It has been proven to be problematic to have access to
hospital and emergency services in a more distant location in Canada.
Geographical distance can result to poor access to healthcare services and poor
usage of emergency services in the rural areas. Meanwhile, there is an
increased pressure to reduce the infrastructure of hospitals, rationalize
specialized services to provide appropriate amount of procedures and quality of
care within the rural and remote areas. Also, this solicits the movement of
services from hospitals into the communities; however, from the perspective of
capital expenditure and budget cost, it has become a problem to retain the
financial support of small hospitals among rural populations. Attracting
skilled healthcare professionals in the rural and remote areas acts as a
challenge in the advancement of healthcare services among these communities ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.healthpol.2016.05.011","ISSN":"18726054","abstract":"Our
study reviewed policies in 8 high-income countries (Australia, Canada, United
States, Italy, Spain, United Kingdom, Croatia and Estonia) in Europe,
Australasia and North America with regard to hospitals in rural or remote
areas. We explored whether any specific policies on hospitals in rural or
remote areas are in place, and, if not, how countries made sure that the
population in remote or rural areas has access to acute inpatient services. We
found that only one of the eight countries (Italy) had drawn up a national
policy on hospitals in rural or remote areas. In the United States, although
there is no singular comprehensive national plan or vision, federal levers have
been used to promote access in rural or remote areas and provide context for
state and local policy decisions. In Australia and Canada, intermittent
policies have been developed at the sub-national level of states and provinces
respectively. In those countries where access to hospital services in rural or
remote areas is a concern, common challenges can be identified, including the
financial sustainability of services, the importance of medical education and
telemedicine and the provision of quick transport to more specialized
services.","author":[{"dropping-particle":"","family":"Rechel","given":"Bernd","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Džakula","given":"Aleksandar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Duran","given":"Antonio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fattore","given":"Giovanni","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edwards","given":"Nigel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Grignon","given":"Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Haas","given":"Marion","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Habicht","given":"Triin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marchildon","given":"Gregory
P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Moreno","given":"Antonio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ricciardi","given":"Walter","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vaughan","given":"Louella","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Smith","given":"Tina
Anderson","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Health
Policy","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2016","7","1"]]},"page":"758-769","publisher":"Elsevier
Ireland Ltd","title":"Hospitals in rural or remote areas:
An exploratory review of policies in 8 high-income
countries","type":"article-journal","volume":"120"},"uris":["http://www.mendeley.com/documents/?uuid=406ec4e4-b6d6-3b38-b84d-33e1323e39af"]}],"mendeley":{"formattedCitation":"(Rechel
et al., 2016)","plainTextFormattedCitation":"(Rechel et
al., 2016)","previouslyFormattedCitation":"(Rechel et al.,
2016)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Rechel
et al., 2016).
The health communities in the rural and northern areas of
Canada emulates the problems of the healthcare system today. The main issues of
the healthcare system are the inadequate access to healthcare services between
the indigenous and non-indigenous populations in Canada. However, for several
years there has been an increase of physicians, nurses and access to healthcare
services within the rural and remote communities; yet, it seems that having
“more” healthcare practitioners is not enough. The rural health reform depends
on the emphasis of developing a new set of relationship between the rural and
urban centers; on the scale of providing other means of healthcare matches the
current geographical problems, educational challenges and allocation of
resources that will support the Improvement of healthcare capacity within the
localitiesADDIN
CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.12927/hcpap.2018.25508","ISSN":"1488917X","author":[{"dropping-particle":"","family":"Brown","given":"Adalsteinn
D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Healthcare
Papers","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2018"]]},"page":"3-4","publisher":"Longwoods
Publishing Corp.","title":"The challenge of rural and
northern health
systems","type":"article","volume":"17"},"uris":["http://www.mendeley.com/documents/?uuid=a88537c5-a3ba-373a-97bd-ad6c95dab3a7"]}],"mendeley":{"formattedCitation":"(Brown,
2018)","plainTextFormattedCitation":"(Brown,
2018)","previouslyFormattedCitation":"(Brown,
2018)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Brown,
2018).
While
accessibility is one of the five pillars of the Canada Health Act, many
Canadians still face major barriers to their access to health care ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"ISSN":"19135440","abstract":"Many
Canadians living in rural and remote communities face difficulty accessing
mental health services. This has become a pressing issue in the Canadian
healthcare system due to an increased focus on mental health and the high rate
of suicide in rural regions as compared to urban communities. The
inaccessibility of mental health services in rural Canada can only be partially
explained by the lack of psychiatrists working in these areas. Additional
access barriers arise from sociocultural nuances within individual rural
communities, including an increased value placed on self-reliance and
stigmatization of seeking mental health support. It has been challenging for
mental health services to adequately address the vast social, economic and
cultural differences that exist among individual rural communities – a reality
that necessitates holistic mental health programs tailored to the unique
complexities of each community. Nonetheless, programs aiming to improve
accessibility of rural mental health services do exist across Canada, often
employing technology to deliver psychiatric support to rural patients or
provide guidance to rural primary care physicians who care for patients with
mental illness. This narrative review outlines the barriers that are impeding
mental health care in rural Canada, the existing strategies to circumvent these
barriers, and the role of current medical students in the future of rural
psychiatry.","author":[{"dropping-particle":"","family":"Friesen","given":"Erik","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"University
of Toronto Medical
Journal","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2019"]]},"page":"47-52","title":"The
landscape of mental health services in rural
Canada","type":"article-journal","volume":"96"},"uris":["http://www.mendeley.com/documents/?uuid=f2afd4e1-4f99-4b99-bbd6-0c3f73bcf652"]}],"mendeley":{"formattedCitation":"(Friesen,
2019)","plainTextFormattedCitation":"(Friesen,
2019)","previouslyFormattedCitation":"(Friesen,
2019)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Friesen, 2019).Citizens living in rural areas in Canada have been
met with obstacles for a long time to achieve equal access to health care. They
make up 18% of the Canadians, yet only 8% of the Canadian physicians serve them.
