In the time of the 1918/19 Spanish flu, the world was a very different place. Of course, there was no internet, TVs, or social media. In fact, there wasn’t even any radio until a few years later. All the news was provided by the newspaper – and almost all long-distance transportation was by rail or ship.
Most traditional activities have survived the past 100 years, but some professional services are now regulated by the government. And, although much modern health care is technology-based, almost no client-doctor interaction uses technology. In fact, it is so antiquated, that most medical interface with clients is through an actual meeting between a doctor and patient – often causing patients to waste hours away from work or school, or by travelling large distances.
The same is true in our legal and judicial systems – which remain horribly expensive and inaccessible. Some of this has to do with the need to produce mountains of largely irrelevant actual paper documents. Lawyers must file reams of paper, accused litigants, their lawyers and witnesses must wait for hours, days, weeks, or months.
Both the Canadian health and legal systems are products of the Canadian culture of hurry up and wait. While the commercial world has moved on over two decades ago, and the world of government is finally on the cusp of major transformational change, the client interface in the areas of law and medicine remain as moribund today as they were during the time of the Spanish flu.
Yet, in the recent span of COVID-19 weeks, we have seen the adoption of technology by doctors who are using their telephone and messaging services to meet and diagnose patients. Many, if not most, consultations with family doctors are for routine matters, which require a physician to do simple in-office tests such as blood pressure, pulse, temperature and breathing. This is coupled with a verbal discussion to render either a diagnosis or a request calling for more sophisticated tests.
The biggest complaint and challenge to a publicly funded health care system like Canada’s is in the initial interface with a family doctor or a specialist. The client has to take hours out of their life – including waiting in an office – only to have a brief discussion with the family physician (who then either makes a diagnosis, orders more tests, or refers to a specialist).
Much of this work can be done faster and more effectively using a routine internet interface between doctors and their patients. The patient can do this from home, their office, or even from a hotel 6,000 miles away. If you have a problem while you are on a trip, why not simply use the internet to be diagnosed by your own doctor. If there is a need to physically see a doctor then that can be arranged, but this should now be the exception, rather than the rule.
The cost savings and client satisfaction would be enormous. It would also reduce the strain on hospitals, where patients wait for hours and hours – simply to see a doctor – often for something that could have been diagnosed remotely.
With improved home technology, some of us have access to smartwatches – which can monitor our heart rate far more effectively than by a doctor listening for a few moments. And, blood pressure machines are common in many homes. It is only a matter of time, before more and more consumer-based testing will be offered – which will make diagnosis remotely easier.
Think of the benefit to those in rural areas and First Nations communities – and how much it would improve their lives. Even in our province, we spend millions and millions, simply transporting people from remote communities to see a physician. It would make far more sense to have the initial diagnosis remotely done over the internet.
The same is true with our court systems – which are still largely based on 100-year-old systems of in-person hearings. Even for mundane matters – such as contesting a traffic ticket, posting bail for a minor offence, or for a small claims court action. All of these – and the plethora of motions seen in any major litigation or criminal trial – require in-person attendance.
This has made our court system unduly expensive and inaccessible to most. It has also made it intolerably slow, as dates must be organized months or even years in advance. Courts and lawyers have been reluctant to embrace technology when it comes to representation, communication, and court appearances. But, there are amazing improvements which can be made by adopting routine teleconferencing technology.
Canadians would benefit from better service and lower costs made possible by our increasingly universally available and powerful internet. Let’s hope that the experiments in the health care system and legal systems brought about by COVID-19 help drag these services into the 21st century. Given that Manitoba is one of the least impacted areas in the world by COVID-19, let’s come out of this with the goal of using the lessons learned around the world to improve client interactions with physicians and modernizing our court systems to make them world leaders in the use of technology.
Randy Boldt is a senior fellow with the Frontier Centre for Public Policy.