The KO/NORTH Telehealth Partnership · Sick Kid’s Hospital, Sunnybrook, Centre for Addictions and Mental Health and the University Health Network; November, 19, 2002 Presentation

November, 19, 2002November, 19, 2002 Presentation to Health Canada Informatics Staff, Poplar Hill, First NationPresentation to Health Canada Informatics Staff, Poplar Hill, First Nation

The KO/NORTH TelehealthThe KO/NORTH TelehealthPartnershipPartnership

Linking Remote First Nations in OntarioLinking Remote First Nations in Ontarioto a comprehensive, reliable and secureto a comprehensive, reliable and secureHealth Informatics InfrastructureHealth Informatics Infrastructure

November, 19, 2002November, 19, 2002 Presentation to Health Canada Staff - Poplar Hill, First NationPresentation to Health Canada Staff - Poplar Hill, First Nation

Who is Keewaytinook Okimakanak?Who is Keewaytinook Okimakanak?

A regional governance organization (tribalA regional governance organization (tribalcouncil) that works on behalf of the interests ofcouncil) that works on behalf of the interests ofits member communities: Fort Severn, Deer Lake,its member communities: Fort Severn, Deer Lake,Keewaywin, McDowell Lake, North Spirit Lake andKeewaywin, McDowell Lake, North Spirit Lake andPoplar Hill. There are three distinct languagesPoplar Hill. There are three distinct languages(Cree, Oji-Cree and (Cree, Oji-Cree and OjibwayOjibway) distributed across a) distributed across apopulation base of more than 2,000 people.population base of more than 2,000 people.

Canada’s SMART First Nation DemonstrationCanada’s SMART First Nation DemonstrationProject (K-Net). Sioux Lookout is K-Net’s hub forProject (K-Net). Sioux Lookout is K-Net’s hub forregional deployment of scalable broadbandregional deployment of scalable broadbandservices throughout the Sioux Lookout Healthservices throughout the Sioux Lookout HealthZone (terrestrial digital microwave & C-Band)Zone (terrestrial digital microwave & C-Band)


What is the KO TelehealthWhat is the KO TelehealthPartnership Project?Partnership Project?

A federally funded partnership betweenA federally funded partnership betweenKeewaytinook Okimakanak (KO Telehealth andKeewaytinook Okimakanak (KO Telehealth andK-Net Services) and the NORTH NetworkK-Net Services) and the NORTH Network

A community-based pilot project to developA community-based pilot project to developeffective regional telemedicine services remoteeffective regional telemedicine services remoteOntario First Nations settings.Ontario First Nations settings.


Project ScopeProject ScopeComprehensive telemedicineComprehensive telemedicineservices in 5 fly-in only Firstservices in 5 fly-in only FirstNations, Balmertown Training HubNations, Balmertown Training Huband the and the MinoyawinMinoyawin Health Centre Health Centre(Sioux Lookout);(Sioux Lookout);Secure/encrypted IP networkSecure/encrypted IP networkaccess to more than 65 sitesaccess to more than 65 sitesincluding major tertiary including major tertiary centrescentres::Thunder Bay Regional Hospital,Thunder Bay Regional Hospital,Winnipeg Health Sciences Centre,Winnipeg Health Sciences Centre,Sick Kid’s Hospital, Sunnybrook,Sick Kid’s Hospital, Sunnybrook,Centre for Addictions and MentalCentre for Addictions and MentalHealth and the University HealthHealth and the University HealthNetwork;Network;


KO Telehealth Project StructureKO Telehealth Project Structure

K-Net Services

Network Planningand Connectivity

24 x7 HelpDesk Services

Technology Installation& Maintenance


Networking ModelNetworking ModelAggregated DemandAggregated Demand

""A concerted approach to the lack of connectivity inA concerted approach to the lack of connectivity inrural and remote communities, and especiallyrural and remote communities, and especiallyAboriginal communities is requiredAboriginal communities is required...A concerted...A concertedapproach to connectivity would not be designed to solelyapproach to connectivity would not be designed to solelybenefit the community health care system. Rather, itbenefit the community health care system. Rather, itwould adopt would adopt the Smart Community modelthe Smart Community model that enables that enablesuptake of technology for community and economicuptake of technology for community and economicdevelopment, education, health, social services, lawdevelopment, education, health, social services, lawenforcement, band management, etc."enforcement, band management, etc."

First Recommendation of the National First NationsFirst Recommendation of the National First NationsTelehealth Research ProjectTelehealth Research Project


Network Services ModelNetwork Services ModelCommunity-Based Regionally Supported


The KO/NORTH Network InterfaceThe KO/NORTH Network Interfacehttp://www.knet.cahttp://www.knet.ca

FEATURESFEATURES

Advanced IP architectureAdvanced IP architectureEncrypted VPN connectivityEncrypted VPN connectivity3MB/s QOS Pool (SLKT)3MB/s QOS Pool (SLKT)1MB/s QOS – Terrestrial FN1MB/s QOS – Terrestrial FN512 KB/s QOS – Satellite FN512 KB/s QOS – Satellite FNKO/NORTH SLA -- distributedKO/NORTH SLA -- distributed24x7 Regional HelpDesk24x7 Regional HelpDesk(Remedy-based tracking)(Remedy-based tracking)Local Technical supportLocal Technical supportLeverages aggregated networkLeverages aggregated networkpricingpricing

NETWORK TOPOGRAPHYNETWORK TOPOGRAPHY


What are the main goals forWhat are the main goals forKO Telehealth?KO Telehealth?

