In the time of the 1918-19 Spanish flu, the world was very different. Of course, there was no Internet, TV 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.
We’ve come a long way in most aspects of life in the ensuing century.
But as we face the COVID-19 pandemic, two crucial areas of society need to move forward.
Although much modern health care is technology-based, almost no client-doctor interaction uses technology. In fact, it’s 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 paper documents. Lawyers must file reams of paper, and accused, litigants and their lawyers and witnesses must wait for hours, days, weeks or months.
The Canadian health and legal systems are products of our culture of hurry up and wait. The commercial world moved on over two decades ago and government is finally on the cusp of major transformational change. But the client interface in law and medicine remain as moribund as they were in the time of the Spanish flu.
Yet within weeks of the onset of COVID-19, we’ve seen doctors using phones, Internet and messaging services to meet and diagnose patients.
Many, if not most, consultations with family doctors are for routine matters. They require physicians to do simple in-office tests such as blood pressure, pulse, temperature and breathing. This is coupled with a discussion to render either a diagnosis or a request 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 specialist. The client has to take hours out of their life only to have a brief discussion with the family physician (who 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 far away. If there’s a need to physically see a doctor it can be arranged, but this should be the exception rather than the rule.
The cost savings and increased client satisfaction would be enormous. It would also reduce the strain on hospitals, where patients wait in emergency rooms for hours to see a doctor, often for something that could have been diagnosed remotely.
Many of us have smart watches, which can monitor our heart rate far more effectively than a doctor listening for a few moments. And blood pressure machines are common in many homes. It’s only a matter of time before more consumer-based testing will be offered, making remote diagnosis even easier.
Think of the benefit in rural areas and First Nations communities – how much it would improve lives. In Canada, we spend millions transporting people from remote communities to see physicians. It would make far more sense to have the initial diagnosis done via Internet.
The same is true with our court systems, which are still largely based on 100-year-old systems of in-person hearings. We even follow this process for mundane matters such as contesting a traffic ticket, posting bail for a minor offence or for a small claims court. 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 amazing improvements can be made by adopting routine teleconferencing technology.
Let’s hope the experiments in the health-care and legal systems brought about by COVID-19 help drag these services into the 21st century.
Randy Boldt is a senior fellow with the Frontier Centre for Public Policy.