The use of technology to improve health care to Saskatchewan’s First Nations communities

Abstract

Saskatchewan is a province of over one million people and over 13% are Indigenous peoples, many of whom live on reserve lands. Despite continued efforts, access to health care remains a significant challenge for these Indigenous people, especially those in the North. To address this challenge, Saskatchewan's health care providers have been incorporating the use of technology for various health services. This paper describes various ways technology has been used in First Nations communities in Saskatchewan. Several pilot projects between First Nations leaders and health care providers, in the communities as well as in the urban setting, have taken place over the past 10 years. Information on these pilots was supplemented with literature reviews and consultations with colleagues at the Northern Inter-Tribal Health Authority, the First Nations and Inuit Health Branch (FNIHB), Health Canada and lead physicians for services to the North. Numerous technologies have shown promise in aiding the timely delivery of high quality health care. Remote Presence Robotic Technology (RPRT) is a form of telemedicine that creates the sense that a clinician is at the patient's side; enabling clinical services to be provided remotely and in real time. Increasing access to internet services and providing computer tablets to community health nurses have improved patients' access to clinical care and to vital health care information. Robotic ultrasonography has been used to provide onsite care for pre-natal patients. The provision of cell phones to HIV-positive patients has improved compliance with anti-retroviral therapy and has resulted in better clinical outcomes. The Xpert MTB/RIF (Mycobacerium tuberculosis complex / resistance to rifampicin) is an automated device that, through analysis of raw sputum samples, can identify the presence of M. tuberculosis with greater speed, sensitivity and specificity than the conventional acid-fast bacilli (AFB) smear. Similarly, telemedicine remote communications equipment is being used for patient care across communities. Panorama is a comprehensive, integrated public health information system designed for public health professionals and is currently being introduced in 21 communities in Saskatchewan. Not only do these innovative technologies appear to improve access and enhance the quality of timely care in remote communities but they also bring comfort to patients, prevent unnecessary transportation and minimize time away from work and family. Although these technologies are not a panacea for some of the determinants of health that can affect the incidence and severity of infectious diseases in First Nations, they do appear to address some of the geographic challenges faced in providing health services in remote communities.