In many remote communities in Northern Ontario, there are seasons when the main link to the outside world is a phone box. The K-Net 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 – 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. 064589

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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