In many remote communities in Northern Ontario, there areseasons when the main link to the outside world is a phone box. TheKNet network has changed that for more than 60 communities in theregion.
It began when the leadership from five First Nations communitiesin Northern Ontario resolved to improve their access to governmentservices and agreed that the right way to do it was to bridge thedigital divide.
The chiefs from these communities worked with five federaldepartments to develop the K-Net network, the telecommunicationsinfrastructure that supports various projects and applications likeTelehealth, e-learning, e-governance and e-commerce, to these 60 orso First Nations communities.
In particular, it has been used to establish Telehealth, whichis a package of online health services delivered directly to someof these communities.
Before Telehealth, someone living in a remote community such asPoplar Hill would be one of 300 residents who could be waiting inthe local clinic to see the only part-time nurse on site. Anyoneneeding further treatment had to fly to Thunder Bay, Sioux Lookoutor even Winnipeg.
This was demanding and stressful in a number of ways. For onething, it was expensive. The Telepsychiatry project, a pilotconducted as part of Telehealth, is a good example. According to anevaluation report the average cost per counseling session beforewas about $2,716. The report finds that under the pilot the costdropped to $710 per session.
The report also notes that before the pilot less than a quarterof a full-time therapist was available for face-to-face treatmentin one community that needed at least two full-time positions. Nowthat community's members have timely access to psychiatric andregular medical treatment through Telehealth. Patients can "see" aspecialist while remaining in their own community – and in theirnative tongue.
In the old system, they often had to travel to cities thatlacked translation services. Moreover, simply being away fromfamily or friends meant most patients were alone and withoutcomfort or support while in hospital.
The new system allows the communities to connect with theoutside world in a number of ways, including videoconferencing,document exchanges such as medical records or X-rays, andinteractive education links.
As a result, residents in remote communities now receiveappropriate care from the comfort of their local health clinic.Their families and friends can visit them without having to travelfor hours.
Moreover, control and management of the new technology and theprograms it delivers are community-driven. As a result, they can bedesigned in ways that will strengthen local languages and culture,as well as giving communities a sense of ownership over theservices.
At the same time, however, pilots such as Telepsychiatry show usthat the new services have limits. It is not a replacement forface-to-face counseling. Community members were clear that they donot want these services to replace existing ones, but rather tocomplement and support them.
Still, projects such as these point in exciting directions andare producing some creative partnerships with important results.They tell us something about where things could be going in thefuture. As remote communities realize that much higher qualityservices are possible, it will create new incentives to exploreoptions.
Moreover, given that there were significant savings forgovernments, these pilots raise questions about how those savingsshould be used. For example, should they be reinvested in newservices that could also be provided through these networks?
One thing is clear. Remote communities should no longer have todo without adequate services. Through community networks such asK-Net, it is possible for the services to come to the patient,rather than the reverse. And communities can have a direct say inhow 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 theMinister of Intergovernmental Affairs in Ontario; MaryantonettFlumian (maryantonett.flumian@servicecanada.gc.ca)is Deputy Head of Service Canada and Associate Deputy Minister ofHuman Resources and Social Development Canada. Both are members ofthe Crossing Boundaries National Council (www.crossingboundaries.ca).