KO/Knet'Report' - The First Milefirstmile.ca/.../2015/03/2012-KOTM-Rural_Health_Research_report_1.… · KO/Knet'Report' Perspectives'of'Rural'and'Remote'First'Nation' Community'Members'Toward'Telehealth

KO/Knet'Report'

Perspectives'of'Rural'and'Remote'First'Nation'Community'Members'Toward'Telehealth'

Services:'The'Case'of'Keewaytinook'Okimakanak'Telemedicine'(KOTM)'

'

Orpah&McKenzie,&Crystal'Kakekaspan,'Kerri'Gibson,'''Susan'O’Donnell,'Tina&Kakepetum4Schultz''

'Presentation'for'the'rural'and'remote'health''

research'conference'in'Levis,'Quebec'October'25M27,'2012'

2&

Background''•  Responses&from&a&online&survey&of&Knet&account&holders&conducted&in&November&2011&&

•  InvitaDons&were&sent&to&all&Knet&email&account&holders&to&parDcipate&in&study&&

•  An&overall&response&of&663,&including&362&from&KOTM&communiDes&&

•  Knet&and&Videocom&collaboraDon&&

3&

Survey'Responses'&

Ques%on:)What)community)do)you)live)in)most)of)the)

%me?))

(n=)number)of)respondents))

&&

663&Knet&mail&account&holders&&from&all&over&North&Western&Ontario&responded&to&the&survey,&362&of&which&were&from&communiDes&where&KeewayDnook&Okimakanak&Telemedicine&(KOTM)&services&are&provided&

4&

)

Highest'Responses'for'KOTM'communities' 5&

Overview'of'Research'•  A&broad&range&of&qualitaDve&and&

quanDtaDve&informaDon&that&examines&the&use&of&technologies&and&the&importance&of&KO/Knet&services,&such&as&KOTM,&in&communiDes.&&

•  Survey&analysis&conducted&with&the&University&of&New&Brunswick&&&

•  CommuniDes&and&leadership&can&use&this&informaDon&to&help&improve&KO/Knet&services.&&&

•  Other&research&papers&and&publicaDons&are&being&prepared&from&the&overall&survey&&&

•  The&survey&is&a&part&of&the&VideoCom&research&project,&with&partners&KO/Knet&&and&KORI.&&hXp://www.videocom.firstnaDon.ca&&

&

6&

Purpose'for'Report'•  To&sDmulate&community&feedback&and&input&on&the&results&in&order&to&help&improve&KOTM’s&relaDons&with&paDents&

&•  InformaDon&can&help&idenDfy&areas&of&KOTM&that&are&doing&well,&as&well&as&areas&that&need&improvement&&

&•  Explores&the&perspecDves&of&community&members&toward&Telehealth&services&&

&&7&

Satisfaction'Ratings'for'KOTM'

Summary'•  Out&of&all&the&respondents,&most&people&agree&that&Telehealth/Telemedicine&is&a&good&service.&

&•  Slightly&more&women&(29.4%)&than&men&(17.1%)&said&they&think&Telemedicine&is&a&excellent&service.&

&•  0%&of&people&up&to&age&29&think&KOTM&is&a&poor&service&

9&

KOTM%Satisfaction%Ratings%Responses'from'KOTM'communities'–'n=362'chart'below'shows'responses'in'percentages''

10&

24.0%&

40.3%&

18.0%&

3.0%&

14.6%&

Excellent& Good& Fair& Poor& I&don't&know&this&service&

KOTM

'Satisfaction'Ratings'

11&

12.3%&

17.7%&

3.4%& 2.5%&

14.7%&

22.2%&

40.2%& 40.5%&

29.4%&

17.1%&

Female& Male&

I&don't&know&what&this&service&is& Poor& Fair& Good& Excellent&

KOTM%Satisfaction%Ratings%Responses'from'KOTM'communities'–'n=362'chart'below'shows'responses'in'percentages'

