For youths, it's gamification.
Evidence of meeting #84 for Health in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was technology.
A recording is available from Parliament.
Evidence of meeting #84 for Health in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was technology.
A recording is available from Parliament.
4:35 p.m.
Conservative
4:35 p.m.
Liberal
4:35 p.m.
Chief Executive Officer, Beagle Productions
No, but they like to be competitive. They're using their phones to have fun, so you can educate them while they're having fun and help them earn points.
4:35 p.m.
Chair, Rural Medicine, Gateway Rural Health Research Institute
If I understand it correctly, Dr. Fry, your question is how to reach the people who aren't really reachable or aren't motivated, and that's why we're not reaching them. The answer is to go to them. You identify them by taking the top 10% users of emergency departments, the most frequent users, and those are your lower socio-economic, under-literate, or health illiterate people, and you identify those and you target them. You use your money carefully on those individuals who are heavy users. That's how you get them.
4:35 p.m.
Conservative
4:35 p.m.
Conservative
Patrick Brown Conservative Barrie, ON
Thank you, Madam Chair. We've certainly had interesting comments so far.
I want to pick up on the theme we're talking about in terms of rural health.
I come from the city of Barrie in the Simcoe County area. It is part of ROMP, which deals with the lack of doctors in rural areas. As you spoke, it made me think about some of the challenges we face and solutions that might exist to enhance health care in small towns and rural communities.
One project that I thought was particularly effective was a U of T pilot project whereby they trained some of their family doctors, 12 a year, in a rural setting as part of a hospital. Half of those who did that training stayed in Barrie. I remember when our committee went to Nunavut. We looked at telehealth and how it was enhancing the reach of health care services that would otherwise not be available.
Are there other ideas or other pilot projects like that, which you think would be particularly helpful to enhance the health care in those settings where we have significant physician shortages? I look at my town where 30,000 people are without a family physician. It is a real, tangible problem.
4:40 p.m.
Chair, Rural Medicine, Gateway Rural Health Research Institute
I've been part of the University of Western Ontario Their program was originally called SWARM. Then it was changed to SWOMEN, the Southwestern Ontario Medical Education Network, and it was started by Dr. James Rourke. We wrote a paper about 20 years ago about if you grow the doctor locally, you will more likely end up with the doctor in your area.
Gateway has picked up on that. They take high school students who are interested in medicine and let them do a camp with us. They pair along with me and other university students and other medical students as mentors to show them that yes, you could have a career in a rural area that's exciting, invigorating, intellectually challenging, and you could live there. Some of them are worried that if they go to the city and then come back to the rural area, their academics will stop, that will be the end of it.
They already know what it's like to live in a small town because that's where they grew up. If we can make sure that we continue that training from high school to undergrad to residency to doing research, then they're more likely to stay. We've seen success after success over the last dozen years.
4:40 p.m.
Conservative
Patrick Brown Conservative Barrie, ON
Just to play devil's advocate, everyone tells us we need more family doctors, and obviously we love solutions like that. What can we do federally? That's the challenge. You think about education. That's outside our scope. You talk about a camp. I buy the fact that if you spend time in a rural area, there's a much greater chance you're going to stay. I really believe that.
What could we do federally to encourage or enable that?
4:40 p.m.
Chair, Rural Medicine, Gateway Rural Health Research Institute
The federal government could help support farming families to have their children go off to post-secondary education.
Doctors are now graduating with $100,000 to $150,000 of debt because of the huge tuition increases that have taken place over the last.... When I went through medical school, it was $3,000; now it's $15,000, $16,000, $17,000 a year. They are graduating in huge debt. If there weren't that financial burden, if we had some program that would recognize people coming from rural areas wanting to go back to rural areas and showing a commitment to rural areas, that would be helpful.
4:40 p.m.
Conservative
Patrick Brown Conservative Barrie, ON
I think the last budget, two years ago, had a loan forgiveness program....
4:40 p.m.
