title: Telehealth videoconferencing: improving home parenteral nutrition patient care to rural areas of Ontario, Canada.
abstract: BACKGROUND
  Telehealth videoconferencing is a medium for health care professionals to communicate and care for patients living in remote areas. The aim of this study was to provide a survey to examine management outcome of home parenteral nutrition (HPN) patients when followed by telehealth as an alternative modality of care.
  
  
  METHODS
  Twenty-six individuals who were identified to benefit from tele-health were invited to participate in a satisfaction survey. The survey was sent to patients by postal mail. The survey also documented the incidence of line sepsis and other medical HPN complications. A cost analysis was also performed according to technology, human resources, and infrastructure.
  
  
  RESULTS
  Eighty-one telehealth videoconference sessions have been held since the inception of telehealth in 2002. Of the current telehealth patients, 13 were eligible for the survey. The satisfaction survey response rate was 11/13 (84.6%). The average line sepsis rate for the 13 patients was 0.89/1000 catheter-days. All patients were generally satisfied with videoconferencing as an alternative method of communication and care for new consultation, patient and family education, and follow-up. Travel time and costs to the patients, their families, and the health care system were significantly less. For example, a patient who resides 611 km from Toronto would cost CDN (Canadian) 724.00 dollars for flight and accommodation to meet with the team at the HPN clinic in Toronto.
  
  
  CONCLUSIONS
  Telehealth incorporated the cost-saving ability for HPN patients to maintain proper medical care, support, and collaboration of specialists inaccessible to their local community. Thus, its strongly positive role in HPN care deserves further consideration for a national application.
authors.affiliation: Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Olivia
authors.initials: O
authors.lastname: Saqui
authors.forename: Albert
authors.initials: A
authors.lastname: Chang
authors.forename: Sharon
authors.initials: S
authors.lastname: McGonigle
authors.forename: Brendan
authors.initials: B
authors.lastname: Purdy
authors.forename: Lydia
authors.initials: L
authors.lastname: Fairholm
authors.forename: Mary
authors.initials: M
authors.lastname: Baun
authors.forename: Millie
authors.initials: M
authors.lastname: Yeung
authors.forename: Peter
authors.initials: P
authors.lastname: Rossos
authors.forename: Johane
authors.initials: J
authors.lastname: Allard
mesh_terms: D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects; D003266:Continuity of Patient Care / Q000592:standards*; D003362:Cost-Benefit Analysis; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000592:standards*; D017060:Patient Satisfaction; D019114:Remote Consultation / Q000379:methods*; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology*; D013997:Time Factors