KOTM


12&

21.4%&

15.3%&

10.3%&

14.1%&

5.7%&

4.1%&

2.6%&

0.0%&

17.1%&

17.3%&

17.2%&

20.5%&

32.9%&

39.8%&

40.5%&

47.4%&

22.9%&

23.5%&

29.3%&

17.9%&

0.0%& 5.0%& 10.0%& 15.0%& 20.0%& 25.0%& 30.0%& 35.0%& 40.0%& 45.0%& 50.0%&

50&and&up&

40449&

30439&

up&to&29&

Excellent& Good& Fair& Poor& I&don't&know&what&this&service&is&

KOTM%Satisfaction%Ratings%Responses'from'KOTM'communities'–'n=362'chart'below'shows'responses'in'percentages'

KOTM


Quotes'from'participants''I"suppose"more"informa.on"on"the"services"I"don't"know"about."Honestly,"I"thought"Telehealth"was"through"another"service"provider."&telemedicine"would"sort"of"be"beneficial"in"our"community"for"our"elders"that"can't"always"go"by"themselves"to"an"appointment,"at"least"with"this"their"family"members"would"be"available"to"aid"them"with"the"appointment"or"the"health"staff"that"we"have.""More"educa.on"and"awareness"should"be"done"on"the"KNET"services"especially"from"the"local"people"to"talk"about"the"I.T.'s."It'll"be"good"to"create"champions"that"speak"the"local"language"to"bring"educa.on"and"awareness"E"do"some"marke.ng"on"the"services"at"the"community"level."I"learned"that"some"workers"have"addic.on"issues"such"as"drugs"and"it's"affec.ng"the"services..One"way"is"to"exercise/"support"the"Local"policies"and"procedures"to"have"healthy"workers"run"the"workplace."Some"communi.es"have"mandatory"drug"tes.ng"policies"right"now."So"think"about"it..what"is"just"cause!"Improvements:"the"video"conference"in"the"nursing"sta.on"need"sound"barriers.."&&&

13&

Community'Feedback'on'Keewaytinook'Okimakanak'Telemedicine'(KOTM)'

Summary'•  86.1%&of&people&have&heard&about&telemedicine,&but&only&39.2&have&used&it.&

•  91.8%&of&people&in&their&40’s&have&heard&of&telemedicine&

•  Females&use&telemedicine&more&oeen&than&men&

•  67.6%&of&people&think&Telemedicine&would&be&a&good&alternaDve&to&visiDng&a&health&professional&in&person,&yet&46.8%&sDll&would&rather&travel.&

•  49.6%&of&people&are&concerned&with&the&privacy&of&a&telemedicine&session&

•  60.5%&of&people&wish&KOTM&would&be&increased&in&their&community&

15&

16&86.1%&

5.8%&

8.1%&

Yes& No& I&don't&know&

I%have%heard%about%telemedicine%Responses'from'KOTM'communities'–'n=360'chart'below'shows'responses'in'percentages'

Community'Feedback'

17&

7.2%&

5.1%&

8.6%&

11.7%&

2.9%&

3.1%&

3.4%&

15.6%&

89.9%&

91.8%&

87.9%&

72.7%&

0.0%& 10.0%& 20.0%& 30.0%& 40.0%& 50.0%& 60.0%& 70.0%& 80.0%& 90.0%& 100.0%&

50&and&up&

40449&

30439&

up&to&29&


I%have%heard%about%telemedicine%Responses'from'KOTM'communities'–'n=360'chart'below'shows'responses'in'percentages'

Community'Feedback'

18&

I%have%used%telemedicine%Responses'from'KOTM'communities'–'n=360'chart'below'shows'responses'in'percentages'

39.2%&

48.1%&

12.8%&


Community'Feedback'

19&10.9%&

15.2%&

45.5%&

51.3%&

43.6%&

33.5%&

Female& Male&

I&don't&know& No& Yes&

I%have%used%telemedicine%Responses'from'KOTM'communities'–'n=360'chart'below'shows'responses'in'percentages'

