Nurses dispense health tips with CTI: college launches telehealth program to ease pressure on hospital ERs

A community college in Toronto has launched North America's first post-graduate telehealth nursing program in the hopes of staffing the increasing number of medical information call centres in Canada.

"Nobody else is doing it. There is no other post diploma program in this -- not in Canada or in the United States," says Gail Beagan, chair of the community health and wellness division in Centennial College's applied arts and health sciences program.

Beagan says that though health care professionals are generally computer-shy, she has received more than 100 calls from eager nurses since the program was announced.

The idea behind telehealth is to route medical questions and concerns to a call centre staffed by nurses who can assess whether a caller should go straight to a hospital or simply make an appointment with their family practitioner. The goal is to ease the pressure on hospital emergency rooms.

Nurses in the Centennial program will train on $600,000 worth of software donated by Boise, Idaho-based Healthwise Inc., a non-profit organization that aims to deliver accurate health information to health-care consumers.

"Our mission, simply, is to build a better patient," says Steve Havis, the company's international marketing director.

As nurses type in the information from callers, Healthwise's Knowledgebase software identifies parts of the database containing appropriate information and offers prompts to ensure that nurses ask the appropriate questions, Havis adds. The software has information on about 500 health problems and is updated every three months.

This type of tool is invaluable to health care, Beagan says.

"Technology has given us the ability to do things we wouldn't have been able to do." Setting up a call centre for public access to nurses is more than a cost-cutting measure, she says. The phone service will help triage calls to the right health professional, easing pressure on emergency rooms and reducing the time patients have to wait for answers to their specific health concerns.

Like many call centres, however, cost efficiencies are a significant motivator.

"For every three people you move out of emergency into a clinic, you save money because you are now able to allocate those funds to one acute care patient," Beagan says.

To ensure that Canadians using the service get the same level of expertise as in a traditional health care setting, admittance to the Centennial College program is limited to nurses who have at least three years of experience and proven assessment skills.

"What they are now being asked to do is basically practise independently in conjunction with the client on the phone and the computer screen in front of them," Beagan says.

The Knowledgebase software runs on Windows-based computers in the school's simulated call centre. There will be a maximum of 26 people per class attending the $800 part-time program over a 20-week period. Once they graduate, there will be plenty of opportunity for telehealth nurses, Beagan says.

In Ontario, most call centre health initiatives have taken root in the private sector, such as insurance companies, but other Canadian provinces have partnered with call centre and software vendors to establish medical information lines for the public.

"We are very slow at that," admits Beagan of Ontario. "Every other province seems to have been much more adept at getting on board."

An established call centre in New Brunswick, for example, employs 43 nurses who process about 12,000 calls per month and offer 24-hour service, seven days a week.

Ontario's telehealth movement is gaining momentum, however. Kirkland, Que.-based Clinidata Inc., the company that helped the New Brunswick government set up its call centre, was recently awarded a similar contract in northern Ontario.

The province is ripe for this type of service, according to Lois Scott, Clinidata's vice-president of clinical services. The centre in New Brunswick often gets calls from Maritime grand-parents who want to get information on behalf of their grandchildren in Ontario, she says.

Delivery of health care information by phone has received the support of organizations such as the Canadian Nurses Association, but some insiders say nurses are concerned about whether adequate care can be dispensed without seeing the patient in person.

"That's why you are starting to see programs like the Centennial one," says Maureen Farrington, director of corporate services for the Canadian Nurses Association, "to see how you can establish that therapeutic relationship over the phone lines."

Copyright Plesman Publications Ltd. May 1999
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