This article is based on a talk held at McMaster University that is part of a series of nine delving into the theme of “What should be on Canada’s policy radar?” The panel discussions are being held through this year to mark the 50th anniversary celebrations of the Institute for Research on Public Policy, publisher of Policy Options magazine. The McMaster discussion focused on the politics and policies of remote rehabilitation. Panelists included Vass Bednar, executive director of the master of public policy program at McMaster University; Rachel Bartholomew, CEO and founder of Hyivy Health; and Dawn Bowdish, executive director of the Firestone Institute of Respiratory Health. The moderator was CBC’s Eva Salinas. You can also watch a video recording of the discussion.
The pressure felt within the health-care sector during the pandemic has demonstrated the need for more remote rehabilitation services in Canada. But while these services are progressing and present several advantages, there are still some ongoing issues. They include a lack of control over data collection and the misuse of data, accessibility-related issues for those who don’t have the appropriate technology and adequate health-care funding.
Remote rehabilitation is a digital health-care service that helps patients get out of a hospital bed. It can also help those dealing with symptoms that stop them from leading a full life. Its online devices can also do things such as monitor and measure exercises, and solve problems related to patient access to rehabilitation, therapies or physicians.
Since the pandemic, the necessity and development of these health technologies have become clearer and have progressed, with Canadian companies such as Hyivy Health offering virtual pelvic health rehabilitation services. This company creates a comfortable and informed pelvic health recovery by providing patients with real-time information directly to their devices during their recovery.
Remote rehabilitation services can help eliminate existing health divides by providing health care to those who live far from major health-care institutions. They also improve access for those with a lower socioeconomic status. Almost 50 million women in North America are on a waiting list to see a pelvic rehabilitation therapist while there are only 5,400 therapists, according to Rachel Bartholomew, Hyivy Health’s CEO. Remote health care helps connect individuals with medical specialists that they may otherwise not be able to access without commuting to a major city.
There are problems with accessibility for those who don’t have access to the technology necessary to implement the services. While the majority of Canadians have adequate broadband access, only 53.4 per cent of rural households have such access, with Indigenous communities having even lower coverage on average. Because of this, Dawn Bowdish, executive director of the Firestone Institute of Respiratory Health at McMaster University, says many patients, especially those in rural communities and within marginalized groups, can’t participate or benefit from remote rehabilitation services.
Affordability is also an issue. While there are several health-care services that are publicly funded, not all virtual care services are. Virtual rehabilitation is usually covered through corporate sponsorships rather than public funding. While the “generosity” of corporate sponsorships help promote the availability of rehabilitation services, these corporate sponsorships are not enough in the long term. Without public investment, the availability of virtual rehabilitation services is limited for those who do not have equitable access to health or technology.
New technologies also pose several challenges to the protection of individual health data. Vass Bednar, a researcher at McMaster University, says these fall within a grey regulatory area. They are not covered by consumer protection regulations but are regulated by colleges, which often bypass the protection of individual data.
The Ontario Personal Health Information Protection Act (PHIPA) does not explicitly outline private corporations or colleges as private health information collectors. Because of this, private corporations and colleges that facilitate remote rehabilitation services fall outside PHIPA. Given this regulatory gap, there are fears about how data is collected and the type of data that is collected.
There are also concerns that the data collected may be used by corporations to misdirect consumers. In some instances, corporations can inaccurately advertise their product. On the receiving end, consumers often lack the ability to recognize misappropriated data. Corporations can inaccurately advertise a health product, resulting in individuals buying devices that are not safe and not cleared by regulatory agencies, such as the Food and Drug Administration (FDA) in the United States, or Health Canada.
Bartholomew says many consumers often do not know the difference between FDA-approved and FDA-registered devices, allowing corporations to masquerade their devices as medically approved. Bednar says that while medical-device regulations enacted by Health Canada exist, devices that fall outside the boundaries of existing Canadian regulations can masquerade as medical.
There needs to be better accessibility and regulation of digital services/virtual health services. More government funding should be provided for the innovation and advancements of affordable and accessible health technologies in Canada. As well, investments should be made for greater broadband access across the country to address issues of access, as services are increasingly becoming digital.
There also needs to be more caution about how data is being collected and used through these services. Particularly, regulators need to update our current consumer laws and protections to encompass health technologies and ensure that users of health technologies are protected under the same standards as those using other everyday devices.
While there is still work to be done, advances in health-care technology can still improve issues of access and standards of care, particularly for groups that struggle to access traditional health-care services. Canadians should be excited about the advancements in this sector. However, to guarantee that the interests of Canadians are met, regulators, government officials, and institutions need to ensure that these technologies are workable and protect the health data of individuals.
This article is part of What Should Be on Canada’s Policy Radar? special feature series.