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Dr. Michael Dunbar

Halifax, N.S.

"Nova Scotia can be leading the country because of the demand we see here in Halifax. There is a huge opportunity here to have some vision and change."

Wait times? There’s an app for that

An orthopaedic surgeon specializing in arthroplasty (joint replacement) with the QEII Health Sciences Centre in Halifax, NS, wants his province to lead the country through medical innovation and technology.

And he has an app to make it happen.

Dr. Michael Dunbar is all too familiar with the lengthy wait times affecting his patients, who are adults from across Atlantic Canada. On average, his patients travel 180 km one way to see him – for joint replacement surgery, or for an annual X-ray and follow-up.

The wait list for knee and hip replacement surgeries, like many subspecialties in Nova Scotia, is long. Patients can wait years to see an orthopaedic surgeon, only to be told they don’t require surgery but would benefit instead from physiotherapy or another form of treatment. Such patients are then cycled back to their family doctor to begin again the process of being referred for alternate treatment. There’s no satisfaction for these patients.

Patients at a hospital for a surgical follow-up often wait between three and four hours in the hospital to see an orthopaedic surgeon for a matter of minutes. Many follow-up patients make an annual journey to the hospital for a face-to-face visit with their surgeon. Of the hundred or more patients who Dr. Dunbar or his colleagues will see every week during follow-ups, only a handful need any additional care after their initial surgery.

The inefficiency of the orthopaedic follow-up system inspired Dr. Dunbar and his team of specialists, nurses, allied health care workers and hospital management to use technology to stem the growing tide of patients who need follow-up but who don’t need to spend their time and money travelling and then waiting for a face-to-face visit.

Enter the Gait Monitoring System (GMS). This mobile app is being designed to bring the evaluation to the patient without travel or wait time. It can measure a patient’s gait just like Dr. Dunbar would in a face-to-face consultation.

With a $2.5 million grant from the Atlantic Innovation Fund called Movement at Capital Health (or M@CH), Dr. Dunbar, his collaborators  and team are developing several technologies, including the GMS smartphone technology to improve access for orthopaedic patients, deliver more personalized care, and gain higher satisfaction from both patients and doctors. The M@CH team plans to commercialize the app across Nova Scotia and throughout Canada, with revenues from the device sales flowing back into the provincial health-care system.

Other specialities and subspecialties in Nova Scotia have already expressed interest in the M@CH technologies behind the GMS, and how it may be able to help improve care in geriatrics, spinal cord injury and childhood obesity.

The GMS demonstrates the combined power of intuitive technology and leadership in medicine. Dr. Dunbar said he believes Nova Scotia has the right combination of need and potential to excel in this area.

He said his team imagines having patients stay in their own homes, and have doctors evaluate them from the hospital and physiotherapy clinics, giving them better care at the end of the day through this technology.

“Nova Scotia can be leading the country because of the demand we see here in Halifax. There is a huge opportunity here to have some vision and change which, if we’re smart, should help pay for health care in this province,” he said.

Dr. Dunbar’s work developing this new innovation is an excellent example of the kind of work doctors do behind-the-scenes and aside from patient visits which is so critical to reducing wait times, improving patient access, and increasing patient satisfaction overall.

For Dr. Dunbar and his team, focusing on patients’ needs and the potential of technology has led to innovation and leadership in the M@CH AIF program.

For patients who require surgery, the GMS will speed up the process that leads to it. In the long run, it will save them time and travel expenses by replacing hospital visits with the smartphone app that’s easily accessed from anywhere at any time.

 For those who don’t require surgery, through the GMS app they’ll have an answer much quicker compared with waiting for a face-to-face visit and will be able to explore other care options with their family doctor much sooner.

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