Physician Shortage: How can telemedicine help to reduce strain on healthcare in rural Canada?

The Canadian healthcare landscape is experiencing a significant shift, and at the heart of this transformation lies a pressing issue — the shortage of physicians and other health care workers. Nationally, a multitude of factors have played a role in exacerbating the existing physician shortage such as diminished enrolment at Canadian medical schools, heightened competition for international medical graduates in urban hubs and prolonged postgraduate training periods. This issue is particularly grave in rural Canada where the challenge is further compounded by the nation's aging population and physicians relocating to more urban areas, which have combined to create a perfect storm of healthcare demands in remote regions.

Many rural areas have aging populations, which require more healthcare services and support. The shortage of healthcare providers can make it challenging to meet the healthcare needs of older residents. People are having to travel long distances for care, and facilities are lacking in proper resources to support their patients. Practitioners are struggling with burnout, staff retention issues, and heavy workloads. This is particularly noticeable when looking at the opioid crisis that is ravaging rural communities. Patients in acute crises often do not have adequate care or support and the staffing resources are not sufficient to support both acute care needs and long term prevention programs.

Telemedicine is the use of telecommunication technologies and electronic information in remote health care and can be used to address some of the health care issues in rural Canada that has become increasingly popular over the last decade. Telemedicine is a field that continues to evolve but here are several key areas that will help increase access to healthcare services and improve the efficiency of healthcare delivery in rural settings — health monitoring, virtual consultations, specialist access, remote imaging, training and education, and reduced wait times.

Telemedicine technology can facilitate remote monitoring of chronic conditions, allowing healthcare providers to keep an eye on patients' health without frequent in-person visits. This can improve patient outcomes and reduce the need for regular check-ups. An example of this could include something as simple as wearing an apple watch and a healthcare provider surveilling the data recorded.

Virtual consultations are an essential part of improving healthcare access in remote areas. According to the Canadian Medical Association, up to 71% of Canadians would like to be able to meet with their provider through phone and 41% over video, however only 9% of providers offer phone consultations and 4% over video (2019). By increasing services that support video, phone, and message consultations, patients will no longer need to travel long distances to see a doctor, making it easier to access care and reducing the strain on local health care providers.

Additionally, rural areas often lack specialized medical services. Telemedicine can connect rural patients with specialists from urban centers, enabling them to receive expert consultations without traveling far. Images such as X-Rays and PET scans can also be analysed at a distance leading to faster diagnoses and reduced wait times for specialist services.

Telemedicine can support the training and education of healthcare professionals in rural areas. It can provide access to online resources, virtual training, and consultations with experts, helping rural healthcare providers stay up-to-date with the latest medical practices.

However, telemedicine is not without its challenges. As the target population is aging there are likely issues with media literacy and knowing how to use technology in their homes. This leads to barriers with information being given to them through technology, accessing their own health related data online, and using health monitoring tools by themselves. Here there needs to be greater attention placed on education within the population that requires human resources. Furthermore, as telemedicine relies on electricity and technology services, issues are encountered if the power goes out or the technology breaks. Rural communities often have much longer wait times for power to be restored and either have no access or limited access to technology repair professionals which could lead to gaps in health monitoring, backlogs, and worst case scenario patients in acute crisis not receiving the care they need. Finally, while telemedicine helps to reduce workload and strain on the system, the fundamental issue of human resources needed to increase bed numbers and support them remains.

In short, telemedicine emerges as a powerful ally in the ongoing efforts to alleviate the strain on the healthcare system in rural Canada. This innovative approach offers solutions to several pressing challenges, from limited access to specialized care and the aging population's healthcare needs to recruitment and retention struggles. Telemedicine not only enhances access to healthcare services but also promotes more efficient healthcare delivery, reduces wait times, and can improve the overall well-being of rural communities. By bridging the geographical gap and connecting healthcare providers with patients in remote areas, telemedicine holds the potential to create a more equitable and sustainable healthcare system in rural Canada. While it is not without its limitations, it is a vital tool in the broader strategy to address healthcare disparities and ensure that all Canadians, regardless of where they live, can access the quality care they deserve.