Community'Feedback'

20&

Telemedicine%could%be%a%good%alternative%to%visiting%the%health%professional%in%person%

Responses'from'KOTM'communities'–'n=361'chart'below'shows'responses'in'percentages'

67.6%&

6.4%&

26.0%&


Community'Feedback'

21&20.0%&

24.5%&

25.9%&

33.8%&

1.4%&

3.1%&

6.0%&

15.6%&

78.6%&

72.4%&

68.1%&

50.6%&

0.0%& 10.0%& 20.0%& 30.0%& 40.0%& 50.0%& 60.0%& 70.0%& 80.0%& 90.0%&

50&and&up&

40449&

30439&

up&to&29&


Telemedicine%could%be%a%good%alternative%to%visiting%the%health%professional%in%person%


Community'Feedback'

22&

I%would%rather%travel%to%visit%the%health%%professional%in%person%


46.8%&

27.1%&

26.0%&


Community'Feedback'

23&24.3%&

28.6%&

26.1%&

24.4%&

28.6%&

27.6%&

29.6%&

21.8%&

47.1%&

43.9%&

44.3%&

53.8%&

0.0%& 10.0%& 20.0%& 30.0%& 40.0%& 50.0%& 60.0%&

50&and&up&

40449&

30439&

up&to&29&


I%would%rather%travel%to%visit%the%health%%professional%in%person%


Community'Feedback'

24&

Telemedicine%would%be%a%useful%service%for%me%Responses'from'KOTM'communities'–'n=360'chart'below'shows'responses'in'percentages'

55.8%&

8.3%&

35.8%&


Community'Feedback'

25&

24.3%&

34.0%&

36.5%&

47.4%&

2.9%&

4.1%&

7.8%&

19.2%&

72.9%&

61.9%&

55.7%&

33.3%&

0.0%& 10.0%& 20.0%& 30.0%& 40.0%& 50.0%& 60.0%& 70.0%& 80.0%&

50&and&up&

40449&

30439&

up&to&29&


Telemedicine%would%be%a%useful%service%for%me%Responses'from'KOTM'communities'–'n=360'chart'below'shows'responses'in'percentages'

Community'Feedback'

26&

I%intend%to%use%telemedicine%in%the%next%year%Responses'from'KOTM'communities'–'n=360'chart'below'shows'responses'in'percentages'

25.8%&

16.1%&

58.1%&


Community'Feedback'

27&

56.2%&

60.5%&

15.3%&17.2%&

28.6%&

22.3%&

Female& Male&


I%intend%to%use%telemedicine%in%the%next%year%%Responses'from'KOTM'communities'–'n=360'chart'below'shows'responses'in'percentages'

Community'Feedback'

28&

49.6%&

27.1%&

23.3%&

Yes&& No& I&don't&know&

I%would%be%concerned%about%the%privacy%%of%a%telemedicine%session%


Community'Feedback'

29&

21.7%&

25.3%&23.2%&

32.2%&

55.2%&

42.4%&

Female& Male&




Community'Feedback'

30&

18.6%&

18.4%&

27.8%&

26.9%&

22.9%&

27.6%&

30.4%&

25.6%&

58.6%&

54.1%&

41.7%&

47.4%&

0.0%& 10.0%& 20.0%& 30.0%& 40.0%& 50.0%& 60.0%& 70.0%&

50&and&up&

40449&

30439&

up&to&29&




Community'Feedback'

31&

60.5%&

3.9%&

35.6%&


Telemedicine%should%be%increased%in%my%community%Responses'from'KOTM'communities'–'n=362'chart'below'shows'responses'in'percentages'

Community'Feedback'

32&

27.1%&

33.7%&

37.1%&

43.6%&

1.4%&

3.1%&

2.6%&

9.0%&

71.4%&

63.3%&

60.3%&

47.4%&

0.0%& 10.0%& 20.0%& 30.0%& 40.0%& 50.0%& 60.0%& 70.0%& 80.0%&

50&and&up&

40449&

30439&

up&to&29&


Telemedicine%should%be%increased%in%my%community%Responses'from'KOTM'communities'–'n=362'chart'below'shows'responses'in'percentages'

