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Nancy Mareck



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  • OS21 - Adoption & Engagement (ID 27)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical
    • Presentations: 1
    • Coordinates: 6/06/2017, 01:00 PM - 02:00 PM, Room 206B
    • OS21.02 - Telehealth and Medical Assistance in Dying - Enabling Equitable Access (ID 102)

      Nancy Mareck, Telehealth, Vancouver Island Health Authority; Campbell RIver/CA

      • Abstract
      • Slides

      Purpose/Objectives: In June 2016, federal legislation governing Medical Assistance in Dying (MAiD) was passed by Parliament. Patients experiencing intolerable suffering due to a grievous and irremediable medical condition may now end their life with the assistance of a qualified medical professional. However, MAiD is not immediately available in every community and not all doctors/nurse practitioners are willing or able to provide the service. The Island Health Authority has turned to Telehealth to help bridge this gap by connecting patients to appropriately qualified clinicians in other communities.

      Methodology/Approach: Patients requesting MAiD need to have access to the highest standard of compassionate and respectful care, and healthcare professionals must be fully informed and supported. Every person requesting MAiD must be assessed to see if they are eligible for this service. A written and signed request must be witnessed by two independent individuals. In addition to the primary physician, a second independent physician or NP must also provide an assessment and written second opinion. Access to a secondary physician/nurse practitioner to complete the necessary documentation and assessment can be difficult in smaller communities. It may be easier for clinicians in larger urban facilities to access resources related to MAiD requests and develop proficiency in the associated processes. Given this reality, Telehealth was identified as a way to connect these providers to patients requesting MAiD in smaller centres such as Campbell River. Regardless of location, regulated Island Health healthcare professionals can act as a witness for a telehealth assessment to comply with the requirements of the process. Telehealth staff members have connected community hospital in-patients by video both at the bedside and in standard telemedicine rooms to clinicians in Victoria, across Vancouver Island, and to surrounding islands to complete MAiD assessments.

      Finding/Results: Telehealth removes a significant barrier to MAiD for individuals facing end of life in rural and remote locations, or where no providers are available to support their application. Although Telehealth is accepted as part of an integrated approach to care, using it in this new, time sensitive and emotionally delicate service demonstrates the degree to which that integration has occurred. Challenges remain in terms of reliable quality video over wireless hospital networks; however, through the combined efforts of the clinical teams and the telehealth staff, those hurdles can be overcome and patients provided the same level of access to MAiD regardless of their location.

      Conclusion/Implication/Recommendations: Telehealth, through the use of live video conferencing, can be used effectively to enable access for patients to MAiD where the necessary qualified health care providers may not be available in person.

      140 Character Summary: Telehealth enables equitable access for Island Health patients to MAiD when qualified health care providers are not locally available.

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