In order to improve access and equity of healthcare services, better recruitment
and retention of professional family physicians is essential ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"URL":"https://www.cfpc.ca/uploadedFiles/Publications/News_Releases/News_Items/ARFM
News Release FINAL ENG .pdf","accessed":{"date-parts":[["2019","11","28"]]},"author":[{"dropping-particle":"","family":"The
College of Family Physicians of
Canada","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2017"]]},"title":"Steps
to improving rural healthcare in
Canada","type":"webpage"},"uris":["http://www.mendeley.com/documents/?uuid=cc5886ea-dffb-300c-b442-d6a5fb8aa2a6"]}],"mendeley":{"formattedCitation":"(The
College of Family Physicians of Canada, 2017)","plainTextFormattedCitation":"(The
College of Family Physicians of Canada,
2017)","previouslyFormattedCitation":"(The College of
Family Physicians of Canada,
2017)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(The College of
Family Physicians of Canada, 2017). Access to care that urban residents consider to be routine,
such as services for mental health, counselling, caring for disabled children,
speech therapy, physiotherapy, occupation and job therapy, support groups, etc.
either is rarely found in rural areas or is improved by very short
practitioners ADDIN
CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"URL":"https://www.nlma.nl.ca/News-And-Events/Media/Fact-Sheets","accessed":{"date-parts":[["2019","11","28"]]},"author":[{"dropping-particle":"","family":"Newfoundland
and Labrador Medical
Association","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2010"]]},"title":"Newfoundland
and Labrador Medical Association (NLMA) – Fact
Sheets","type":"webpage"},"uris":["http://www.mendeley.com/documents/?uuid=b4d93a21-3cdd-34bc-8b26-2f4225ad6023"]}],"mendeley":{"formattedCitation":"(Newfoundland
and Labrador Medical Association, 2010)","plainTextFormattedCitation":"(Newfoundland
and Labrador Medical Association,
2010)","previouslyFormattedCitation":"(Newfoundland and
Labrador Medical Association, 2010)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Newfoundland and Labrador
Medical Association, 2010).
Studies in several
countries have shown that suicide has increased significantly in rural
communities in respect of urban populations. Although there is a growing
suicide rate, rural communities do not seem to face a rising mental illness
burden. However, most of the research suggests that mental illness in rural
communities was comparable or reduced compared to urban centers. There has been
a lower risk of depression in rural populations, for example in Canada, in
Romans and colleagues. One reason for a
higher suicide rate in rural communities without a proportionally higher mental
illness rate is that limited access to mental health services leads to rising
adverse outcomes of mental health, including suicide. In a recent study in
Newfoundland, people who live in rural communities have been shown to be very
difficult to access their community-based mental health services, and rural
residents need to travel to large centers to receive treatment. The lack of
psychiatrists working in rural areas can partially explain limited access to
rural mental health services ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"ISSN":"19135440","abstract":"Many
Canadians living in rural and remote communities face difficulty accessing
mental health services. This has become a pressing issue in the Canadian
healthcare system due to an increased focus on mental health and the high rate
of suicide in rural regions as compared to urban communities. The
inaccessibility of mental health services in rural Canada can only be partially
explained by the lack of psychiatrists working in these areas. Additional
access barriers arise from sociocultural nuances within individual rural
communities, including an increased value placed on self-reliance and
stigmatization of seeking mental health support. It has been challenging for
mental health services to adequately address the vast social, economic and
cultural differences that exist among individual rural communities – a reality
that necessitates holistic mental health programs tailored to the unique
complexities of each community. Nonetheless, programs aiming to improve
accessibility of rural mental health services do exist across Canada, often
employing technology to deliver psychiatric support to rural patients or
provide guidance to rural primary care physicians who care for patients with
mental illness. This narrative review outlines the barriers that are impeding
mental health care in rural Canada, the existing strategies to circumvent these
barriers, and the role of current medical students in the future of rural
psychiatry.","author":[{"dropping-particle":"","family":"Friesen","given":"Erik","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"University
of Toronto Medical
Journal","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2019"]]},"page":"47-52","title":"The
landscape of mental health services in rural
Canada","type":"article-journal","volume":"96"},"uris":["http://www.mendeley.com/documents/?uuid=f2afd4e1-4f99-4b99-bbd6-0c3f73bcf652"]}],"mendeley":{"formattedCitation":"(Friesen,
2019)","plainTextFormattedCitation":"(Friesen,
2019)","previouslyFormattedCitation":"(Friesen,
2019)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Friesen, 2019).