Community'Feedback'

Quotes'from'Respondents''It"would"be"nice"to"see"more"tech"support"in"the"remote"communi.es"for"connec.vity"and"quality."Also"more"support"for"the"teleEmedicine"network"to"be"u.lized"more"effec.vely."More"bandwidth"also"from"the"government"to"support"the"ini.a.ves.""Communi.es"need"to"upgrade."The"internet"in"this"community"is"really"bad."Trying"to"do"this"survey"is"a"test"on"one's"pa.ence."Even"going"to"my"Telehealth"appointment"last"week"was"unsuccessful"because"they"could"not"get"on...gatekeeper"issue"and"no"body"could"fix"it...even"Sl"."Now"awai.ng"a"new"date...""I"would"like"to"see"issues"with"our"internet"dealt"with"in"our"reserve."The"connec.on"we"have"is"not"good"at"all."We"have"lousy"connec.ons"to"the"internet,"with"it"going"off"quite"a"bit."I"would"like"to"see"it"fixed,"as"it"does"affect"my"job"as"the"telemedicine"coordinator"for"my"reserve."It"seems"my"consults"never"happen"as"i"always"have"gatekeeper"issues"along"with"the"lousy"connec.on."I"hope"it"gets"fixed"so"there"will"be"no"more"cancelled"appointments"for"my"fellow"band"members"who"don't"want"to"travel"to"see"doctors."Thanks."&

33&

KOTM'&'Videoconferencing'

Summary'

&

35&

•  3.0%&of&people&use&videoconferencing&for&telemedicine&weekly,&and&10.5%&of&people&say&the&use&it&monthly&•  Females&use&videoconferencing&for&telemedicine&more&oeen&than&men&•  People&age&50&and&up&use&videoconferencing&for&telemedicine&less&than&any&other&age&group&

36&

2.8%&3.0%&

10.5%&

45.6%&

38.1%&

Daily& Weekly& Monthly& Rarely& Never&

Frequency%of%videoconferencing%for%Telehealth'Responses'from'KOTM'communities'–'n=362'chart'below'shows'responses'in'percentages'

KOTM

'&'Videoconferencing''

37&

43.6%&

48.1%&

36.3%&

40.5%&

10.8%& 10.1%&

4.9%&

0.6%&

4.4%&

0.6%&

Female& Male&

Never& Rarely& Monthly& Weekly& Daily&

Frequency%of%videoconferencing%for%Telehealth%Responses'from'KOTM'communities'–'n=362'chart'below'shows'responses'in'percentages'

KOTM


38&

44.3%&

46.9%&

41.4%&

51.3%&

41.4%&

37.8%&

41.4%&

30.8%&

12.9%&

10.2%&

9.5%&

10.3%&

1.4%&

3.1%&

3.4%&

3.8%&

0.0%&

2.0%&

4.3%&

3.8%&

0.0%& 10.0%& 20.0%& 30.0%& 40.0%& 50.0%& 60.0%&

50&and&up&

40449&

30439&

up&to&29&

Daily& Weekly& Monthly& Rarely& Never&

Frequency%of%videoconferencing%for%Telehealth'Responses'from'KOTM'communities'–'n=362'chart'below'shows'responses'in'percentages'

KOTM


Constructive'feedback'from'respondents'

