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Ed Brown's tele-health brings care to remote areas Add to ...

The Transformational Canadians program celebrates 25 living citizens who have made a difference by immeasurably improving the lives of others. Readers were invited to nominate Canadians who fit this description. Over the next several weeks, a panel of six judges will select 25 Transformational Canadians from among the nominees.

Ed Brown, pioneer of telemedicine, has been selected one of 25 Transformational Canadians.

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As a physician, Ed Brown is passionate about improving Ontario's health-care system. As a former software developer who studied mathematics and engineering before completing his medical degree at the University of Toronto, he loves information and communication technologies.

So back in 1992, when the then-emergency room specialist heard about the concept of telemedicine from a friend, he was excited and intrigued. "I thought, 'How can you get something like this happening in Ontario?'"

The result was the Ontario Telemedicine Network, which uses two-way video-conferencing and accompanying diagnostic equipment to deliver clinical care and even distance education to communities throughout the province.

Through the organization's video-conferencing services, a specialist in Toronto might check on a bone fracture in remote Elliot Lake, or a dietician might give a talk on healthy eating for diabetics.

Though it stretches across the province, the not-for-profit network led by Toronto-based Dr. Brown helps address shortfalls in health-care services in Ontario's vast, sparsely populated hinterlands. Larger than France, for example, Northern Ontario is home to just one million residents.

Likely the world's biggest and busiest, Ontario's telemedicine network has 180 staff and more than 1,100 sites where the services can be accessed. Last year, some 3,200 health-care professionals accessed it, tallying 102,000 patient events. Meanwhile, 360,000 practitioners and administrators turned to the network for education.

Dr. Brown, who says he went into medicine because it's about people, explains that the network makes life better for many patients. "The low-hanging fruit for us was folks in the northern and rural areas who [otherwise]have to travel, leave their families, leave their jobs, who often can't bring their families, so they're facing a diagnosis on their own."

Almost every week, Dr. Brown says, international visitors show up at the network's offices. "There are a lot of telemedicine programs all over the world, but what we've done is found a way to make this practical and to make it work in a more scalable way so that it can actually become part of the health-care system."

The telemedicine network had humble beginnings. After securing funding from the Ontario Medical Association for a feasibility study, Dr. Brown spent what he describes as several years in the wilderness, drafting a plan on evenings and weekends.

With funding from several hospitals and a matching grant from the Ontario government - which now provides the organization's base funding - Dr. Brown launched a pilot project called NORTH Network in 1998. It then expanded across most of Northern Ontario. Then in 2006, the provincial government worked with it and the province's two other telemedicine networks to create OTN.

To supplement its traditional telemedicine, the network recently added a feature that allows physicians to electronically share images of injuries and conditions. It also launched a program in which chronically ill patients receive remote monitoring equipment.



Dr. Brown says the network has a long way to go, given that just 10 per cent of the province's specialist physicians use it. "We are big and busy, but we're not mainstream yet," he admits. "We'd like to make this part of everyday practice."

Asked about the state of Canadian health care, Dr. Brown says the country has an "incredible" system. Still, he argues, that system won't meet its cost and organizational challenges without a transformation.

"A lot of people recognize that we have to keep it moving forward, we have to move that transformation agenda," Dr. Brown says. "We have to build innovation, we have to come up with some new strategies and policies to keep it going, so that when guys like me get old, it's still out there and functioning well."

Ed Brown on why leaders must start with a goal

It's important to think about what the end picture should look like when you're done. And then start small, but start in a direction that you think will get you to where that end zone is. The other issue is to be realistic and think about what the real challenges are, and come up with a strategy or a plan that enables you to address those challenges. Otherwise, you're just going to be stopped cold.



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