Keewaytinook Okimakanak Developing Telehealth Initiatives in First Nations Orpah McKenzie, KO Health Director First Nations Connect Conference February 11-14, Thunder Bay, ON

ISSUES EXPRESSED BY COMMUNITY MEMBERS Community Consultation Report, 2000 ( The overall reaction to local telehealth access was positive but common concerns were expressed during the consultation: physical location of the telemedicine suite and the integration with existing services the introduction of telemedicine services (levels, timeframes) privacy and security (i.e. how user confidentiality would be respected) possibility of fewer CHNs and/or physicians in the communities effect on local health transportation services local coordination and staffing (distribution of work and training) sustainability

TELEPSYCHIATRY PILOT PROJECT ( Project Goals: Maximize access to professional services for isolated communities through the use of videoconferencing Minimize the disruption to clients Utilize and enhance the capabilities and skills of community support persons in terms of overall care of clients Determine whether this method of mental health intervention is less expensive than the traditional face-to-face process

Project Planning (Chief, Council, local Health staff, staff at Keewaytinook Okimakanak, project coordinator and psychiatrist) community orientation community education and awareness determining effective structures, procedures and protocols screening clients for appropriateness of the tele- psychiatric consult medium organizing and implementing the video consultations evaluation of acceptance by the clients

LESSONS LEARNED (from the telepsychiatry pilot project - fall 2000) Telehealth takes TIME-requires planning, teamwork Telehealth takes new money for equipment and staffing Telehealth involves CHANGE- way of doing business Need to negotiate with technology providers! Support from other health professionals will take time. Control of program and applications belongs with the community Appropriate training, facilities and support systems must be available for the workers and the clients Telehealth cannot be used to replace, but rather to enhance existing services Partnerships at all levels are required (effective communication systems must be in place)

Next Steps Electronic Patient Medical Records –proposed project for records to move with patient electronically KO Health Centre (a modern “Smart” Facility) –coordinated physician, nurse, hostel, administration services Developing and Supporting First Nation “Smart” Health Facilities and Services –new Nursing Station in Poplar Hill, up grade of Health Services in North Spirit Lake and Keewaywin to full Nursing station status –full time nursing services in each First Nation –children-centred programs (Head Start), home care services with call centre support, diabetes education and support programs On-line Health Education and Training programs for First Nation staff and professional development