Studies on health disparities confirm that geography is a
health determinant. Rural and rural people tend to have poorer health outcomes
than Individuals residing in broader centers. life expectancy for people in
predominantly rural areas is lower than the Canadian averages. It is more
likely that Canadians in rural parts of the country have poorer economic
conditions and less healthy behaviors, which results in higher Overall death
rates. While low-level health areas tend to have small populations and cover
large geographic areas, higher-level regions generally have large populations
and smaller geographical regions ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"URL":"https://www.nlma.nl.ca/News-And-Events/Media/Fact-Sheets","accessed":{"date-parts":[["2019","11","28"]]},"author":[{"dropping-particle":"","family":"Newfoundland
and Labrador Medical Association","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2010"]]},"title":"Newfoundland
and Labrador Medical Association (NLMA) – Fact
Sheets","type":"webpage"},"uris":["http://www.mendeley.com/documents/?uuid=b4d93a21-3cdd-34bc-8b26-2f4225ad6023"]}],"mendeley":{"formattedCitation":"(Newfoundland
and Labrador Medical Association,
2010)","plainTextFormattedCitation":"(Newfoundland and
Labrador Medical Association,
2010)","previouslyFormattedCitation":"(Newfoundland and
Labrador Medical Association,
2010)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Newfoundland
and Labrador Medical Association, 2010).
Health facilities are significantly less concentrated in
remote and rural areas than in urban areas. Therefore, people usually travel
far away to retrieve services which are unavailable locally. It is common to go
travel kilometers to the nearest healthcare facility for people requiring specialized
health services and diagnostic testing. In the northern regions, the issue is
exacerbated by the difficult weather north which renders road or air travel
risky or impractical. The financial burden of travel is not only stressful;
families and communities should find ways to cope without members, parents,
salaried workers or community leaders. Pregnant women in communities without a
hospital must move to a regional center weeks before babies are delivered. This
separation between their families and their homes takes a toll in
relationships, problems with childcare and related stresses ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Browne","given":"Annette","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["0"]]},"title":"Issues
Affecting Access to Health Services in Northern, Rural and Remote Regions of
Canada","type":"report"},"uris":["http://www.mendeley.com/documents/?uuid=6981d744-78a4-315d-b816-289558c29531"]}],"mendeley":{"formattedCitation":"(Browne,
n.d.)","plainTextFormattedCitation":"(Browne,
n.d.)","previouslyFormattedCitation":"(Browne,
n.d.)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Browne,
n.d.).
In contrast, there is a high burden of travel costs in
accessing the necessary treatment for patients in rural communities. It often
requires days or weeks to provide families and social care with extra
accommodation and food prices ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"URL":"https://www.nlma.nl.ca/News-And-Events/Media/Fact-Sheets","accessed":{"date-parts":[["2019","11","28"]]},"author":[{"dropping-particle":"","family":"Newfoundland
and Labrador Medical
Association","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2010"]]},"title":"Newfoundland
and Labrador Medical Association (NLMA) – Fact
Sheets","type":"webpage"},"uris":["http://www.mendeley.com/documents/?uuid=b4d93a21-3cdd-34bc-8b26-2f4225ad6023"]}],"mendeley":{"formattedCitation":"(Newfoundland
and Labrador Medical Association, 2010)","plainTextFormattedCitation":"(Newfoundland
and Labrador Medical Association,
2010)","previouslyFormattedCitation":"(Newfoundland and
Labrador Medical Association,
2010)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Newfoundland
and Labrador Medical Association, 2010).
Problems with healthcare
access are caused by a serious shortage of healthcare providers even for the
most basic healthcare services. Rural communities often have difficulty
accessing primary and community hospitals and retaining access to healthcare
facilities, providing access to clinical clinics, and more specialized
therapies. This increase in the pressure on rural physicians,
nurses and administrators contributes to the existing recruitment and retention
problem. The burden of paying the high cost of travel to the health care
required is also added for people in rural communities. Often means days or
weeks away from family and social support and the additional cost of lodging
and food ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"URL":"https://www.nlma.nl.ca/News-And-Events/Media/Fact-Sheets","accessed":{"date-parts":[["2019","11","28"]]},"author":[{"dropping-particle":"","family":"Newfoundland
and Labrador Medical
Association","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2010"]]},"title":"Newfoundland
and Labrador Medical Association (NLMA) – Fact
Sheets","type":"webpage"},"uris":["http://www.mendeley.com/documents/?uuid=b4d93a21-3cdd-34bc-8b26-2f4225ad6023"]}],"mendeley":{"formattedCitation":"(Newfoundland
and Labrador Medical Association,
2010)","plainTextFormattedCitation":"(Newfoundland and
Labrador Medical Association, 2010)","previouslyFormattedCitation":"(Newfoundland
and Labrador Medical Association,
2010)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Newfoundland and Labrador
Medical Association, 2010).
Professional isolation is very
problematic for rural health care professionals who are often isolated from
regional hospitals and medical specialists, particularly when medical
emergencies arise Geographic distance often contributes to the cost of attending
selected CPE activities and can increase the time to be away from family and
work. Some rural health care professionals, many of whom are the sole providers
of health care in their communities, simply cannot leave their communities to
attend an educational session, regardless of how beneficial it might be for
their patients and their practices ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1440-1584.2006.00763.x","ISSN":"10385282","abstract":"Objectives:
The purposes of this study were to explore the perceived barriers and
challenges to continuing professional education (CPE) access for Canadian
health care professionals and to identify best practices for improving access
to CPE. Design: Key informant interviews and Web-based online surveys were
conducted. Participants: Key informant interviews were conducted with national
CPE accreditation bodies and health professional associations. An online survey
was distributed to health professional education programs, as well as provincial
professional associations, licensing and professional regulatory bodies. Main
outcome measures: The perceived barriers and challenges to CPE access for
Canadian health care professionals and best practices for improving access to
CPE. Results and conclusions: Geographic isolation and poor technological and
telecommunications infrastructure were identified as key barriers to CPE
delivery and access. Financial factors, such as funding to support travel or
cost of attendance, were also identified as major challenges. Tele-education
programming was identified as a best practice approach to improve CPE access,
as were regional CPE activities and self-directed learning programs.
