New technologies are changing how healthcare services are delivered to communities. The partnering of Information and Communication Technologies (ICTs) to healthcare has created delivery services such as telehealth, eChart, Panorama, electronic medical records, community electronic medical records, or “eHealth”. These eHealth services can help to overcome barriers of remoteness and isolation to provide better access to healthcare. Nanaandawewigamig eHealth Unit must advocate that such ICTs are made available to Manitoba First Nations communities and develop an ICT Development Strategy (Training), so that MFNs receive equal access to eHealth and eHealth planning as does the rest of Manitoba and Canada. Back in 2010, MFNs recognized that with the new investments in broadband, connectivity, infrastructure, training, etc., the eHealth strategy needed to be created in a timely fashion so as to not miss existing opportunities. Assembly of Manitoba Chiefs (AMC) eHealth (now called FNHSSM eHealth Unit) met in an advisory capacity nationally, regionally and with as many of the MFNs as possible to disseminate and gather information. Meetings with First Nations on an individual, Tribal Council and workshop basis had occurred over 5 years. The Action Plan was in its initial stages, and was established through guidance and feedback from:
MFNs recognize that with the new investments in broadband, connectivity, infrastructure, training, etc., the eHealth strategy needs to be created in a timely fashion so as to not miss existing opportunities. AMC has met in an advisory capacity nationally, regionally and with as many of the MFNs as possible to disseminate and gather information. Meetings with First Nations on an individual, Tribal Council and workshop basis have occurred over the past 5 years. The Action Plan is in its initial stages, and here AMC eHealth is presenting pieces of the plan that have been established through guidance and feedback from:
The eHealth Long Term Strategy – A Plan for Action 2012-2022 was passed in March of 2012 at Brokenhead Ojibway Nation by the AMC Executive Council of Chiefs, on behalf of the Chiefs in Assembly
There are 6 goals to the eHLTS:
Overall Goal #1: First Nations to define and prioritize long & short term objectives for eHealth in general and align these with the MFNs eHealth Long Term Plan 2012-2022 with the MFNs Health & Wellness Strategy “A 10 Year Plan for Action 2005-2015”.
Overall Goal #2: Use eHealth infostructure* to build better healthcare services in MFN communities to provide more adequate and appropriate healthcare service delivery to FN peoples.
Overall Goal #3: Every First Nation in Manitoba will have High-speed Industrial Strength Connectivity by 2013.
Overall Goal #4: Improve communication networks and FNs involvement in eHealth planning; ensuring FNs have access to eHealth services comparable to the rest of Manitoba and Canada.
Overall Goal #5: Build a MFN Technology Council that is aligned with First Nations rights to self-determination and governance, including the Centre of Excellence and MFNs Privacy Commissioner.
Overall Goal #6: Develop an ICT Capacity Development Strategy.
Manitoba First Nations: Please log into the Portal for your copy of the Manitoba First Nations eHealth Long Term Strategy at: www.fnhssm.com/portal. The FNHSSM Health & Social Portal is for the MFN Health Directors and other health care providers to share their updates, documents, successes, statistics and challenges. The Health Human Resource Inventory module allows communities to determine who the “users” of the eHealth applications would be, and will show what hardware and software requirements are in place for said applications. If you do not yet have a user name and password please create a new account here.
The FNHSSM eHealth team has been working with Manitoba First Nations in the establishment of a Manitoba First Nations Technology Council (MFNTC) to advise on the use of ICTs for the positive development of health, education, economy and all sectors of First Nations society. Participating in the committee are representation from the seven Tribal Councils, MKO, SCO, one Independent north and one Independent south, with the latter represented by two Co-Chair Chiefs respectively. The MFNTC was formally endorsed by the AMC Chiefs-in-Assembly at Sagkeeng First Nation in May of 2009. The MFNTC Secretariat is the FNHSSM eHealth Unit. All initiatives pertaining to the eHLTS are endorsed by the MFNTC and routed to the FNHSSM Board of Directors for final approval. The 3 Committees of the MFNTC are:
Manitoba First Nations: Please log into the Portal for your copy of the AMC Resolutions pertaining to eHealth.
In 2010 the eHealth team worked on a proposal in conjunction with Broadband Communications North (of Keewatin Tribal Council) to have 60 community Information Communication Technology specialists trained under the Human Resources and Skills Development Canada (HRSDC) program of the Government of Canada. The MFNTC spearheaded the Initiative and a separate not-for-profit entity was created in order to receive the funding: the Manitoba First Nations ICT Training Initiative Incorporated (MFNICTTII). The training was delivered by the University of Winnipeg’s Manitoba First Nations ICT Diploma Program. It was offered at two locations, one in Winnipeg at the UW and one in the north at the Atoskiwin Training and Employment Centre of Excellence in Nisichawayasihk Cree Nation (Nelson House), Manitoba. Manitoba First Nations and Tribal Councils provided Letters of Commitment to hire graduates from the program. These First Nations sent applicants selected from their communities to be screened through the MFNICTII selection process with the aim of hiring the graduate from their own administration funding.
