Island doctor pioneers new health-care technology
Physically in Ireland, virtually in Tignish — Dr. Declan Fox to provide international primary care
TIGNISH – The Tignish Health Centre is about a month away from being one of the first health-care centres in the world to offer virtual primary care to patients being seen by a physician in another country.
Dr. Declan Fox, who retires from his medical practice in Tignish on Friday, has agreed to see patients virtually at home in his native Ireland commencing in late October.
The service will be offered just one day a week initially, although Dr. Fox believes he will need at least another half-day or full day a week to get caught up on all the reports and paperwork.
The health centre posted a message on Facebook Wednesday to inform patients that Health P.E.I. and the health centre are working with Fox to find an innovative way to provide patients some access to Fox, virtually, while efforts continue to recruit for a permanent physician.
Virtual primary care will utilize technology similar to the tele-rounding service currently being provided to in-patients at Western Hospital in Alberton.
Fox acknowledged the success of the tele-rounding program has given him confidence virtual primary care will work for his patients.
“If they can make it work in Western (hospital), where the patients are the sickest in the area, it shouldn’t be difficult at all to make it work here,” he said Wednesday from the Tignish Health Co-op Centre, where he has been seeing a panel of 2,500 patients for the past five and a half years.
“He is not an easy guy to replace and he will be greatly missed for his contributions in West Prince,” Paul Young, administrator of Community Hospitals West, said of Fox.
While Fox said his patients are saddened that he is retiring, the ones he’s informed about the virtual primary care model have been supportive.
“They’ve all been fairly happy about that,” he said.
He doesn’t know if that is due to the success of Western Hospital’s tele-rounding program, or simply an acknowledgement that he will still be overseeing their care.
He added he hopes to return to P.E.I. next year for a couple of locum contracts.
One of the nurses from Fox’s practice will continue to work at the health centre and will assist with Fox’s virtual care. Fox is also hopeful Health P.E.I. efforts to recruit a nurse practitioner to the clinic will soon prove successful.
Young was actively involved in rolling out Western Hospitals tele-rounding program and he has just returned from Vietnam where he spoke about the program’s success to 2,500 health-care delegates from all over Asia.
Young is also playing a leadership role in introducing virtual primary care to Tignish.
The “what if?” discussions on primary care options started about six months ago, he said.
“It kept going back to, ‘what if we did this; what if we leveraged the success we’ve seen here at Western Hospital; what if we looked at the application of how we use virtual care and use it differently to fit another one of our needs?’” he said.
Young stressed virtual primary care is not groundbreaking in itself but this case adds a new element to the equation.
"(Dr. Fox) being in Ireland and providing care to patients in Tignish, P.E.I., I think we’re treading on new ground, certainly within the country, but I think that is going to be a first for across the globe, to look to a physician in another continent… and provide care to a patient in another jurisdiction.”
In introducing this new level of care, Young said it is beneficial that the physician who is pioneering the international model knows the patients he will be seeing, and his patients know him.
“The biggest benefit for us is it is Dr. Fox,” health centre manager Wendy Arsenault said.
The health centre hosted a farewell party for Dr. Fox and his family Wednesday. Young admitted a lot of heavy lifting was required to make this virtual model happen.
“We’ve had a tremendous team that have been working throughout this project to pull this altogether. A lot of hands are continuing to move heaven and earth to make this a reality for Tignish, and we’re really excited about that.”
Young and Fox believe the attention the new virtual primary care model in Tignish generates will ultimately help attract a new physician. Once that happens, the virtual care model would no longer be required in Tignish, but Young believes what’s being piloted in Tignish will help pave the way for similar services being offered in other communities when resources are challenged.
“This can potentially reshape how we can access capacity to deliver care,” he suggested.