In many remote communities in Northern Ontario, there are
seasons when the main link to the outside world is a phone box. The
KNet network has changed that for more than 60 communities in the
region.
It began when the leadership from five First Nations communities
in Northern Ontario resolved to improve their access to government
services and agreed that the right way to do it was to bridge the
digital divide.
The chiefs from these communities worked with five federal
departments to develop the K-Net network, the telecommunications
infrastructure that supports various projects and applications like
Telehealth, e-learning, e-governance and e-commerce, to these 60 or
so First Nations communities.
In particular, it has been used to establish Telehealth, which
is a package of online health services delivered directly to some
of these communities.
Before Telehealth, someone living in a remote community such as
Poplar Hill would be one of 300 residents who could be waiting in
the local clinic to see the only part-time nurse on site. Anyone
needing further treatment had to fly to Thunder Bay, Sioux Lookout
or even Winnipeg.
This was demanding and stressful in a number of ways. For one
thing, it was expensive. The Telepsychiatry project, a pilot
conducted as part of Telehealth, is a good example. According to an
evaluation report the average cost per counseling session before
was about $2,716. The report finds that under the pilot the cost
dropped to $710 per session.
The report also notes that before the pilot less than a quarter
of a full-time therapist was available for face-to-face treatment
in one community that needed at least two full-time positions. Now
that community's members have timely access to psychiatric and
regular medical treatment through Telehealth. Patients can "see" a
specialist while remaining in their own community b and in their
native tongue.
In the old system, they often had to travel to cities that
lacked translation services. Moreover, simply being away from
family or friends meant most patients were alone and without
comfort or support while in hospital.
The new system allows the communities to connect with the
outside world in a number of ways, including videoconferencing,
document exchanges such as medical records or X-rays, and
interactive education links.
As a result, residents in remote communities now receive
appropriate care from the comfort of their local health clinic.
Their families and friends can visit them without having to travel
for hours.
Moreover, control and management of the new technology and the
programs it delivers are community-driven. As a result, they can be
designed in ways that will strengthen local languages and culture,
as well as giving communities a sense of ownership over the
services.
At the same time, however, pilots such as Telepsychiatry show us
that the new services have limits. It is not a replacement for
face-to-face counseling. Community members were clear that they do
not want these services to replace existing ones, but rather to
complement and support them.
Still, projects such as these point in exciting directions and
are producing some creative partnerships with important results.
They tell us something about where things could be going in the
future. As remote communities realize that much higher quality
services are possible, it will create new incentives to explore
options.
Moreover, given that there were significant savings for
governments, these pilots raise questions about how those savings
should be used. For example, should they be reinvested in new
services that could also be provided through these networks?
One thing is clear. Remote communities should no longer have to
do without adequate services. Through community networks such as
K-Net, it is possible for the services to come to the patient,
rather than the reverse. And communities can have a direct say in
how these services meet their particular needs and goals.
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John Milloy (john.milloy@mia.gov.on.ca)
is MPP for Kitchener Centre and Parliamentary Assistant to the
Minister of Intergovernmental Affairs in Ontario; Maryantonett
Flumian (maryantonett.flumian@servicecanada.gc.ca)
is Deputy Head of Service Canada and Associate Deputy Minister of
Human Resources and Social Development Canada. Both are members of
the Crossing Boundaries National Council (www.crossingboundaries.ca).
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