Employer-sponsored initiatives, including staff coverage or locum support, remuneration
for time off and paid travel expenses for CPE participation were also
identified as best practice approaches. © 2006 The Authors; Journal Compilation
National Rural Health Alliance
Inc.","author":[{"dropping-particle":"","family":"Curran","given":"Vernon
R.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fleet","given":"Lisa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kirby","given":"Fran","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Australian
Journal of Rural
Health","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2006"]]},"page":"51-55","title":"Factors
influencing rural health care professionals’ access to continuing professional
education","type":"article-journal","volume":"14"},"uris":["http://www.mendeley.com/documents/?uuid=62fa732d-da9d-4bfb-adc2-79c89279b7cf"]}],"mendeley":{"formattedCitation":"(Curran,
Fleet, & Kirby, 2006)","plainTextFormattedCitation":"(Curran,
Fleet, & Kirby,
2006)","previouslyFormattedCitation":"(Curran, Fleet, &
Kirby,
2006)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Curran, Fleet, & Kirby, 2006).
Not
only are there few services available to people living in northern,
agricultural and remote regions, but there are a limited number of
professionals that provide care. Across rural communities, health care workers,
including physicians, surgeons, dentists and others, usually face higher
turnover (Browne, n.d.). Part of the difficulty of recruiting medical providers
and maintaining them in northern and rural areas is attributed to demanding
working conditions. Long working hours, a shortage of staff, the absence of
additional training, difficulties in the regular continuing education, and a
perceived failure to provide wife and childcare for these obstacles ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Browne","given":"Annette","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["0"]]},"title":"Issues
Affecting Access to Health Services in Northern, Rural and Remote Regions of
Canada","type":"report"},"uris":["http://www.mendeley.com/documents/?uuid=6981d744-78a4-315d-b816-289558c29531"]}],"mendeley":{"formattedCitation":"(Browne,
n.d.)","plainTextFormattedCitation":"(Browne,
n.d.)","previouslyFormattedCitation":"(Browne,
n.d.)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Browne, n.d.).
Across the provinces of Canada, Health Canada;
Northern First Nations; local physicians; and health authorities, have searched
for various creative means of delivering healthcare services in the rural and
northern areas. As a result of this effort, there has been an introduction of
the use of different technologies such as digital and portable diagnostic
devices to provide the necessary healthcare assistance to the rural and remote
population ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.14745/ccdr.v43i06a01","ISSN":"1481-8531","PMID":"29770076","abstract":"Background
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. Objective 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. Methods
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. Results 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 (Mycobacerium tuberculosis complex / resistance to rifampicin) is
an automated device that, through analysis of raw sputum samples, can identify
the presence of M. tuberculosis 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. Conclusion 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
tra…","author":[{"dropping-particle":"","family":"Khan","given":"I","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ndubuka","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stewart","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McKinney","given":"V","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mendez","given":"I","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Canada
Communicable Disease
Report","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2017","6","1"]]},"page":"120-124","publisher":"Infectious
Disease and Control Branch (IDPCB) – Public Health Agency of
Canada","title":"The use of technology to improve health
care to Saskatchewan’s First Nations
communities","type":"article-journal","volume":"43"},"uris":["http://www.mendeley.com/documents/?uuid=b0f68ae2-5a4c-326a-b5ab-7d2fb97ab137"]}],"mendeley":{"formattedCitation":"(Khan,
Ndubuka, Stewart, McKinney, & Mendez, 2017)","plainTextFormattedCitation":"(Khan,
Ndubuka, Stewart, McKinney, & Mendez,
2017)","previouslyFormattedCitation":"(Khan, Ndubuka,
Stewart, McKinney, & Mendez,
2017)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Khan, Ndubuka,
Stewart, McKinney, & Mendez, 2017). World Health Organization defines telehealth care as
the delivery of healthcare services for far distance purpose to improve the
access to healthcare services for people who live in the rural and remote
communities ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1177/1479972316633414","ISSN":"14799731","abstract":"The
challenges of providing quality respiratory care to persons living in rural or
remote communities can be daunting. These populations are often vulnerable in
terms of both health status and access to care, highlighting the need for
innovation in service delivery. The rapidly expanding options available using
telehealthcare technologies have the capacity to allow patients in rural and
remote communities to connect with providers at distant sites and to facilitate
the provision of diagnostic, monitoring, and therapeutic services. Successful
implementation of telehealthcare programs in rural and remote settings is,
however, contingent upon accounting for key technical, organizational, social,
and legal considerations at the individual, community, and system levels. This
review article discusses five types of telehealthcare delivery that can facilitate
respiratory care for residents of rural or remote communities: remote
monitoring (including wearable and ambient systems; remote consultations
(between providers and between patients and providers), remote pulmonary
rehabilitation, telepharmacy, and remote sleep monitoring. Current and future
challenges related to telehealthcare are
discussed.","author":[{"dropping-particle":"","family":"Goodridge","given":"Donna","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marciniuk","given":"Darcy","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Chronic
Respiratory Disease","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2016"]]},"page":"192-203","publisher":"SAGE
Publications Ltd","title":"Rural and remote
care","type":"article","volume":"13"},"uris":["http://www.mendeley.com/documents/?uuid=d6be5576-dea5-3150-9a78-4d40821697de"]}],"mendeley":{"formattedCitation":"(Goodridge
& Marciniuk,
2016)","plainTextFormattedCitation":"(Goodridge &
Marciniuk, 2016)","previouslyFormattedCitation":"(Goodridge
& Marciniuk,
2016)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Goodridge &
Marciniuk, 2016).
