August 13, 2012
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Using the Ontario Telehealth Network's (OTN) video conferencing capabilities, St. Joseph's is able to provide the necessary assessment and follow up care for bariatric patients who live in northern parts of the province – close to where they live.
As a centre for bariatric surgery, St. Joe's has been providing bariatric surgery for the last five years. In 2009 when the University of Toronto Collaborative Bariatric Surgery Program was created, St. Joe's and five other Toronto-area hospitals became surgical sites of excellence for this specialized surgery and two intake and assessment centres were developed.
Since then, an assessment clinic was opened in Sudbury which partners exclusively with St. Joe's to provide surgical assessment, surgery and follow up care for bariatric patients.
"The way the program works is that prior to having bariatric surgery, patients must undergo an initial screening conducted by a nurse, a dietitian, psychologist, internist and surgeon at one of two intake centers," said Dr. Lloyd Smith, Chief of Surgery at St. Joseph's.
"Patients referred to the Sudbury clinic would go to that clinic to see the nurse, dietitian and so forth but will have their surgical assessment conducted by myself, Dr. Paul Sullivan or Dr. David Lindsay via video teleconferencing through OTN. We would talk to the patient about the benefits and risks of having bariatric surgery. We are the only hospital to do this because we are the only one that is remote," said Dr. Smith.
Dr. Smith explains that since the northern part of the province is very well connected through OTN, that this is a great way for St. Joe's to conduct the surgical assessments and follow up care for the Sudbury clinic patients.
"The first time a (St. Joe's) bariatric patient would come to Toronto would be for their pre-anaesthetic work up, three to four weeks prior to surgery," said Dr. Smith. "The benefit for our patients of not having to travel (to Toronto) several times for appointments before surgery is significant, because these patients don't drive. Through OTN we are saving our patients two days worth of travel for them for a 15-minute appointment," he said.
"It's actually pretty cool the way it's set up," said Dr. Smith. "The appointments are booked in advance by the Sudbury clinic and are set at 15-minute intervals. So, if it's a 15-minute appointment we speak for 13 minutes and a voice comes on and says you have two minutes left. Then at 15 minutes the connection just flips to the next patient. The OTN set ups are quite sophisticated so the Ministry of Health and Long-Term Care (MOHLTC) has them in hospitals – so that patients would be at their local hospital for the video conference."
Bariatric surgery, or weight loss surgery, is a type of procedure performed on people who are obese, for the purpose of losing weight. As part of the Ontario MOHLTC's diabetes strategy, funding has been provided to increase the number of surgeries that can be performed throughout the province. The surgery is done laproscopically, which allows for a quick recovery period. Patients are expected to stay in hospital only one to two nights after surgery and should be able to return to normal activity after three to four weeks. Last year, St. Joe's conducted 209 bariatric surgeries.
Using OTN, our surgeons can continue to follow bariatric surgery patients for five years after their procedure. Based on the patient, surgical follow up appointments can vary, anywhere from one to four times per year, said Dr. Smith.
Page last updated: March 25, 2011
