From the industrial cities along the Great Lakes in the south to the First Nations communities along the Hudson Bay to the north, the Canadian province of Ontario is home to some 13 million people. And all of them have access to one of the largest and most diverse telehealth networks in the world.

The Ontario Telemedicine Network (OTN) was launched in 2006, comprised of three regional networks that had been in operation since the 1990s. Serving a land mass the size of California, Texas and Maryland combined, the OTN features more than 3,000 healthcare professionals in more than 1,175 sites, conducting more than 135,000 patient visits a year.

All of this keeps Ed Brown busy.

“I used to have to chase doctors down (to participate in the network), but now they’re chasing after me,” says the OTN’s founder and chief executive officer, who is also vice president of the American Telemedicine Association. “It’s a very exciting time for us.”

The OTN is an independent, non-profit organization, funded by the provincial government. It also receives funding from Canada Health Infoway and eHealth Ontario, and has developed an innovative membership model that has enabled more than 300 organizations in the province to sign on and make use of the OTN’s resources, especially the videoconferencing services.

“We’re certainly creating a lot of creativity,” he says of the network, which comprises all of the province’s hospitals, hundreds of clinics and agencies, nursing homes, assisted living communities, health agencies, even schools and prisons. “It’s not that simple, especially since there are so many different organizations and so many different services involved.”

Aside from videoconferencing – the OTN boasts one of the largest live, two-way videoconferencing networks in the world – the OTN offers concierge services, emergency services, “Store Forward” technology (an image storage and management system that started with dermatology and is now branching out into ophthalmology and wound care), web-conferencing and webcasting and tele-homecare – which Brown sees as an area ripe for innovation and expansion in the near future.

While approximately 12 million of the province’s 13 million inhabitants live within 100 miles of the U.S. border, the OTN’s services are spread evenly throughout the province. In the north, along the vast Hudson Bay, the OTN partners with the Keewaytinook Okimakanak Telemedicine network to serve First Nations communities, some of which can’t be reached by road.

Brown says the network is always looking for – and coming up with – new telemedicine uses. While the videoconferencing program is the OTN’s longest running service (branching out from medicine to include education), consults for mental health issues and addictions comprise the biggest use of the system. The telestroke program has been in operation since 2002, says Brown, and is expanding, as is the aforementioned Store Forward program. Tele-trauma and critical care programs are now in the works.

“Pretty much any specialty that you can imagine, we’re helping out,” says Brown.

“It’s really about adoption now – if you can find a champion out there, some doctor who is willing to do it, we’ll work to make it simpler and easier so that everyone can get involved,” he adds. “The world is changing – everyone has an iPhone or an iPad now, and they’re catching on. “

Brown sees the OTN as “a neutral, non-threatening central organization that can aggregate the service” of telemedicine. He entertains visitors from all over the globe, and sees organizations like the ATA as a resource and force for global adoption and integration.

“Telemedicine is really just a technology – it’s an enabling technology,” he says. “It helps us get to where we want to be. We kind of see our job as collecting successful business models.”