The application of telehealth care has the means to address
several problems of the present-day healthcare system by improving the quality,
accessibility, efficiency and effectiveness of the delivery of healthcare
services as well as escalating the advantages of cost reduction. To example, a
significant amount of research studies has indicated that telehealth could
bring about a positive impact on the organizational, educational and
professional aspects of recruiting and retaining healthcare providers among the
rural and remote areas ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1177/2050312116648047","ISSN":"2050-3121","author":[{"dropping-particle":"","family":"Mbemba","given":"Gisèle
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Oumar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gagnon","given":"Marie-Pierre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hamelin-Brabant","given":"Louise","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Simonyan","given":"David
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Open
Medicine","id":"ITEM-1","issued":{"date-parts":[["2016","1","11"]]},"page":"205031211664804","title":"The
influence of a telehealth project on healthcare professional recruitment and
retention in remote areas in Mali: A longitudinal
study","type":"article-journal","volume":"4"},"uris":["http://www.mendeley.com/documents/?uuid=6e614397-3f1b-3b97-b38a-46186fde5803"]}],"mendeley":{"formattedCitation":"(Mbemba,
Bagayoko, Gagnon, Hamelin-Brabant, & Simonyan, 2016b)","plainTextFormattedCitation":"(Mbemba,
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2016b)","previouslyFormattedCitation":"(Mbemba, Bagayoko,
Gagnon, Hamelin-Brabant, & Simonyan,
2016b)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Mbemba,
Bagayoko, Gagnon, Hamelin-Brabant, & Simonyan, 2016b).
With the use of technology, the previously mentioned
struggles of delivering healthcare to remote areas of Canada can be reduced.
The main strategy to reducing limitations currently being used are Telehealth
or other e-consultation services ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1186/s12919-016-0006-0","ISSN":"17536561","abstract":"An
international conference titled \"Transforming Health Care in Remote
Communities\" was held at the Chateau Lacombe Hotel in Edmonton, Canada,
April 28-30, 2016. The event was organized by the University of Alberta’s
School of Public Health, in partnership with the Institute for Circumpolar
Health Research in Yellowknife, Northwest Territories, and the Qaujigiartiit
Health Research Centre in Iqaluit, Nunavut. There were 150 registrants from 7
countries: Canada (7 provinces and 3 territories), United States, Denmark,
Iceland, Norway, Sweden, and Australia. They included representatives of
academic institutions, health care agencies, government ministries, community
organizations, and private industry. The Conference focused on developing
solutions to address health care in remote regions. It enabled new networks to
be established and existing ones
consolidated.","author":[{"dropping-particle":"","family":"Kue
Young","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chatwood","given":"Susan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ford","given":"James","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Healey","given":"Gwen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jong","given":"Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lavoie","given":"Josée","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"White","given":"And
Mason","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"BMC
Proceedings","id":"ITEM-1","issued":{"date-parts":[["2016"]]},"publisher":"BioMed
Central Ltd.","title":"Transforming Health Care in Remote
Communities: Report on an international
conference","type":"paper-conference","volume":"10"},"uris":["http://www.mendeley.com/documents/?uuid=0b5752bd-1097-3ee8-b8c0-ea9055109fbb"]}],"mendeley":{"formattedCitation":"(Kue
Young et al., 2016)","plainTextFormattedCitation":"(Kue
Young et al., 2016)","previouslyFormattedCitation":"(Kue
Young et al., 2016)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Kue Young et al.,
2016). These types of services can increase populations’ access to
healthcare providers ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1177/2050312116648047","ISSN":"2050-3121","abstract":"OBJECTIVES
The telehealth project EQUI-ResHuS (in French, Les TIC pour un accès Équitable
aux Ressources Humaines en Santé) aimed to contribute to more equitable access
to care and support practice in remote regions in Mali. This study explored the
evolution of perceptions concerning telehealth among healthcare professionals
in the four district health centres that participated in the EQUI-ResHus project
and identified variables influencing their perceptions of telehealth impact on
recruitment and retention of health professionals. METHODS One year after a
first survey (T1), a second data collection (T2) was carried out among
healthcare professionals using a 91-item questionnaire. Questions assessing
telehealth use and perceptions and perceived impact on recruitment and
retention of healthcare professionals were rated on a 5-point Likert scale. A
total of 10 independent variables were considered for the analyses. A Wilcoxon
signed-rank test was performed to detect differences between T1 and T2, and a
bivariate linear regression model for repeated measures was carried out to
assess the impact of independent variables on dependent variables. RESULTS There
were no noticeable changes in perceptions related to telehealth influence on
recruitment and retention. Only access to information and communication
technology significantly differed between T1 and T2 according the Wilcoxon rank
test (p = 0.001). Perceived influence of telehealth on recruitment and
retention was mostly explained by attitude towards telehealth, perceived effect
on recruitment and retention and barriers to recruitment and retention.
