resources are a challenge everywhere, the rural areas suffer more than the urban centers because of the greater strains they put on practitioners.

Demand in rural areas is greater because there are fewer practitioners, which leads to fewer practitioners wanting to work in rural areas and so on. “Eventually it becomes like the straw that broke the camel’s back,” he says.

Interior Health works with rural communities to increase their profiles and make them more attractive to practitioners, Ramsden continues. He says the authority alone cannot convince professionals to take on these challenging but ultimately rewarding assignments.

“It’s very much a community engagement strategy,” he says. “We also have to work closely with our colleges.” Interior Health’s initiatives in this area include establishing committees in each community that work to attract practitioners.

“The community has to be attractive to them, and it’s also up to the communities to put the best foot forward,” he says. “These challenges are not going to go away, and I would predict that it’s only going to escalate in the next five years.”

New Outlooks
Aside from its telehealth programs, Interior Health is paving the way to the future in other areas. Ramsden says the authority is a pioneer in “green” building in Canadian health care. Hillside Centre, its Mental Health Facility in Kamloops, British Columbia, was the first Canadian mental health facility to receive Leadership in Energy and Environmental Design (LEED) gold certification when it was built in 2005.

“With all construction of new facilities, our goal is to work toward LEED gold standards,” Ramsden says.

That includes the expansion of Interior Health’s Kelowna General Hospital, its premier tertiary care facility. A new 187,000-square-foot outpatient tower is being built, along with a modernization of its emergency department that will increase its size from 7,000 square feet to 30,000 square feet.

Ramsden says Kelowna is the region’s fastest-growing community, and the hospital has been feeling the pressure for years. The new tower will not only provide more space, but will also move the hospital from an inpatient model to more of a focus on ambulatory programs, Ramsden says.