U of R and partners receive $1.27 million in research funding for a Northern Saskatchewan virtual health-care pilot project.
“Having grown up in Northern Saskatchewan, I remember how long it took to see a doctor because of the constant shortage and how far we sometimes had to travel to see one. It wasn’t easy to get into the city at the best of times, but it was next to impossible in the winter if you even had a vehicle to get there,” recalls Cassandra Opikokew Wajuntah, assistant professor and director of the Indigenous Peoples’ Health Research Centre at the First Nations University of Canada.
A Saskatoon-based doctor says stories like these are common, and they must change.
“Indigenous children in remote Canadian communities are at risk because of poor access to comprehensive and local pediatric health care. They require rapid solutions that are culturally safe, community directed, and consistent with the Truth and Reconciliation Commission’s Calls to Action,” says Dr. Gregory Hansen, pediatric neurointensivist at the Jim Pattison Children’s Hospital and adjunct nursing professor at the University of Regina.
Now, funding from the federal government through a Canada Institutes for Health Research Project Grant has provided $1,273,726 over 5 years to Hansen, Opikokew Wajuntah, and their team to address these challenges by expanding a previously piloted virtual health-care platform.
The previous pilot project, led by co-investigator Dr. Tanya Holt—a colleague of Hansen’s at the Jim Pattison Children’s Hospital—worked with one Northern Saskatchewan community using a robot with a screen that allowed a pediatric specialist to virtually be at the bedside of a patient. The robot was controlled by a pediatric intensivist in Saskatoon who could direct the robot and talk to the patients, parents, and health-care providers in the room. This new, expanded project will see the research team implement virtual health care using tablets—a much more efficient and portable approach.
Dr. Gregory Hansen is a pediatric neurointensivist at the Jim Pattison Children’s Hospital and an adjunct nursing professor at the University of Regina. (Photo by Dave Stobbe)
“Most of the time we approach health-care delivery from a Western point of view. But, when we try to bring these systems to First Nations communities, we are often being ignorant to Indigenous notions of well-being,” says Hansen. “We’re currently working with 15 First Nations communities to create a virtual health-care platform based on what they want and need. We hope that more communities will sign on once we get started.”
Both the File Hills Qu’Appelle Tribal Council and the Northern Inter-Tribal Health Authority—which together serve 44 different Saskatchewan First Nations communities—support this project. These communities are coming together to work alongside researchers at the University of Regina, the Indigenous Peoples’ Health Research Centre, and the Jim Pattison Children’s Hospital.
“This project, which is guided by community and is driven by each community's needs, will help to build trust and respect for the health-care system, while also building capacity in each of the Northern communities taking part.”
“Developing a virtual health system in First Nations communities that is guided by community engagement allows the focus to be on caregiver engagement and customizing software,” says Hansen. “This means ensuring that what’s on the screen is useful and resonates with the users.”
Opikokew Wajuntah says she’s excited to start working with all of these communities in a good way, and says the communities are equally as ready to get to work.
“Each community our team is working with will now have access to pediatric specialists without patients or their families having to leave their communities—something that is long overdue,” says Wajuntah, who connected the team with the communities currently on board with the pilot.
Tara Campbell, the executive director of the Northern Inter-Tribal Health Authority and a member of the IPHRC Indigenous Health Advisory Council, says Northern communities are in need of this service.
“Removing our children from our communities creates discomfort. This project, which is guided by community and is driven by each community's needs, will help to build trust and respect for the health-care system, while also building capacity in each of the Northern communities taking part,” says Campbell.
Hansen says the reality for Indigenous communities is that relying on telephone consults usually fails to engage caregivers and leads to unnecessary transports to distant health centres. Ultimately, this can undermine Indigenous self-determination, decolonization, and reconciliation.
Tara Campbell is the executive director of the Northern Inter-Tribal Health Authority and a member of the IPHRC Indigenous Health Advisory Council. (Photo by Dave Stobbe)
“These are inefficient methods of care, and they’ve led to enormous social burdens on families, increased morbidity and mortality, high health-care costs, as well as fears associated with previous colonial narratives,” says Hansen.
Virtual health care allows specialists to provide a real-time assessment of the patient, who can stay in their home community. The doctors will also be able to offer support and follow-up conversations. And while the critically ill may still need to travel for treatment, if patients don’t have to leave their communities, then Hansen says they shouldn’t have to.
"On a personal level, as a First Nations person who grew up in Northern Saskatchewan, who has four kids under the age of six, I am so excited that this funding will allow Indigenous communities to drive the project with their voices, especially when they are so often left out of these processes.”
“Indigenous Peoples' lived experiences with the health-care system in Canada have been shaped by colonial inequity. When children who didn’t need to travel to bigger centres were transported out of their communities, the colonization narrative of “giving up kids” was playing out again. There is also the big cost to parents travelling with their kids because then they are also removed from their support systems,” says Hansen. “This program aims to enhance cultural safety by fostering communication with family members.”
Dr. Kathleen McNutt, Vice-President (Research), says that by providing easy-to-access, culturally appropriate, and, most importantly, community-informed health care, the research team will be making an immense difference in the lives of Indigenous children and their families.
Cassandra Opikokew Wajuntah is an assistant professor and director of the Indigenous Peoples’ Health Research Centre at the First Nations University of Canada.
“While the team is currently focused on providing virtual health care to Saskatchewan communities, once the pilot project is completed, the software and what they have learned will be applicable in other parts of Canada, and certainly throughout the world,” says McNutt.
Opikokew Wajuntah says up North, where there is chronic underfunding of health care, it’s imperative to find creative ways, like virtual health care, to provide care for these communities—and that’s why this project means so much to her.
“I grew up in Meadow Lake and am a member of the Canoe Lake Cree First Nation, so, on a professional level, I see how important it is for rural and remote Indigenous communities to have access to health care."
"On a personal level, as a First Nations person who grew up in Northern Saskatchewan, who has four kids under the age of six, I am so excited that this funding will allow Indigenous communities to drive the project with their voices, especially when they are so often left out of these processes," says Opikokew Wajuntah.
CIHR Project Grant program is designed to capture ideas with the greatest potential to advance health-related fundamental or applied knowledge, health research, health care, health systems, and/or health outcomes.
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