The initial intent of the HRSDC proposal was around the development of the MFNs ICT Capacity Development Strategy of which a component is to have First Nations owned and operated Internet Service Provider (ISP) businesses. Student recruitment and later, student attrition, became more of a focus and a challenge, as the HRSDC requirement of maintaining 60 trainees needed to be abided by. Thus, additional work is still required to assist the First Nations communities with securing additional administrative funding for the IT and eHealth realm. BCN and FNHSSM eHealth Unit continue to work with the communities to delve into the ISP model so they can reap the economic development benefits and maintain capacity at the community level. With technically trained people working onsite, the communities can consolidate, optimize, and leverage the ICT infrastructure. By relying entirely on outside resources for technical support and solution, this leaves the local community under-resourced in terms of ICT awareness and support, and the resulting infrastructure will be pieced together, possibly rendering service delivery that is ineffective, unpredictable, and costly.
The outcomes of the training initiative and the lessons learned have now evolved into:
1. The ICT Capacity Development Strategy
2. The eHealth-ICT Training Initiative Proposal
3. The overarching “MFNs Technology Plan” of which a component is the Connectivity Plan, now formally titled the “Building the MFNs Network Initiative: The Gateway to Economic Development Opportunities”.
Manitoba First Nations: Please log into the Portal for your copy of the MFNICTTII Final Report.
The team has worked hard in getting a proposal funded for the Feasibility Study that looks at the costs associated with realizing a First Nations owned and operated network. The five projects of the Feasibility Study are:
1. Northern Modular Datacentre
2. Traditional fibre Deployments
3. Forest Floor/Marsh fibre Deployments
4. Community WiFi
Some of the driving forces of the Building the Manitoba First Nations (MFNs) Network initiatives are:
The list of MFN Telehealth sites can be found at http://www.mbtelehealth.ca/locFirstNations.html. New sites are added as funding is approved from Health Canada’s First Nations and Inuit Health Branch Headquarters. Telehealth enables YOU to visit relatives in the hospital via TV screen, talk to doctors and specialists, even do some pre-op examinations instead of travelling, and encourage health staff to take courses to enhance their knowledge and skills.
eChart Manitoba is available at all FNIHB nursing stations, a few Health Centres and the 2 Federal Hospitals (Percy E. Moore & Norway House). Health Canada and Manitoba eHealth seek to expand deployment to all FN health facilities by 2015. Further information on First Nation health linkages to eChart can be found by visiting: www.connectedcare.ca/echartmanitoba/. If your community has not taken part in an eChart information session yet, please do so to get your community engaged in the said initiative. We look forward to your feedback as we are aware there are challenges with eChart and want to ensure we are representing concerns at the planning tables accordingly.
The Mustimuhw cEMRII (community Electronic Medical Record) project funded by Canada Health Infoway was officially completed in June of 2013. The deployment of the 3 new sites brings the total to 9 that FNHSSM eHealth provides administrative support. On their own initiative, two other communities have obtained funding and are also deploying Mustimuhw. This will bring the total of First Nation sites in Manitoba with a cEMR to 11. Receiving the funding from Infoway allowed us to experience what occurs provincially and nationally with respect to Electronic Medical Record (EMR) deployment. We are now in a better position to deploy more sites when new funding becomes available to Infoway for EMR’s. Next steps include obtaining funding for the cEMRIII project – testing interoperability (data exchange) between cEMR and provincial systems.
The Northern MFNs eMR-cEMR Technical Readiness Assessment project was an initiative undertaken by AMC eHealth at the request of Keewatin Tribal Council and Cree Nation Tribal Health (SCTC) Health Directors. The Northern Regional Health Authority (NRHA) was engaged to do technical assessments of the band health staff, equipment & networks in partnership with AMC on 17 of the First Nations in the NRHA catchment area. The grueling efforts of the staff to complete the assessments within the 8 week timeframe is highly commendable, and the outcomes will give a clearer picture of what is needed in the remote & isolated communities, as well as the larger First Nations. Challenges experienced with the winter weather caused 1 trip out of the 17 to take an unexpected turn. After the crew was finished assessing War Lake Cree Nation, the pilot of the chartered flight had to make an emergency landing in Poplar River as freezing mist caused zero visibility. The eHealth team continues to strive to bring the realities of working in the remote communities to the regional and national tables for consideration in equitable funding formulae. Hopefully funding will be awarded to do the same type of assessments for the Southern communities, and those from the north that did not meet the proposal funding deadline.
|Siksika Health & Wellness Centre Site Visit, Alberta|
Panorama – the electronic public health record that will be used to manage information about immunizations, vaccine inventory, communicable diseases and outbreaks. In Manitoba, Panorama will be used by all public health providers in regional health authorities, Manitoba Health, nursing stations and health centres. It will replace the current provincial immunization registry (MIMS) and other paper based systems. We will make history as we work with the provincial and federal governments on ensuring OCAP is recognized and included in the Information Sharing Agreement that needs to be signed between the community & the province. This leaves our communities empowered to decide what information leaves the community, to whom, and when.
The FNHSSM eHealth unit takes pride in getting commended from our colleagues across the country for our efforts in making sure our communities’ interests are included in all eHealth planning processes possible. We learn from our brothers and sisters all over Canada and the world on how to think outside the box and do things differently.