title: Driving Distance to Telemedicine Units in Northern Ontario as a Measure of Potential Access to Healthcare.
abstract: BACKGROUND
  The Ontario Telemedicine Network (OTN) uses technology to help make medical services more accessible to people in medically underserved rural and remote parts of Ontario, Canada. We examined access to OTN-enabled health and medical services in Northern Ontario, which has 775,000 people in communities scattered across an area of 803,000 km(2).
  
  
  METHODS
  We used ArcGIS Network Analyst (Esri, Redlands, CA) to conduct a service area analysis with travel time as a measure of potential access to care. We used road distance and speed limits to estimate travel time between Northern Ontario communities and the nearest OTN unit.
  
  
  RESULTS
  In 2014 there were 2,331 OTN units, of which 552 (24%) were located in Northern Ontario. All seven communities in Northern Ontario with a population of 10,000 or greater had OTN units. Almost 97% of the 59 communities with 1,000-10,000 people were within 30 min of an OTN unit. The percentage of communities within 30 min steadily decreased with decreasing population size, to 58% for communities with fewer than 50 people. In total, 86% (690/802) of Northern Ontario communities were within an hour's drive of an OTN unit.
  
  
  CONCLUSIONS
  This study showed that most Northern Ontario communities were within an hour's drive of an OTN unit. The current distribution of OTN units has the potential to increase access to medical services and to reduce the need for medically related travel for residents of these communities.
authors.affiliation: Center for Rural and Northern Health Research, Laurentian University , Sudbury, Ontario, Canada .
authors.forename: Laurel D
authors.initials: LD
authors.lastname: O'Gorman
authors.affiliation: Center for Rural and Northern Health Research, Laurentian University , Sudbury, Ontario, Canada .
authors.forename: John C
authors.initials: JC
authors.lastname: Hogenbirk
mesh_terms: D040362:Geographic Information Systems; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D008507:Medically Underserved Area; D009864:Ontario; D012111:Residence Characteristics / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000458:organization & administration*; D017216:Telemedicine / Q000706:statistics & numerical data*; D013997:Time Factors; D014195:Travel / Q000706:statistics & numerical data*
keywords: Canada; geographic information systems; health services accessibility; medically underserved area; road network analysis; rural health services; telemedicine; travel