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June 29, 1998

PHONE CURES

DOCTORS FEAR PATIENT SAFETY

By BILL KAUFMANN -- Calgary Sun
  Patient safety could be at risk if health officials follow through with a telephone diagnosis line that's being examined, says the Alberta Medical Association's incoming president.
 A report on the merits of a multimillion-dollar patient diagnosis line goes before the Calgary Regional Health Authority this week.
 But the AMA's Dr. Rowland Nichol says such a telephone line could pose a dangerous delay in treating the sick.
 "Because physicians haven't been involved (in assessing patients in person), they would concerned about delays," said Nichol.
 "You're putting barriers in the way of coming in."
 And Nichol said telephone diagnosis might fail to detect critical symptoms that would be more evident in a physical examination.
 "If you've got the flu or meningitis, how can you tell over the phone?" he said.
 But the CRHA's director of emergency medicine said the plan has been stringently developed with patient safety in mind.
 "If it is done, it'll be beneficial to the patients --that's the goal," said Dr. Robert Abernethy.
 "It's to make sure the public has possible."
 Abernethy said the lines have already been in use at the Alberta's Children's Hospital, as well as by numerous U.S. medical centres.
 "It's ongoing in the system now and it's very beneficial," he said.
 It's unclear who would operate the lines, but in other cities, doctors and nurses are on the phones.
 A CRHA steering committee has been examining a host of medical information systems -- including the experience of diagnosis lines in American hospitals, said Abernethy.
 "They've been examining those outside of Calgary to see if they can be brought here and be best put to our advantage," he said.
 The adoption of such a phone line "isn't a foregone conclusion," he said.
 The diagnosis line comes under consideration at a time when the city's busy emergency rooms are feeling immense strain from patient visits.
 One recent study showed Calgary emergency units were some of the busiest in Western Canada, with 1,609 patients per treatment space compared to 1,507 in Edmonton and 1,103 in Winnipeg in 1996-97.
 Nichol said it's important that physicians have sufficient input in any plan that establishes a diagnosis line.
 Abernethy said that's been done "to see how (doctors) would do it and what it would have to be like."

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