Celebrating 20 years of Telemedicine: How video conferencing technology is redefining the way we care, educate and collaborate at SickKids

Every day families from across Ontario make the trip to SickKids for their child's appointment. For some families, travelling to our hospital is nothing more than a short drive or subway ride. But for other families, getting to SickKids for an appointment can be challenging. Add to this having a sick child to look after and the stress of the whole situation becomes difficult to imagine.​

Twenty years ago, there was nothing that could be done about this situation. Families would either have to make the journey to SickKids or stay at home and have their child not receive the specialized care they needed. Fast-forward to 2016 and this is no longer the case.

The Telemedicine Program has helped evolve the way we deliver care at SickKids. The program, which is celebrating its 20th anniversary, has become an integral resource for clinicians. From its humble beginnings transmitting images over telephone lines using a TV and video camera to now supporting over 5,000 video conferences annually through TVs, desktops, laptops and tablets, the program has become a reliable way to remotely assess patients, including triage, management and follow-up.

In addition to supporting care, Telemedicine facilitates video conferencing to meet education and research needs. With 45 video conferencing-enabled rooms across the organization, the program connects staff with other health-care and research facilities and permits distance learning. Multi-point connections allow staff to present their work or listen to a colleague's lecture, whether they are at SickKids or halfway across the world.

"SickKids is a leader in the deployment of telemedicine technologies within the Canadian health-care system, especially with regards to paediatrics," says David Willis, Clinical Manager, Psychiatry and Telemedicine. "Applications within all areas of patient care are being explored in the hope that through Telemedicine, patients can access the best care regardless of their location. As we look to the future, the potential for 'tele' services is endless."

With rapid advancements in technology over the last 10 years, Telemedicine has been able to embrace new platforms as they become applicable to health care. Moving to Internet-based video conferencing was the first major enhancement to Telemedicine's technology, which drastically improved the quality of video and significantly decreased the cost of connection. Now, using the Ontario Telemedicine Network's (OTN) secure network, the program has three distinct technology platforms to support the needs of our staff, patients and families.

Guest-Link

Telemedicine's newest technology, Guest-Link, takes the idea of video conferencing one step further. Guest-Link allows clinicians to securely connect (using OTN) with a patient at home through the patient's computer, laptop, tablet or even their smartphone.

"Guest-Link adds a completely new dimension to providing patient care through video-conferencing," says Willis. "Patients and families who face barriers such as geography or other complexities can now access the specialized care they need from the comfort of their own home."

Room-based video conferencing

Room-based systems, which consist of a large, wall-mounted screen with a camera attached, provide the ability to video conference. These systems are mostly used for educational events or assessments that require multiple clinicians to be present.

Personal Computer Video Conferencing (PCVC)

PCVC allows clinicians to connect securely through the OTN network from the comfort of their office or clinic setting. The technology is deployed from a desktop or laptop and can connect to other health-care organizations' room-based systems. Several ambulatory areas use PCVC as a cost-effective way to carry out aspects of their daily clinical activity. In fact, the Tele-Link Mental Health program has nine psychiatrists who provide care to patients remotely from their offices or homes, without ever having to come to SickKids.

PCVC and Guest-Link are on track to dramatically change the way SickKids clinicians deliver care to patients and families. Use of clinical video conferencing has increased by 15 per cent annually since 2010, and while the data for 2016 is just starting to come in, the number of staff using these platforms has already doubled from January 2015. Ambulatory programs such as Urology, Respiratory Medicine, Learning Disabilities, STOMP, GI and PACT are leading the way, and now more than 250 staff use PCVC and Guest-Link at the hospital. The Telemedicine team is now in the process of setting up these platforms for use in Endocrinology, Pain Medicine, Communicable Diseases, and Orthopaedics.