First Nations Health Care in Transition: The Alberta Story

Overcoming the challenges of distance

Let's face it: Alberta is big - and in a province covering over 660,000 square kilometres, travelling to get certain health care services can be a challenge for those in isolated communities. Happily, distance is now a little less ominous for certain Alberta First Nations communities, thanks to the use of videoconferencing to improve access to services.

The opportunity

Alberta has a decentralized First Nations population with a high percentage living in remote areas. It's a well known fact that there are fewer services available locally for First Nations than in the more populated urban areas - it's an inherent inequity in access to health and human services for people living in remote areas. Add to this the increasing costs and complexity of delivering health services in these communities and the need for a new way of doing things was obvious.

In October 2001, the Alberta First Nations Health Directors decided they needed a way to set service priorities locally, ensure wide-spread availability of training, foster collaborative relationships between communities and service providers and encourage regular communication with all involved. A TeleHealth pilot project in the isolated First Nations community of Fort Chipewyan proved to be an eye-opener for the region - a taste of the future.

Those involved saw great potential for videoconferencing, and knew it was time for some innovative thinking.

The response

After a detailed needs assessment, a set of minimum requirements was developed to identify which communities could participate in the pilot project. Of the 44 Alberta First Nations communities, 21 had access to the bandwidth required to conduct videoconferencing, and each of these was asked to identify its community programming priorities.

By February 2002, the technical infrastructure was in place, and the Telehealth equipment - including a videoconferencing cart, document camera and general-purpose camera - was installed and tested. The initial roll-out focused on targeted client initiatives, including:

• A treatment program in conjunction with the National Native Alcohol and Drug Abuse Program (NNADAP);
• An educational nutrition program with the Dieticians of Canada; and
• An educational and assessment program with the Podiatrists Association of Alberta and the Victorian Order of Nurses.

There were also some immediate benefits for First Nations healthcare workers, including increased professional development opportunities and administrative applications.

Before the official launch, all participating healthcare workers were thoroughly trained. As John Cristescu, Program Manager of the Alberta First Nations TeleHealth Program, explains:

"Great effort was made to make people feel comfortable with the new technology. Comprehensive training was offered, all training material was written in plain language with the neophyte in mind, and a help desk was set up to handle technical inquiries. While at first, people were apprehensive about the new technology, one year later, user and client comfort levels are high and communities are working extremely well together."

Positive outcomes

It's hard to ignore the positive impact that videoconferencing has had on First Nations communities in Alberta. From the sheer joy of children seeing themselves on television for the first time to the heartfelt reunion of family members through videoconferencing technology, Alberta eHealth initiatives are touching the lives of people. The combination of information technologies, telecommunications and TeleHealth is beginning to have a significant effect on First Nations healthcare in Alberta - and proving that large distances can be overcome.