CONCLUSION Based on our results, telehealth was perceived as having a positive
influence but mostly indirect influence on healthcare professional recruitment
and retention. Also, there were no major changes after 1 year of telehealth
use.","author":[{"dropping-particle":"","family":"Mbemba","given":"Gisèle
Irène Claudine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bagayoko","given":"Cheick
Oumar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gagnon","given":"Marie-Pierre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hamelin-Brabant","given":"Louise","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Simonyan","given":"David
A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"SAGE
Open
Medicine","id":"ITEM-1","issued":{"date-parts":[["2016","1"]]},"page":"205031211664804","publisher":"SAGE
Publications","title":"The influence of a telehealth
project on healthcare professional recruitment and retention in remote areas in
Mali: A longitudinal
study","type":"article-journal","volume":"4"},"uris":["http://www.mendeley.com/documents/?uuid=ba7d6e78-a30c-3f09-8288-736cf893e7a4"]}],"mendeley":{"formattedCitation":"(Mbemba,
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2016a)","plainTextFormattedCitation":"(Mbemba, Bagayoko,
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2016a)","previouslyFormattedCitation":"(Mbemba, Bagayoko,
Gagnon, Hamelin-Brabant, & Simonyan, 2016a)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Mbemba, Bagayoko,
Gagnon, Hamelin-Brabant, & Simonyan, 2016a). By having the technology to support Telehealth it
can connect specialist to those areas, such as psychiatric assessments. This is
done by family physicians, or other primary care givers, being able to
communicate with the specialist, with or without the patient, to discuss
treatment options and care plans. This allows access to physicians in areas
that are not typically accessible, while reducing travel time and costs ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1186/s12919-016-0006-0","ISSN":"17536561","abstract":"An
international conference titled \"Transforming Health Care in Remote
Communities\" was held at the Chateau Lacombe Hotel in Edmonton, Canada,
April 28-30, 2016. The event was organized by the University of Alberta’s
School of Public Health, in partnership with the Institute for Circumpolar
Health Research in Yellowknife, Northwest Territories, and the Qaujigiartiit
Health Research Centre in Iqaluit, Nunavut. There were 150 registrants from 7
countries: Canada (7 provinces and 3 territories), United States, Denmark,
Iceland, Norway, Sweden, and Australia. They included representatives of
academic institutions, health care agencies, government ministries, community
organizations, and private industry. The Conference focused on developing
solutions to address health care in remote regions. It enabled new networks to
be established and existing ones
consolidated.","author":[{"dropping-particle":"","family":"Kue
Young","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chatwood","given":"Susan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ford","given":"James","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Healey","given":"Gwen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jong","given":"Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lavoie","given":"Josée","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"White","given":"And
Mason","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"BMC
Proceedings","id":"ITEM-1","issued":{"date-parts":[["2016"]]},"publisher":"BioMed
Central Ltd.","title":"Transforming Health Care in Remote
Communities: Report on an international
conference","type":"paper-conference","volume":"10"},"uris":["http://www.mendeley.com/documents/?uuid=0b5752bd-1097-3ee8-b8c0-ea9055109fbb"]}],"mendeley":{"formattedCitation":"(Kue
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2016).
Telehealth can also help in educating healthcare
providers that are currently located in remote areas ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Young","given":"Kue","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2013"]]},"title":"Transforming
Primary Health Care in Remote Northern Communities: The Circumpolar Health
Systems Innovation Team
[CircHSIT]","type":"report"},"uris":["http://www.mendeley.com/documents/?uuid=7107bac6-dcdb-3b7e-93cb-801c1910a382"]}],"mendeley":{"formattedCitation":"(Young,
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2013)","previouslyFormattedCitation":"(Young, 2013)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Young, 2013). Best practices are always changing and as healthcare
providers continuous education is very important to providing quality care.
Technology allows these providers to remotely access education seminars and
classes, while allowing them to stay where they are, reducing travel time away
from their practices/jobs. Technology allows for these professionals to be
trained through virtue or augmented realities to improve the variety of care
and treatments available to their patients ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"CADTH","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2018"]]},"title":"Characteristics
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ENVIRONMENTAL
SCAN","type":"report"},"uris":["http://www.mendeley.com/documents/?uuid=e22a7dff-85b8-36ef-adf4-8d0795338ad1"]}],"mendeley":{"formattedCitation":"(CADTH,
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2018)","previouslyFormattedCitation":"(CADTH,
2018)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(CADTH, 2018).
