title: Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network.
abstract: Northern Ontario is a region in Canada with approximately 775,000 people in communities scattered across 803,000 km(2). The Ontario Telemedicine Network (OTN) facilitates access to medical care in areas that are often underserved. We assessed how OTN utilization differed throughout the province.
  
  
  
  We used OTN medical service utilization data collected through the Ontario Health Insurance Plan and provided by the Ministry of Health and Long Term Care. Using census subdivisions grouped by Northern and Southern Ontario as well as urban and rural areas, we calculated utilization rates per fiscal year and total from 2008/2009 to 2013/2014. We also used billing codes to calculate utilization by therapeutic area of care.
  
  
  
  There were 652,337 OTN patient visits in Ontario from 2008/2009 to 2013/2014. Median annual utilization rates per 1,000 people were higher in northern areas (rural, 52.0; urban, 32.1) than in southern areas (rural, 6.1; urban, 3.1). The majority of usage in Ontario was in mental health and addictions (61.8%). Utilization in other areas of care such as surgery, oncology, and internal medicine was highest in the rural north, whereas primary care use was highest in the urban south.
  
  
  
  Utilization was higher and therapeutic areas of care were more diverse in rural Northern Ontario than in other parts of the province. Utilization was also higher in urban Northern Ontario than in Southern Ontario. This suggests that telemedicine is being used to improve access to medical care services, especially in sparsely populated regions of the province.
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
authors.affiliation: Center for Rural and Northern Health Research, Laurentian University , Sudbury, Ontario, Canada .
authors.forename: Wayne
authors.initials: W
authors.lastname: Warry
mesh_terms: D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D009864:Ontario; D012111:Residence Characteristics; D019035:Rural Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data*; D017216:Telemedicine / Q000458:organization & administration* / Q000706:statistics & numerical data*; D019037:Urban Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data*
keywords: Canada; health services accessibility; medically underserved area; rural health services; telehealth; telemedicine