Ontario’s Ministry of Health has a “free, confidential telephone service you can call to get health advice or general health information from a registered nurse” called Telehealth Ontario. I don’t know about you, but as someone who works and studies in the ehealth domain, I find the name of the service somewhat confusing. I can understand the rationale for naming the program as such: telephone + health + Ontario = telehealth Ontario. But, the name makes things somewhat confusing for people who are familiar with the terms telemedicine and telehealth. Perhaps something like “health phone” or “health line” would have been better.
In any case, I’m not writing about the name of the program. A few days ago, I had an opportunity to use the service. While out for his evening walk, my dad got bitten by a neighbourhood dog (I hesitate to use the word “attacked” because I wasn’t there to witness it). Anyway, by the time my dad got home, he had a nice rip in his shorts and a matching bite mark on his thigh. He wasn’t in any pain, but you could see several puncture and cut marks and some blood. After making sure he was (relatively) okay, my first thought was “does he need to go to the ER for some sort of shot?”. I had no clue, so my sister and looked up “animal bites” in a home health reference book we had as well as the Internet. The answers that we found weren’t too comforting and as our family tried to figure out what to do, I remembered Telehealth Ontario. So, we called the number (1-800-797-0000).
An operator answered fairly quickly and asked a few questions and then said to expect a call from a nurse within 20 minutes. Some of the questions asked about any existing health conditions (he has diabetes) and any medications he may be taking (we mentioned the drug types and why, but no specific names). Whoa – didn’t realize that the person on the other end of the line wasn’t a nurse. I guess there’s some sort of triage system in place to direct calls. Basically, all we wanted to know was if a dog bite is serious enough to go to the ER or if we could wait till the morning to visit our family physician.
Anyway, we were surprised that after only about one minute, we received a call-back. The nurse asked us to describe the wound and to see if my dad was experiencing any symptoms. We had to describe the size and nature of the wound(s) (was blood oozing or not). The nurse gave us some instructions as to what to do next and said that if stitches were required to go to the local ER. The nurse didn’t answer the question we wanted, so we asked: does he need to get a shot right away? Since the dog was a domesticated animal, probably not. Great – gotta love the definitive answer. So, my dad waited till the next morning to go see our family physician – our neighbour dropped off a copy of the dog’s shot history from the veterinarian to take to the physician.
Overall, I think the 24 hour service seems to be pretty useful. My guess is that the objective of the service is to keep people from going to the ER unnecessarily. By having a health professional give advice is comforting for people (like me) who don’t know if something can wait “till the morning”. I was pleasantly surprised to learn that the nurse has access to any previous calls we have made, although I wonder how the privacy issues work out for the initial operator taking our call. Does this person need to see the entire call history if they are only collecting information on the behalf of the nurse?
I can’t say if the costs of the program are offset by decreasing demand to the ER because I don’t have that data, but it is an interesting question to ask. I’m also curious to know how many people and how often the service is used. Honestly, I’m not sure if I’m comfortable having the nurse call back. Why can’t the nurse be the one answering the call right away? But, overall, I think the program works and is a pretty low-tech example of telehealth in action.
In the future, I wonder if these types of interactions can take place over the Internet using real-time chatting or using some sort of VOIP service. Since we have a digital camera, we could have easily photographed the wound and uploaded the image to the nurse to view.
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