Khan I, Ndubuka N, Stewart K, McKinney V, Mendez I
First Nations and Inuit Health Branch, Health Canada, Saskatchewan Region, Regina, SK.
Northern Inter-Tribal Health Authority, Prince Albert, SK.
Can Commun Dis Rep. 2017 Jun 1;43(6):120-124. doi: 10.14745/ccdr.v43i06a01.
Saskatchewan is a province of over one million people and over 13% are Indigenous peoples, many of whom live on reserve lands. Despite continued efforts, access to health care remains a significant challenge for these Indigenous people, especially those in the North.
To address this challenge, Saskatchewan's health care providers have been incorporating the use of technology for various health services. This paper describes various ways technology has been used in First Nations communities in Saskatchewan.
Several pilot projects between First Nations leaders and health care providers, in the communities as well as in the urban setting, have taken place over the past 10 years. Information on these pilots was supplemented with literature reviews and consultations with colleagues at the Northern Inter-Tribal Health Authority, the First Nations and Inuit Health Branch (FNIHB), Health Canada and lead physicians for services to the North.
Numerous technologies have shown promise in aiding the timely delivery of high quality health care. Remote Presence Robotic Technology (RPRT) is a form of telemedicine that creates the sense that a clinician is at the patient's side; enabling clinical services to be provided remotely and in real time. Increasing access to internet services and providing computer tablets to community health nurses have improved patients' access to clinical care and to vital health care information. Robotic ultrasonography has been used to provide onsite care for pre-natal patients. The provision of cell phones to HIV-positive patients has improved compliance with anti-retroviral therapy and has resulted in better clinical outcomes. The Xpert MTB/RIF ( complex / resistance to rifampicin) is an automated device that, through analysis of raw sputum samples, can identify the presence of with greater speed, sensitivity and specificity than the conventional acid-fast bacilli (AFB) smear. Similarly, telemedicine remote communications equipment is being used for patient care across communities. Panorama is a comprehensive, integrated public health information system designed for public health professionals and is currently being introduced in 21 communities in Saskatchewan.
Not only do these innovative technologies appear to improve access and enhance the quality of timely care in remote communities but they also bring comfort to patients, prevent unnecessary transportation and minimize time away from work and family. Although these technologies are not a panacea for some of the determinants of health that can affect the incidence and severity of infectious diseases in First Nations, they do appear to address some of the geographic challenges faced in providing health services in remote communities.
萨斯喀彻温省有超过一百万人口,其中超过13%是原住民,他们中的许多人生活在保留地上。尽管不断努力,但获得医疗保健对这些原住民来说仍然是一项重大挑战,尤其是北部的原住民。
为应对这一挑战,萨斯喀彻温省的医疗保健提供者一直在将技术应用于各种医疗服务中。本文描述了技术在萨斯喀彻温省第一民族社区中的各种应用方式。
在过去10年里,第一民族领袖与医疗保健提供者在社区以及城市环境中开展了多个试点项目。通过文献综述以及与北部部落间卫生局、第一民族和因纽特人健康处(FNIHB)、加拿大卫生部的同事以及为北部提供服务的首席医生进行磋商,补充了这些试点项目的信息。
众多技术在协助及时提供高质量医疗保健方面显示出前景。远程临场机器人技术(RPRT)是一种远程医疗形式,能营造出临床医生就在患者身边的感觉;可实现远程实时提供临床服务。增加互联网服务的接入并为社区健康护士提供平板电脑,改善了患者获得临床护理和重要医疗保健信息的机会。机器人超声检查已用于为产前患者提供现场护理。为艾滋病毒呈阳性的患者提供手机,提高了他们对抗逆转录病毒疗法的依从性,并带来了更好的临床效果。Xpert MTB/RIF(复合/利福平耐药)是一种自动化设备,通过分析原始痰液样本,能够比传统的抗酸杆菌(AFB)涂片更快、更灵敏、更具特异性地识别结核杆菌的存在。同样,远程医疗远程通信设备正用于跨社区的患者护理。全景系统是一个为公共卫生专业人员设计的全面、综合的公共卫生信息系统,目前正在萨斯喀彻温省的21个社区引入。
这些创新技术不仅似乎改善了偏远社区获得医疗服务的机会并提高了及时护理的质量,还为患者带来了便利,避免了不必要的交通出行,并最大限度地减少了与工作和家庭分离的时间。尽管这些技术并非解决影响第一民族传染病发病率和严重程度的某些健康决定因素的万灵药,但它们确实似乎解决了在偏远社区提供医疗服务时面临的一些地理挑战。