Improved Access to health information and Medical ServicesImproved Access to health information and Medical ServicesCloser to HomeCloser to Home

Local access to comprehensive Specialist/allied health professional servicesLocal access to comprehensive Specialist/allied health professional servicesTimely access to diagnostic servicesTimely access to diagnostic servicesExpanded 24 x 7 access to essential services: spontaneous consults & emergent careExpanded 24 x 7 access to essential services: spontaneous consults & emergent care

Reduced Health Professional/Health Worker IsolationReduced Health Professional/Health Worker IsolationRetention and recruitment tool for medical and health staff working in rural and remoteRetention and recruitment tool for medical and health staff working in rural and remotecommunitiescommunitiesSpecialized educational programming for Community NursesSpecialized educational programming for Community NursesCoordination and integration of regional health servicesCoordination and integration of regional health servicesSupport network for community health staffSupport network for community health staff

Improved Well-being and Healthy ChoicesImproved Well-being and Healthy ChoicesContinuity of Care FocusContinuity of Care FocusReduced wait times for treatment and follow-upReduced wait times for treatment and follow-upReduced travel burden on individuals and familiesReduced travel burden on individuals and familiesImproved access to a broad range of patient support and health promotion servicesImproved access to a broad range of patient support and health promotion services[patient education programming, pre-admission clinics, wellness campaigns)[patient education programming, pre-admission clinics, wellness campaigns)


What is KeewaytinookWhat is KeewaytinookOkimakanak’sOkimakanak’s Role? Role?

ModellingModelling: Developing and applying a: Developing and applying aworking First Nations telehealth model –working First Nations telehealth model –training, scheduling, clinical referrals andtraining, scheduling, clinical referrals andprotocolsprotocols

Demonstration/ConsultationDemonstration/Consultation: Identifying: IdentifyingFirst Nations telehealth expectations andFirst Nations telehealth expectations andprioritiespriorities

Partnership DevelopmentPartnership Development: Working with: Working withlocal, regional and national bodies to deviselocal, regional and national bodies to deviseand implement sustainable telehealthand implement sustainable telehealthservicesservices

MigrationMigration:: Supporting the regional migration Supporting the regional migrationof telehealth services to other First Nations inof telehealth services to other First Nations inthe Sioux Lookout Health Zonethe Sioux Lookout Health Zone

Creating aTelehealth

Toolkit


When Can Telehealth Make a Difference?When Can Telehealth Make a Difference?

61%

11%6% 5% 3%

14%

Consultation & Follow-up Medevac Diagnostic ImagingSurgery Prenatal Confinement All Other

Reason for Patient Transfers Sioux Lookout Health Zone April 2001 to March 2002

Where telehealthmakes a

difference now


Where Telehealth Makes a DifferenceWhere Telehealth Makes a Difference

The Sioux Lookout HealthThe Sioux Lookout HealthZone ranks first in healthZone ranks first in healthtransportation spending for thetransportation spending for theOntario Region of HealthOntario Region of HealthCanada’s First Nations andCanada’s First Nations andInuit Health Branch.Inuit Health Branch.

In 2001, Non-Insured HealthIn 2001, Non-Insured HealthBenefits reported transportBenefits reported transportcost in the SLHZ of more thancost in the SLHZ of more than$8.3 million. In FY 2001-2002,$8.3 million. In FY 2001-2002,this cost had increased tothis cost had increased tomore than $12.2 million.more than $12.2 million.

March 8th: March 8th: The network carries its The network carries its first telehealth session connecting first telehealth session connecting family members at Sick Kid’s Hospital family members at Sick Kid’s Hospital and family members at the Poplar Hill and family members at the Poplar Hill Nursing Station. Nursing Station.


11stst Drawer Services Drawer Services

Moving from this… …to this too!

Comprehensive Community-basedAccess to Specialist Services


22ndnd Drawer Services Drawer ServicesContinuing Health Education

• CME: Emergency Medicine

• CNE: Adolescent psychiatry

• Patient Education : e.g.Diabetes management

• Health Worker training –Healthy Babies, Home andCommunity Care, MentalHealth…


33rdrd Drawer Services Drawer ServicesResponding to unique health informatics nees needs of

isolated First Nations communities: Store and Forward andDiabetic Retinopathy Screening sub-projects


44thth Drawer Services Drawer ServicesTeleradiology and Regional PACS

Regional Imaging Archive


The 5The 5thth Drawer Services Drawer Services

Make sure Band Council’s andMake sure Band Council’s andlocal people fully support the newlocal people fully support the newservice, answer their questions;service, answer their questions;Find a local champion who willFind a local champion who willlead telehealth development;lead telehealth development;Know what telehealth services areKnow what telehealth services aremost important to people in themost important to people in thecommunitycommunityIdentify a private and secureIdentify a private and securetelehealth room in the Nursingtelehealth room in the NursingStationStationIdentify and train a local telehealthIdentify and train a local telehealthCoordinator and backupsCoordinator and backupsTake ‘baby steps’ and focus onTake ‘baby steps’ and focus onproviding an excellent service!providing an excellent service!

Change Management: Migrating Lessons Learned to otherFirst Nations in the Sioux Lookout Health Zone


Challenges Moving ForwardChallenges Moving Forward

Sustainability & ScalabilitySustainability & ScalabilitySupporting the core service beyond theSupporting the core service beyond theCHIPP funding periodCHIPP funding periodMoving from Project to Program statusMoving from Project to Program statusHorizontal and Vertical Service integrationHorizontal and Vertical Service integration


http://http://telehealth.knet.catelehealth.knet.ca

Documents

The KO/NORTH Telehealth Partnership · Sick Kid’s Hospital, Sunnybrook, Centre for Addictions and Mental Health and the University Health Network; November, 19, 2002 Presentation