Michael Dunbar, the leading orthopaedic surgeon in Nova Scotia, sounded a call on Tuesday for the province to adopt new flexible methods of delivering healthcare to its citizens because the current system is not sustainable.
Speaking at the BioPort Atlantic conference, he cited the simple and effective gait monitoring technology he and his team at Capital Health in Halifax have helped to devise. The project, involving three startups, is known as Mobility at Capital Health, abbreviated as “M@ch”.
Dunbar noted that that the M@ch project lets patients waiting for hip or knee replacements use their cell phones to see if they need surgery without visiting a surgeon’s office. It saves money, cuts wait times and produces a range of data that can help in the treatment of the hip and knee disorders.
Dunbar, the professor of orthopaedic surgery at Dalhousie University, said this sort of disruptive technology is needed because Nova Scotia faces an aging population, shrinking pool of productive young people and reductions in healthcare transfers from the federal government.
“The time is now,” said Dunbar. “I’m in the trenches and I see it. The current model is unsustainable. If you think it’s bad now, wait till you see what is going to happen.”
Nova Scotia recently received an F from the Wait Time Alliance how long patients have to wait for hip replacements. Dunbar said there is a process of referrals from family doctors through to surgeons to determine whether someone needs a replacement. It takes years, and only about one-third of the patients end up being selected for immediate surgery.
The way surgeons determine whether surgery is required is having people undergo gait analysis using a treadmill and a lot of equipment, all in a centralized hospital. But M@CH – in cooperation with Halifax startups Kinduct Technologies and OrthoMX Inc. and Laval, Que.-based Emovi – is commercializing a system that gets the same result, only with a common smartphone. Such phones have built-in gyroscopes and accelerometers, and a simple app can measure gait just as efficiently as the expensive machinery.
Dunbar said a doctor, after the first referral, could have a patient take a smartphone home and do the gait analysis on their own time. The results can be sent to an orthopaedic surgeon, who could quickly determine whether the patient needs a consultation. About two-third wouldn’t, so wait times would fall and the health system would save money.
The system could also be used for post-operation monitoring. Patients could do their exercises at home and the results could be monitored remotely by a doctor, who could then issue instructions on the next set of exercises. All the data would be collected, and the analysis would help to improve recovery programs.
Dunbar said Nova Scotia is the perfect place to initiate such programs because of its fiscal situation and the age and heft of its population.
“We have a living health lab here in Nova Scotia,” he said. “We have the oldest, heaviest population in Canada and we should be taking advantage of it.”
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