The availability of these services in remote areas of
Canada can also help to recruit and retain healthcare providers as they,
themselves, have the effective means to support their patients ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1177/2050312116648047","ISSN":"2050-3121","abstract":"OBJECTIVES
The telehealth project EQUI-ResHuS (in French, Les TIC pour un accès Équitable
aux Ressources Humaines en Santé) aimed to contribute to more equitable access
to care and support practice in remote regions in Mali. This study explored the
evolution of perceptions concerning telehealth among healthcare professionals
in the four district health centres that participated in the EQUI-ResHus
project and identified variables influencing their perceptions of telehealth
impact on recruitment and retention of health professionals. METHODS One year
after a first survey (T1), a second data collection (T2) was carried out among
healthcare professionals using a 91-item questionnaire. Questions assessing
telehealth use and perceptions and perceived impact on recruitment and
retention of healthcare professionals were rated on a 5-point Likert scale. A
total of 10 independent variables were considered for the analyses. A Wilcoxon
signed-rank test was performed to detect differences between T1 and T2, and a
bivariate linear regression model for repeated measures was carried out to
assess the impact of independent variables on dependent variables. RESULTS
There were no noticeable changes in perceptions related to telehealth influence
on recruitment and retention. Only access to information and communication
technology significantly differed between T1 and T2 according the Wilcoxon rank
test (p = 0.001). Perceived influence of telehealth on recruitment and
retention was mostly explained by attitude towards telehealth, perceived effect
on recruitment and retention and barriers to recruitment and retention.
CONCLUSION Based on our results, telehealth was perceived as having a positive
influence but mostly indirect influence on healthcare professional recruitment
and retention. Also, there were no major changes after 1 year of telehealth
use.","author":[{"dropping-particle":"","family":"Mbemba","given":"Gisèle
Irène Claudine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bagayoko","given":"Cheick
Oumar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gagnon","given":"Marie-Pierre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hamelin-Brabant","given":"Louise","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Simonyan","given":"David
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Open Medicine","id":"ITEM-1","issued":{"date-parts":[["2016","1"]]},"page":"205031211664804","publisher":"SAGE
Publications","title":"The influence of a telehealth
project on healthcare professional recruitment and retention in remote areas in
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et al., 2016a)","plainTextFormattedCitation":"(Mbemba et
al., 2016a)","previouslyFormattedCitation":"(Mbemba et al.,
2016a)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Mbemba et al., 2016a). Another potential available support for remote
healthcare providers is artificial intelligence-this technology can help in
reading diagnostics or test results that could potentially be more accurate
depending on the healthcare providers area of practice ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"CADTH","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2018"]]},"title":"Characteristics
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2018)","previouslyFormattedCitation":"(CADTH, 2018)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(CADTH, 2018). This could also help to evaluate, monitor, and treat
chronic conditions in remote areas.
Having access to more healthcare professionals will
also increase these areas in accessing timely care. Telehealth will help family
physician diagnoses and treat conditions/illness with the guidance of
specialists. As well as reduce the number of patients travelling long distances
to receive care, which can increase the patient level of comfort ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.14745/ccdr.v43i06a01","abstract":"Background:
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.","author":[{"dropping-particle":"","family":"Khan","given":"I","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ndubuka","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stewart","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mckinney","given":"V","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mendez","given":"I","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issue":"6","issued":{"date-parts":[["2017"]]},"title":"The
use of technology to improve health care to Saskatchewan’s First Nations
communities","type":"article-journal","volume":"43"},"uris":["http://www.mendeley.com/documents/?uuid=924184df-be76-351b-80cf-1b733e3e1e48"]}],"mendeley":{"formattedCitation":"(Khan,
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Stewart, Mckinney, & Mendez,
2017)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Khan, Ndubuka,
Stewart, Mckinney, & Mendez, 2017). and
potentially improve their recovery time.
Technology can also improve access to care through
robots or portable machines, such as scanners, or health monitors. TELUS Health
has created peripheral devices that connect to a tablet and transmit data
related to heart failure to a remote nurse for monitoring ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1186/s12919-016-0006-0","ISSN":"17536561","abstract":"An
international conference titled \"Transforming Health Care in Remote
Communities\" was held at the Chateau Lacombe Hotel in Edmonton, Canada,
April 28-30, 2016. The event was organized by the University of Alberta’s
School of Public Health, in partnership with the Institute for Circumpolar
Health Research in Yellowknife, Northwest Territories, and the Qaujigiartiit
Health Research Centre in Iqaluit, Nunavut. There were 150 registrants from 7
countries: Canada (7 provinces and 3 territories), United States, Denmark,
Iceland, Norway, Sweden, and Australia. They included representatives of
academic institutions, health care agencies, government ministries, community
organizations, and private industry. The Conference focused on developing
solutions to address health care in remote regions. It enabled new networks to
be established and existing ones
consolidated.","author":[{"dropping-particle":"","family":"Kue
Young","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chatwood","given":"Susan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ford","given":"James","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Healey","given":"Gwen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jong","given":"Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lavoie","given":"Josée","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"White","given":"And
Mason","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"BMC
Proceedings","id":"ITEM-1","issued":{"date-parts":[["2016"]]},"publisher":"BioMed
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Young et al., 2016)","plainTextFormattedCitation":"(Kue
Young et al., 2016)","previouslyFormattedCitation":"(Kue
Young et al., 2016)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Kue Young et al.,
2016). This allows for the patient to have continuous care while still
living in their desired location or home.
