First Nations Health Care in Transition: The Alberta Story

Finding new ways to improve client health

Health care professionals in Alberta's First Nations communities are working toward one clear goal: improving the health outcomes of their clients. Information technology and telecommunications play a key role in reaching that goal.

The opportunity

Historically, the First Nations population in Canada has had a poorer health status than the non-First Nations population. Studies today show that if you're First Nations and living on a reserve, your life expectancy is about eight years shorter than other Canadians, you're at two to six times higher risk of developing an alcohol- or substance-related problem, and the likelihood that you have diabetes has more than quadrupled.

The numbers are shocking, but the situation is improving thanks to programs delivered on reserve in First Nations communities in Alberta in areas such as prevention and promotion, treatment and continuing care, and health protection. Indeed, in conjunction with Band Health Care Workers and the Office of Nursing Services, the region is doing good work.

Nonetheless, those in the Alberta Region knew that more could be done to address specific First Nations health concerns ... and that technology might hold the key.

The response

The Alberta community of Fort Chipewyan was at the centre of a TeleHealth pilot project, that produced encouraging results. By installing videoconferencing equipment and taking advantage of existing telecommunications lines, the remote community was able to link with other communities and healthcare centres. Tammy Buchanen, a TeleHealth Rehabilitation Assistant with Nunee Health Authority in Fort Chipewyan, describes the project's impact on the community:

" It has improved continuity of care, reduced travel time, allowed for better monitoring during care and discharge and provided us with many TeleLearning opportunities. Most of all, it's had a real human impact. I've seen lots of tears - tears of joy - especially when we were able to unite family members through videoconferencing when one member was out of the community for treatment. "

While the videoconferencing approach does offer many advantages, sometimes the situation calls for an in-person meeting - the Alberta solution is really "SLICK".

Short for "screen for limbs, eyes, cardiovascular and kidney" complications, the acronym SLICK is the namesake for a project that uses a mobile diabetes clinic to visit all 44 First Nations communities in Alberta. Linda Steinhauer, SLICK Project Coordinator, describes how communities have received the project:

" The last time a government van went through First Nations communities in Alberta was during a Tuberculosis scare in the 1970s. Some of the elders remember their relatives being taken away for up to two years for treatment. While that does make for some apprehension at first, people are eager to learn more about what we're doing - all the high-tech gadgets are a draw. More importantly, SLICK is purely voluntary, and we have First Nations running the clinic and explaining the process. "

Positive outcomes

Videoconferencing and the SLICK project are just two of the many initiatives using cutting-edge technology to improve the health outcomes of First Nations in Alberta. Overall, the province's First Nations eHealth strategy has lead to:

• Significant increases in diabetes screening, treatment and awareness;
• Convenience and independence for clients who can now receive care in their own communities;
• Reduced isolation for patients that must be transferred out of their home community, by allowing them to stay in touch with loved ones through TeleVisitation;
• Increased individual empowerment and community capacity building through employment and training opportunities to develop local technical expertise;
• Enhanced continuum of care with face-to-face conferencing for people in remote communities; and
• Improved overall client health outcomes.