Health care, anywhere

Providing efficient, effective health care to remote communities isn’t unlike travelling to Mars.

So says Dr. Ivar Mendez, unified head of the Department of Surgery at the University of Saskatchewan and Saskatoon Health Region.

Mendez, also a faculty member in the College of Medicine, recently travelled to Montreal to lend his expertise to the Canadian Space Agency. The organization’s American counterpart, NASA, has been given the go-ahead to travel to Mars, and the two groups were looking for advice regarding using technology to provide health care from a distance—in this case, a pretty far distance—because even the youngest, healthiest astronauts are not immune to injuries or illness in deep space.

“What will happen if something that is serious, in terms of health care, happens?” he asked, adding that it takes 21 minutes to transmit data to and from the red planet. “Someone can have an appendicitis or somebody can break their leg. So how can we take care of them?”

Robotic success

Closer to home, Mendez is known for embracing technological innovations to improve the patient experience, particularly for those in underserved and remote communities.

Not long after starting at the U of S in 2013, he spearheaded an initiative that brought remote sensing robots to northern communities in Saskatchewan. Controlled by a smartphone, the robots can manoeuvre autonomously to perform a medical triage and determine patient treatment.

This, in turn, also provides relief to a centralized, overloaded health-care system, said Mendez—and he has the numbers to back it up. Over the course of one year, the small community of Pelican Narrows—population 1,700 and located a six-hour drive northeast of Saskatoon—saved approximately $400,000 in costs associated with health care and travelling to larger centres for medical service.

The larger concept, labelled point-of-care diagnosis and treatment, calls for a decentralized medical system—that is, the clinician comes to where the patient is, albeit virtually. This area is of particular interest to Mendez, and was one of the main reasons he moved to Saskatchewan—a large, expansive province where medical practitioners aren’t readily available to the most vulnerable citizens.

“I truly believe there are certain technological advances that will allow us to provide better care for our patients,” he said.

Through the Google Glass

Following the success of the remote sensing robots, Mendez turned his interest to another emerging technology: Google Glass.

Released by the tech giant in 2013, the head-mounted hardware resembles standard eyeglasses. The spectacles can connect to the Internet and contain a small camera that can feed to a monitor—essentially showing the user on the other end what they are seeing, at eye level, in real time. Seeing its potential beyond games and chatting, Mendez partnered with an American firm to pilot a specific type of glasses for telemedical purposes.

Dr. Mendez examines a virtual patient using Google Glass.

“I felt that for the next step, in terms of our ability to reach many more places, a wearable system that you can wear and communicate with is probably the next stage,” said Mendez.

As with most gizmos and gadgets, the glasses’ technology has evolved considerably since its debut, he added. Lag time, often an issue with real-time video, is mere milliseconds, allowing the viewer to perform intricate tasks like examining a wound. Mendez also touted the mobility of the product, which provides a higher degree of independence and flexibility for health-care practitioners.

“A paramedic or nurse or colleague can actually be using their hands without the need to hold anything,” he explained. “You are in good communication with them, and you are seeing what they’re seeing. At the same time, they have feedback of what they’re showing you because they can look at the other screen.”

Not surprisingly, Mendez has the same aspirations for the Google Glass project as he did with the robots, and hopes to see the two technologies working in tandem soon.

“These are not just isolated things that we’re doing,” he said. “We’re doing this in a systematic manner to bring technology to the point that we will truly be able to take care of people wherever they are.”

What's next?

Mendez and his team will continue to apply technological breakthroughs to remote health-care issues. Currently, he and his team are developing a telepalpation device that will allow a surgeon to palpate an abdomen on a patient 1,000 kilometres away—in order to see the rigidity of the abdomen up close.

“We are really advancing on these peripheral technologies that will allow us to not only see the patient, talk to the patient, do an ultrasound, listen to their chest, but touch them,” he said, adding that the technology is being developed in conjunction with the College of Engineering.

Another area of importance, he explained, is using virtual reality (VR) to create a richer reality environment for medical students. Most recently, he was part of a study with 80 medical students learning the complex anatomy of the human brain. Half of the students used traditional methods (lectures, textbooks and diagrams), while the other half used a VR brain structure to learn the intricate neuroanatomy. “They could actually enter the brain and see the relationship with the different anatomical nuclei,” he said.

Preliminary results showed that the students using the VR technology were able to retain the information to a greater degree. As an academic and a professor, embracing this dynamic technology for learning purposes is just as crucial for educating the next generation of physicians—and instilling the importance of technology in them.

“I think that’s going to be a very important part of teaching, to be able to understand complex relationships in many dimensions,” he said.

Back to the Canadian Space Agency, Mendez is exploring how technology can serve an astronaut in a voyage into deep space. One of the areas is going to be the issue of artificial intelligence in terms of constantly monitoring people.

“To be able to predict that you will have a heart attack in the next 24 hours, or to be able to control your sugars and have an algorithm that will determine the risk you have so that an intervention could happen and you can prevent a stroke, for example—those are the things that an astronaut will need some sort of autonomy and intelligence on,” he said. “I think that’s going to be part of the future.”

Photos by David Stobbe.

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