Khan et al. (2017) also discussed the use of portable liver scanner in
remote regions to help in diagnostics ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.14745/ccdr.v43i06a01","abstract":"Background:
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.","author":[{"dropping-particle":"","family":"Khan","given":"I","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ndubuka","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stewart","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mckinney","given":"V","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mendez","given":"I","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issue":"6","issued":{"date-parts":[["2017"]]},"title":"The
use of technology to improve health care to Saskatchewan’s First Nations
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Ndubuka, Stewart, Mckinney, et al.,
2017)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Khan, Ndubuka,
Stewart, Mckinney, et al., 2017). An example is that of a pediatrician using remote
diagnostics to detect infants with pneumonia in more remote regions so that
they then were able to stay in a smaller hospital closer to home instead of
being transported to a larger facility ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"CADTH","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2018"]]},"title":"Characteristics
of Remote and Isolated Health Care Facilities: An Environmental Scan
ENVIRONMENTAL
SCAN","type":"report"},"uris":["http://www.mendeley.com/documents/?uuid=e22a7dff-85b8-36ef-adf4-8d0795338ad1"]}],"mendeley":{"formattedCitation":"(CADTH,
2018)","plainTextFormattedCitation":"(CADTH, 2018)","previouslyFormattedCitation":"(CADTH,
2018)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(CADTH, 2018). Also, there is the use of robots. The Canadian
Medical Association (2018) discuss the use
of remote presence robots to help in delivering care. These robots have been
used to provide mental health services to youth in remote areas ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"CADTH","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2018"]]},"title":"Characteristics
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ENVIRONMENTAL
SCAN","type":"report"},"uris":["http://www.mendeley.com/documents/?uuid=e22a7dff-85b8-36ef-adf4-8d0795338ad1"]}],"mendeley":{"formattedCitation":"(CADTH,
2018)","plainTextFormattedCitation":"(CADTH,
2018)","previouslyFormattedCitation":"(CADTH,
2018)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(CADTH, 2018) as well as perform surgeries. This allows the patient
to have the right health care provider at the right time ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"ISSN":"18443117","PMID":"25870712","abstract":"At
the time of the writing of this article, there are three operational
telemedicine control centers in Bucharest, Targul-Mures, and Iasi; however, the
current telemedicine infrastructure has limited geographic coverage and is
exclusively used in the field of emergency medicine with only few promising
beginnings in the domain of family medicine. Nevertheless, many areas of
Romania are still lacking qualified medical personnel that can perform vital
surgeries thus requiring patients to travel long distances to obtain the health
care services they require. In order to improve the current healthcare infrastructure
and eliminate the difficulties associated with a lack of qualified medical
personnel in rural areas of the country, this article suggests the
implementation of telesurgery as a practical solution. This article will hope
to analyze the applicability of telesurgery by looking at the benefits and
costs of creating a national telesurgery infrastructure, by predicting possible
obstacles in creating such a system and by suggesting ways in which these
obstacles can be avoided. The writing of this article was possible thanks to
interviews, articles, and data obtained from surgeons and medical personnel
that practice in Romania, the Republic of Moldova, Canada, and the United
States of America. A vast majority of technical details has been furnished by
the producers of robotic surgery platforms such as Intuitive
Surgical®.","author":[{"dropping-particle":"","family":"Cazac","given":"C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Radu","given":"G.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal
of medicine and
life","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2014"]]},"page":"137-141","title":"Telesurgery–an
efficient interdisciplinary approach used to improve the health care
system","type":"article-journal","volume":"7
.
3"},"uris":["http://www.mendeley.com/documents/?uuid=dcefbb49-25fa-4cdc-86be-acf1fe82257b"]}],"mendeley":{"formattedCitation":"(Cazac
& Radu, 2014)","plainTextFormattedCitation":"(Cazac
& Radu, 2014)","previouslyFormattedCitation":"(Cazac
& Radu,
2014)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Cazac & Radu,
2014) even when they are not physically in the same location. Some examples
of these robots are “Rosie”, and “Doc-In-The-Box” ADDIN CSL_CITATION
{"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.14745/ccdr.v43i06a01","abstract":"Background:
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.","author":[{"dropping-particle":"","family":"Khan","given":"I","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ndubuka","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stewart","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mckinney","given":"V","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mendez","given":"I","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issue":"6","issued":{"date-parts":[["2017"]]},"title":"The
use of technology to improve health care to Saskatchewan’s First Nations
communities","type":"article-journal","volume":"43"},"uris":["http://www.mendeley.com/documents/?uuid=924184df-be76-351b-80cf-1b733e3e1e48"]}],"mendeley":{"formattedCitation":"(Khan,
Ndubuka, Stewart, Mckinney, et al.,
2017)","plainTextFormattedCitation":"(Khan, Ndubuka,
Stewart, Mckinney, et al.,
2017)","previouslyFormattedCitation":"(Khan, Ndubuka,
Stewart, Mckinney, et al.,
2017)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Khan, Ndubuka,
Stewart, Mckinney, et al., 2017)
Conclusion:
To conclude, Canadian rural and remote areas are
facing the challenge of inadequate healthcare services. A considerable number
of studies have illustrated that geographical diverse populations have
difficulty in receiving the necessary medical treatment due to far distance,
and limited number of healthcare providers. Even though in the recent years
there has been an increase of health care professionals in the rural and remote
settlements of Canada, there are still healthcare disparities among these
areas. For this reason, many of the physicians and other practitioners have
introduced the idea of incorporating the use of technology in the healthcare
system. This innovation will aid at delivering the best quality of healthcare
services to the rural and remote population efficiently and effectively.
Patients that reside in the remote areas will have the convenience of
communicating with their healthcare provider from a distance.
REFERENCES:
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