This project established a “mother-child network” among hospitals in four health regions in Montreal and the surrounding area, reaching into rural areas north of the city, to lighten the burden on urban centres by shifting primary and secondary care to hospitals close to patients. The project used telemedicine technologies and telehealth training for practitioners. Clinical practice was reorganized to care for mothers and children in hospitals near their home, and the project developed coordination mechanisms to ensure a continuum of care during the transfer process. The evaluation of the project records some success, particularly at the level of operational coordination. The telemedicine aspect of the project also improved access to services in isolated areas where qualified doctors were rare. No estimate of cost-effectiveness could be done because of current data-collection practices. The authors note that one of the most intractable obstacles was that parents preferred to go to a hospital emergency department because they knew they could find pediatricians there. During the short time period of the study, access patterns did not change significantly.
This project was supported by the Health Transition Fund, which was created in 1997 to provide support for evidence-based decision-making in health care reform by supporting pilot and evaluation projects which test innovative approaches to health care delivery. The views expressed herein do no necessarily represent the official policy of federal, provincial, or territorial governments.