Principal, CENSE Research + Design , Adjunct Professor, Dalla Lana School of Public Health, University of Toronto, As an Individual
If it could be done at the federal level, I have a suggestion also around the idea of supporting research in this area. CIHR, the Canadian Institutes of Health Research, does not have a panel on medical and health informatics or anything like that. There is no panel for anything dealing with technology and education decision-making. Studies are being reviewed by people who, while maybe not unqualified, may not be the best qualified to be doing that stuff.
Also, the way the scientific cycles are often done is that you put in for a grant in, say, March, or you start getting your team together over the summer—because they always make people work in the summer. You put in your proposal in September, you find out by March, and you're supposed to have the cutting-edge innovation ready to go the following summer. If there were a way to support some type of funding that could allow more rapid response stuff as well as stuff that was.... If a priority were put on health informatics, that would help tremendously in advancing some of this, so that health units at the local level and provincial level could think, “Maybe we have evidence that puts some investment in these sorts of resources”.
4:40 p.m.
Conservative
Patrick Brown Conservative Barrie, ON
Another question that I've asked of previous panels is on the regulation of medical devices, which is solely a federal jurisdiction.
We’ve heard complaints that it's difficult. We also heard one doctor who said it was much easier than his attempts in the U.S., that it was quite easy to deal in Canada.
For any of the panellists, what are your impressions on the regulation of medical devices, given that they are tools of innovation? Are we making a system that is supportive of enabling that type of innovation?
4:40 p.m.
Conservative
4:40 p.m.
Principal, CENSE Research + Design , Adjunct Professor, Dalla Lana School of Public Health, University of Toronto, As an Individual
I don't know much from a regular choice standpoint. Again, from my experience in having worked with the private sector as well as the public sector and academics, I would say that we tend not to have a funding envelope that allows this stuff to be really hyper-innovative. Some people are developing some very good products. We've seen some examples, but they are being done by people who are very bold and very risky. It's not supported at a systemic level. I think if it were, you could get a lot more innovations out there and find those that might be the best, not just reward the people who are the gutsiest, because they will still do that.
If we had a systemic ability to support that at a research level, whether it's practice, industry, academic, whatever, we could advance things a lot faster and get to a much better panel of innovations that the regulatory bodies could look at. Right now, they're looking at a handful and I'm not sure that's healthy for everybody.
4:45 p.m.
Conservative
The Chair Conservative Joy Smith
Okay, thank you so very much.
We're going into our second round, of five minutes. We have to be quite tight on the time. If you would be so kind as to pay attention if I give you a little signal, it allows me to not to have to interrupt you. Thank you so much for that.
We'll begin with Dr. Sellah.
April 30th, 2013 / 4:45 p.m.
NDP
Djaouida Sellah NDP Saint-Bruno—Saint-Hubert, QC
Thank you, Madam Chair.
Thank you to all our guests today.
My first question is for the representatives from Gateway Rural Health Research Institute.
Dr. Chang, you said that between 10% to 30% of the rural population suffers from a chronic illness and that their life expectancy is lower than in the past. How can you explain this? Is it because people in rural areas are becoming more and more impoverished and thus don't have access to healthy food?
My second question is for Ms. Collins.
You gave the example of the FDA regulating and verifying certain mobile technologies. Is Health Canada not the equivalent of the FDA? If not, could you explain the federal framework in more detail?
4:45 p.m.
Chair, Rural Pharmacy, Gateway Rural Health Research Institute
I understand that the question is asking for basically some of the reasons or factors behind why rural residents have poorer health status than urban residents. There are numerous factors that play into this. I think a lot of them are interrelated.
The other comment I'll make briefly is that there is also a regional difference. If you were to go to the health status in northern B.C., what they have difficulties with there would be different from what we have difficulties with in southwestern Ontario. There are geographical factors. For example, with lung disease, some of it is related to farm work. That has been shown to be a direct causal factor.
There are also economic factors, such as the loss of industry in a lot of these areas. We heard earlier that lower socio-economic status tends to lead to poorer health status as well.
Also, rural populations are older in comparison to urban centres. There's a higher percentage of older people living in rural communities because of aging across the nation, but also because of the out-migration of young people for economic, job, or education prospects.
I think there's a whole number of factors that can play into this.
