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8 Health L. Rev. 3 (1999-2000)

handle is hein.journals/hthlr8 and id is 1 raw text is: Introduction The vastness of Canada has made the delivery of health care to its widely dispersed population difficult at the best of times, and the adoption of innovative approaches or technologies is often a necessity. The emergence of telehealth is a case in point. Canada is one of the first countries in the world to apply telecommunications technology to health care delivery-in fact, Dr. Albert Jutras, a Montreal radiologist, pioneered teleradiology in 1958.1 Telehealth,2 broadly defined, is the use of communications and information technologies to overcome geographic distances between healthcare practitioners or between practitioners and service users for the purposes of diagnosis, treatment, consultation, information transfer. Telehealth is important tool for enhancing education and health increasingly seen as an health care delivery, particularly in rural and remote areas where health care resources and expertise are often scarce and sometimes non- existent. Services and expertise from major centres can be brought to such communities with the help of telecommunications technology. Over the last few years there has been a sharp increase in telehealth activities. A recent nation-wide survey conducted by Industry Canada has identified over 70 telehealth projects. The founding of the Canadian Society of Telehealth and the Telehealth Association of Ontario in 1998 reflects the upsurge in interest in telehealth. Until recently, most telehealth projects and studies have focused on the technological, clinical and economic aspects. But more and more people are beginning to ask questions about the policy aspects of telehealth. They are interested in finding out how telehealth can be integrated into the health care system and how certain policies may facilitate or impede the application of telecommunications technology to health services delivery. One of the major concerns is practitioner licensure. Potential problems pertaining to licensure have received considerable attention and discussion, but there has been little concrete action to date. Although telehealth can be used for many purposes, including home care, triage, emergency alert, health information hot line, and continuing education for practitioners, in this paper we focus exclusively on the diagnosis and treatment of diseases and physician consultations.3 Also, while many categories of healthcare practitioners are involved in telehealth services, much of the discussion in this paper centres on physicians because at this stage of tele health development, the impact of licensure is mostly on medical practitioners. However, many of the issues and policy options discussed are equally pertinent to practitioners in other disciplines. Finally, although cross-border telehealth practice canbe interprovincial or international in nature, the focus of this paper is on inter-jurisdictional telehealth services within Canada, rather than across national borders. This paper is divided into several major sections. Following the Introduction, the research methodology is outlined. In Section 3, the policy issues are identified and their significance discussed. The major findings and analysis are presented in the two following sections. Section 4 describes the current status of licensure as it relates to telehealth, and also examines how Canada and selected foreign countries deal with this problem. Section 5 presents a number of policy options in addressing the licensure issue. Each option Volume 8, Number 1 Licensing Physicians for Telehealth Practice: Issues and Policy Options Raymond W. Pong and John C. Hogenbirk The vastness of C 9nada has made the delivery of health care to its widely dispersed populatic n difficult at the best of times, and the a loption of innovative approaches or tec'2nologies is often a necessity. The em ?rgence of telehealth is a case in point. 3

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