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Access to health care in Canada's rural areas is a challenge. The Unité de Coordination Clinique des Services Préhospitaliers d'Urgence (UCCSPU) is a telemedicine program designed to improve health care in the Chaudiere-Appalaches and Quebec City regions of Canada. Remote medical services are provided by nurses and by an emergency physician based in a clinical unit at the Alphonse-Desjardins Community Health and Social Services Center. The interventions were developed to meet two objectives. The first is to enhance access to quality health care. To this end, Basic Life Support paramedics and nurses were taught interventions outside of their field of expertise. Prehospital electrocardiograms were used to remotely diagnose ST segment elevation myocardial infarction and to monitor patients who were en route by ambulance to the nearest catheterization facility or emergency department. Basic Life Support paramedics received extended medical authorization that allowed them to provide opioid analgesia via telemedicine physician orders. Nurses from community health centres without physician coverage were able to request medical assistance via a video telemedicine system. The second objective is to optimize medical resources. To this end, remote death certifications were implemented to avoid unnecessary transport of deceased persons to hospitals. This paper presents the telemedicine program and some results. [ABSTRACT FROM AUTHOR]

Objective: Publicly funded cognitive-behavioural therapy (CBT) for mental disorders is scarce in Canada, despite proven efficacy and guidelines recommending its use. This paper reviews published data on the economic impact of CBT to inform recommendations for current Canadian mental health care funding policy.Method: We searched the literature for economic analyses of CBT in the treatment of mental disorders.Results: We identified 22 health economic studies involving CBT for mood, anxiety, psychotic, and somatoform disorders. Across health care settings and patient populations, CBT alone or in combination with pharmacotherapy represented acceptable value for health dollars spent, with CBT costs offset by reduced health care use.Conclusions: International evidence suggests CBT is cost-effective. Greater access to CBT would likely improve outcomes and result in cost savings. Future research is warranted to evaluate the economic impact of CBT in Canada. [ABSTRACT FROM AUTHOR]

The article comments on the paper which discusses the partnership between psychiatry and public health system to ensure addiction care in Canada. The author mentions the need to reassess the role of psychiatrist to achieve successful outcomes in resolving the prevalence of addiction. He states the significance of financial support in encouraging psychiatrists to assume the responsibility and accountability for the prevention and care of addiction. Furthermore, the author stresses that physicians, including psychiatrists, should develop emphatic relationship with addiction sufferers to initiate effective treatment of addiction.

The article comments on the paper which discusses the implication of societal domains on the treatment of addiction in Canada. The author contemplates on the disciplines concerning the prevention and care of addictions as well as the allocation of treatment resources. He stresses the significance of addiction medicine in dealing with the management of addiction. Furthermore, the author believes that the collaborative efforts among those in public health, addiction medicine, and mental health services may be the best option to initiate addiction care for Canadians.