39&

Feedback'from'respondents'Telehealth"EDoctors"to"see"pa.ents"on".me"for"Telehealth"appointment,"pa.ents"leave"by"the".me"the"doctors"come"around"and"we"have"leT"for"lunch"or"something"else"and"not"to"be"reported"as"missed"appointments."Internet"connec.vity"to"be"faster,"some.mes"it"just"slows"right"up."Phone"services"that"are"cheaper"(IP"based)."&improve"the"technology"in"our"community"as"the"technology"improves....update"more"frequently..i"have"not"seen"any"improvements"in"my"community."The"Telemedicine"struggles"to"keep"their"internet"working"smoothly."Telehealth"and"Videoconferencing"can"be"improved"by"Knet"providing"more"informa.on"and"educa.on"to"the"community"organiza.ons,"on"how"and"the"benefits"of"using"these"technologies."&Videoconferencing"can"be"improved."As"some.mes"you"can't"understand"what"is"being"said"or"don't"get"a"clear"picture."This"is"a"ongoing"technical"issue."It's"hard"to"par.cipate"when"the"video"isn't"clear.""I"think"that"the"connec.on"speed"for"communi.es"need"to"improve."In"order"to"par.cipate"effec.vely"in"educa.on,"telehealth"or"videoconferencing,"the"speed"needs"to"be"there"in"order"for"it"to"run"smoothly."Most"of"the"KO"communi.es"that"I"have"been"to"have"slow"internet"and"some"even"have"internet"speeds"similar"to"my"old"dialEup"during"certain"periods"of"the"day."&&&&&

40&

Feedback'from'respondents'

Spreading"the"Chris.an"Religion."A"faster"internet"connec.on."Both,"wired"and"wireless."An"Alcoholics"Anonymous"program"in"my"community."Thank"you.""Teleconference"on"AA"mee.ngs"across"northwestern"Ontario"including"the"Manitoba"region"or"Paren.ng"Conferences"for"the"young"mothers/"couples."&That"there"be"more"news"stories"with"health"issues."&Develop"an"online"physical"fitness"program"catered"to"all"levels,"and"like"men.oned"previously"online"resources"(ie."personality"and"ap.tude"tests)"for"hiring"within"First"Na.ons."&I"think"that"all"northern"commini.es"are"in.tled"as"the"same"[quality]"service"as"the"southerns"

& 41&

Conclusions'and'Next'Steps'

42&

A'few'conclusions'about'KOTM'•  There&needs&to&be&more&community&awareness&for&KOTM.&

&•  Privacy&of&KOTM&sessions&&could&be&a&focus&of&a&awareness&campaign.&

&•  Elders&need&to&become&more&aware&of&KOTM&and&the&benefits&of&this&service.& 43&

Acknowledgements'''A)warm)and)sincere)thank)you)to:&•  &All&of&the&parDcipants&who&took&the&Dme&and&effort&to&share&their&thoughts&and&opinions&with&us.&&

•  KO&staff,&interns,&and&Videocom&project&members&and&associates&who&provided&feedback&on&the&project.&

•  Knet&staff&who&helped&with&technical&aspects&of&the&data&collecDon.&

•  This&survey&is&part&of&the&Videocom&project,&funded&by&in4kind&contribuDons&from&the&social&sciences&and&the&HumaniDes&research&council&of&Canada&(SSHRC).&

•  Meegwetch!)44&

Follow'Up'•  For&feedback&and&ideas&about&next&steps,&contact&Orpah&McKenzie,&KO&Telemedicine&[email protected]&

•  For&more&details&on&survey&analysis,&contact&Susan&O’Donnell,&University&of&New&Brunswick&[email protected]&

You&are&welcome&to&refer&to&this&report&in&any&future&publicaDons&and&reports.&The&reference&is:&&McKenzie,&Orpah.,&Kakekaspan,&C.,&&&O’Donnell,&S.&(2012)&PerspecDves&of&Rural&and&Remote&First&NaDon&Community&Members&Toward&Telehealth&Services:&The&Case&of&KeewayDnook&Okimakanak&Telemedicine&(KOTM).&PresentaDon&from&Lévis,&Quebec,&October&25427,&2012&& 45&

Documents

KO/Knet'Report' - The First Milefirstmile.ca/.../2015/03/2012-KOTM-Rural_Health_Research_report_1.… · KO/Knet'Report' Perspectives'of'Rural'and'Remote'First'Nation' Community'Members'Toward'Telehealth