'Doctor in a box' soon to be used in clinical trials
Dr. Ivar Mendez moved to Saskatoon only six months ago, but he's already met several health professionals across the province just by sitting at his desk.
The University of Saskatchewan's head of surgery is piloting a project he says will revolutionize health care in northern Saskatchewan.
"This technology is going to take away the barriers of distance and time. It is going to save countless lives,” said Mendez.
‘Doctor in a box,’ as he calls it, connects doctors in centres like Saskatoon or Regina to patients in the province's most remote locations. The device, developed in California, uses a regular cell phone signal to establish a two-way video link.
Nurses, paramedics, even doctors can use the box to contact specialists. The box can be connected to everything from an electrocardiogram machine to an ultrasound machine. Vital signs and test results displayed on screen allow the specialist to guide the health care worker through the patient's treatment.
“We will forget that there was a time there were no ‘doctors in a box,’ as we have forgotten there was a time with no internet or cell phones,” said Mendez, who was born in Bolivia and spent nearly two decades with Dalhousie University in Halifax before taking a position in Saskatoon.
Piloting the project
Close to 36,000 people live in over 70 northern Saskatchewan communities, according to a 2011 northern health regions report.
Many of those communities lack close access to physicians and medical professionals.
“It is the perfect setting to implement remote presence technology,” Mendez said of northern Saskatchewan.
The doctor first tested a project similar to ‘doctor in a box’ while he was the head of neurosurgery at Dalhousie.
He introduced a medical robot to Nain, a remote northern community in Newfoundland and Labrador.
The RP-7i robot, who the residents of Nain called Rosie, provided health care to the community by connecting patients to specialists via video link. The residents became so attached to Rosie, they kidnapped the robot on the day the project ended.
There are currently three RP-7i robots in Saskatchewan — one in La Ronge, one in Saskatoon and one in Ile-a-la-Crosse. The university’s College of Nursing uses the robots for training purposes.
The robots work much the same way as the boxes, but they must remain on location at their respective hospitals, said Mendez. The ‘doctor in a box’ is much more mobile.
“You can take the ‘doctor in a box’ to anywhere, say for example, the scene of the accident,” he said. “The emergency room physician or trauma surgeon will be able to beam into the scene of the accident and, for example, perform an ultra sound of the abdomen or chest of that patient and determine if that individual has internal bleeding.”
The specialist on the other end of the video link can see the patient through their laptop or even iPad.
Mendez has plans to soon introduce Saskatchewan’s first ‘doctor in a box,’ as well as a fourth robot, to Pelican Narrows.
Use on patients
Dr. Veronica McKinney from the University of Saskatchewan’s northern medical services department estimated the ‘doctor in a box’ could be used in clinical trials in Pelican Narrows as early as December.
Her department is funding Mendez’s project and was just recently given approval from the province to use provincial funds to test the technology in the Pelican Narrows’ clinic.
The northern Saskatchewan town has over 4,400 charts registered at its clinic, McKinney said, and the town just recently welcomed its first physicians — two doctors now alternate at the clinic every two weeks.
She said the technology will greatly reduce the cost of transporting patients in northern Saskatchewan to and from larger centres like Saskatoon.
“The federal government’s budget to transport patients in Saskatchewan’s First Nations communities is $37 million. I think it would cut it down by a half, even a third,” she said.
“The experience in Nain showed the technology paid for itself within the first three months because of the savings on transportation costs.”
Expanding broadband connections
Health Canada said while they are not directly funding Mendez’s project, they are eager to see the results.
“There is a big interest in exploring future opportunities,” said Dr. Ibrahim Khan, a medical health officer with the First Nations and Inuit Health Branch.
The federal department is currently working with Sasktel and the province to expand broadband connections in northern Saskatchewan.
Khan hopes all First Nations communities in the province will have connections by the end of 2014.
He said 60 per cent of the communities are currently connected.