It’s Time to Tear Down Telehealth Barriers on Remote First Nations

When it comes to health care, remote First Nations face serious challenges. Access to services is one of the biggest. Right now, telehealth has the potential to help – but there are major obstacles in the way.

Currently, most patients in First Nations communities experience poor continuity of care. Many face health complications due to insufficient follow-up with caregivers and medical professionals. Access to specialist expertise may also be limited – or non-existent.

A lot of the factors that contribute to this state of affairs are social and historical. Working through them will take time. But logistical barriers also play a role, and the steps required to tear these down are more straightforward. Take, for example, the implementation of telehealth.

One of the biggest barriers to contemporary telehealth is poor wifi and cellular networks. On remote First Nations, there’s been a lot of recent progress on these fronts. But there are still communities that don’t have reliable access.
Given all of the benefits that telehealth provides, isn’t it time to find a solution?

Access to Health Care: Still a Unique Challenge

It’s no secret. In many rural and remote communities, residents have difficulty accessing the health care services they need. Living far away from medical specialists and leading health care facilities poses obvious challenges. But in remote First Nation communities, geography isn’t the only consideration.

In a talk to a parliamentary committee, Dr. Michael Kirlew noted that services on First Nations are “far inferior” to what most people in Canada receive. He highlighted the role that systemic discrimination has played in creating unequal access to care.

One of the many issues Kirlew delved into was access to specialist expertise. Speaking of his work in northern communities, he noted that mental health care was “virtually non-existent”.

A recent auditor general’s report was just as eye-opening. Findings indicate that clinical services and medical transportation are far from guaranteed on First Nations. Not only that, but many nurses working in the North were found to have inadequate training.

These issues are complex. And given the many social factors at play, addressing them won’t be easy. But Government and service providers can’t forget about logistical considerations, which are just as critical. Taking concrete steps toward improving access will go a long way.

Telehealth Revisited – the Potential Value for Remote Health Care

When it comes to providing better health care services in remote First Nations, feasibility is key. Because in many communities, the need is urgent.

There’s no doubt that strategies to attract and retain care practitioners are important. But what can community leaders, care providers, and policymakers do to help right now?

In many cases, adopting telehealth is the answer. Of course, this care delivery model has been around for a couple of decades. But now, thanks to major technological developments, it’s making a comeback. And it’s going to be especially beneficial in remote communities.

In the past, telehealth technology enabled remote patients to check in with health care providers from a distance. In many cases, it helped them connect with specialists they would never otherwise have had access to. Technology also made it possible for providers to share patient information, improving care overall.

Telehealth will continue to fill these functions – but in even more beneficial ways. Right now, improved videoconferencing and information-sharing technologies are changing health care for the better.

And because these capabilities are now available through mobile devices, they’ve become more accessible and convenient. They’re also easier to use than ever before – even for those who don’t possess high-level technical skills.

If telehealth technology were properly harnessed, health care in remote First Nations could quickly improve.

High-quality follow-up care would result from better patient-practitioner communication. Unprecedented continuity of care would occur if care plans were shared easily, and in real time. And major service gaps – such as the lack of mental health support identified by Dr. Kirlew – could be closed.

Ongoing Telecommunications Barriers

In recent years, there’s been a push from First Nations communities to expand cellular and wifi coverage. A desire for better access to health care is one of the reasons many advocates have championed the cause.

There are First Nations projects like First Mile, which encourages communities to control their broadband networks. There’s also K-Net Mobile – an Ontario cellular service provider that began with the leadership of the Keewaytinook Okimakanak tribal council.

These kinds of information and communication technology projects have the potential to greatly improve health care.

K-Net clearly understands. The company introduced DiabeTEXT, a program that enables diabetes workers in participating communities to send self-care reminders to patients on their phones.

In partnership with First Nations, advanced telehealth apps could take improving care to the next level. And communities with reliable cellular and wifi networks will see the biggest benefits.

Improved coverage would allow more patients to connect with caregivers and engage with their health information via mobile devices.

Crucially, it would also enable medical practitioners and care providers to connect with one another over long distances. Imagine the difference these connections could make in situations where patients urgently need treatment.

Let’s say a nurse working in a remote First Nation has to treat someone experiencing a health emergency. The procedure that could help the patient isn’t particularly difficult to perform. But the nurse has never done it before.

Using a telehealth app with videoconferencing capabilities, the nurse could receive coaching from a qualified specialist.

But the absence of cell towers or wifi service could make this process difficult, if not impossible. The same is true of circumstances where caregivers, health care practitioners, or patients need immediate access to health information.

The Value is Clear

In recent years, telecommunications infrastructure has improved significantly in remote First Nations communities. But the fact that some regions are still without coverage is unacceptable.

Consider this story. Recently, a car and a half-ton truck collided between the northern Saskatchewan communities of Black Lake and Stony Rapids. The accident occurred just weeks after cell service became available in the region.

A passerby was able to call for help, and the injured party received the treatment he needed to recover. Without cell coverage, this scenario could have played out very differently.

These events illustrate just how important digital connectivity can be. And when it comes to health care delivery, there’s no shortage of potential problems that can occur without it.

Feature image courtesy of Blue Coat Photos

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To complete a thorough needs assessment / initial evaluation for a COPD patient of an outpatient clinic

Actors
Patient, Educator (Nurse, RT, the Physician could also be the educator)

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To cover in depth all the necessary elements of self-management education as per the LWWCOPD, with priorities based on patient goals and identified treatable traits

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