Healthy Living in the North

Available now: Summer edition of NH’s public magazine

Check out the latest issue of NH’s public magazine, now available online in flipbook form: Northern Health: Health and Wellness in the North, Summer 2019.

Featuring articles on dementia care, telehealth, the Healthy Terrace program, a new Gitxsan phrasebook in Hazelton, vaping, the NH Connections bus, and more, the magazine will also be distributed soon in print — watch for it in a health care facility near you!

The cover of the summer 2019 edition of Northern Health: Health and Wellness in the North is pictured. The cover features two young boys on the edge of a lake, looking out.

Read the latest issue of NH’s public magazine!

Your feedback and suggestions on the magazine are welcome – email communications@northernhealth.ca.

Anne Scott

About Anne Scott

Anne is a communications officer at Northern Health; she lives in Prince George with her husband Andrew Watkinson. Her current health goals are to do a pull-up and more than one consecutive “real” push-up. She also dreams of becoming a master’s level competitive sprinter and finding a publisher for her children’s book on colourblindness. Anne enjoys cycling, cross-country skiing, reading, writing, sugar-free chocolate, and napping -- sometimes all on the same day!

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Telehealth shrinks the distance between you and your health care provider

Gord looking at a laptop with his health care specialist on the screen.

With telehealth, a health care appointment is a few key strokes away – like this appointment between Gord in Prince George and his speech language pathologist in Vancouver.

Have you ever driven to Vancouver for a doctor’s appointment that only took 10 minutes?

Apart from the time spent on the road, you probably had to miss work or other activities, and arrange care for loved ones — all while dealing with the stress and cost of travelling.

But things are changing.

It’s now possible for Northerners to visit distant health care providers from their local doctor’s office or health care centre — or even from their own homes.

Telehealth, a service that lets patients connect with health care providers over live video, is available in many Northern BC communities.

Gord Simmons, a client from Prince George, likes the telehealth option. His speech-language pathologist, Lisa, is in Vancouver, but he can now do appointments with her from his own living room.

“It’s very much a positive experience to do it from home,” he says. “It’s really convenient.”

His wife, Karen, also likes the program. “It’s a more relaxed environment just being at home,” she says. “It’s helpful for me to listen in, too, because I know what to do in ‘homework’ with him.”

Anne Scott

About Anne Scott

Anne is a communications officer at Northern Health; she lives in Prince George with her husband Andrew Watkinson. Her current health goals are to do a pull-up and more than one consecutive “real” push-up. She also dreams of becoming a master’s level competitive sprinter and finding a publisher for her children’s book on colourblindness. Anne enjoys cycling, cross-country skiing, reading, writing, sugar-free chocolate, and napping -- sometimes all on the same day!

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Robson Valley communities opt for virtual health care to improve rural emergency services

(Editor’s note: This article first appeared in our staff publication, The Northern Way, Fall 2018 edition. Read the full issue here.)

Health care providers posing with telehealth system.
Health care providers in Robson Valley launched a pilot project in November 2016 to evaluate the benefits of using telehealth to improve Northern Health’s rural emergency services. Here they are testing the system. Back row (L-R): Dr. Stefan Du Toit, family practitioner, Dr. Jatinder Baidwan, Northern Health locum (on the monitor), and Kimberly Duncan, RN; front row (L-R): Raymond Tabeshi, medical student, Brendan Lilgert, nurse practitioner student, and Sussana Gasser, RN. Photo: UBC Digital Emergency Medicine Evaluation Team.

Telemedicine technologies such as real-time videoconference consultations are enabling rural health practitioners to deliver improved emergency health care in the Robson Valley.   

Dr. Ray Markham, a general practitioner based in Valemount, BC, and Chief of Staff for Robson Valley, is one of the physicians spearheading the Robson Valley Virtual Medicine project. He says the “virtual care approach” works like this:

  • Rural family physicians in Robson Valley community clinics/emergency rooms use videoconferencing or secure text messaging to link with emergency physicians in Prince George;
  • Nurses-patients at clinics/emergency rooms in Valemount and McBride use video links to connect with local, on-call family physicians at home; and
  • General practitioners connect virtually with patients at their homes.

“Virtual support of clinicians providing emergency care in the Robson Valley has resulted in a number of patients not having to travel for their care,” says Markham. “And it’s improved the confidence and comfort of nurses and physicians in low volume settings. You realize you’re not alone – someone else has their eyes on the patient and can be supportive.”

Pilot Project Launched

Valemount and McBride are served by a total of five physicians, but on weekends or after hours, only one nurse and one physician provide emergency services to clinics in both areas. That means some patients may have to travel 90 kilometres between McBride and Valemount to actually see the on-call physician. In addition, some patients may have to be transferred to Prince George for care, over 200 kilometres away. Depending on the season, that means ambulance crews can run into inclement winter road conditions like snow and ice, or wildlife on highways. Remote locations also mean that ambulance crews are often out of cell phone range.

Markham credits Dr. John Pawlovich as the person who initially saw the need for virtual emergency health care support in northern rural areas. As the video lead for the Rural Coordination Centre of BC, Pawlovich has been providing telehealth support to First Nations communities for several years, working with the Carrier Sekani Family Services (CSFS) group across northern BC.

Following Pawlovich’s lead, the Robson Valley Virtual Medicine initiative began as a pilot project in November 2016, led by Northern Health and the Northern Interior Rural Division of Family Practice (NIRD). Over the ensuing 18 months, the telehealth approach was used and evaluated in 26 consultations. An evaluation report of the pilot, conducted by the UBC Digital Emergency Medicine Evaluation Team, was released in April 2018. Its findings showed that virtual care improves rural patient care and safety, reduces patient transfer costs, and builds relationships between rural and emergency physicians. Another benefit? It reduces stress for rural physicians, especially in acute situations.

Patients support the telemedicine approach, as well.

“The more hands involved, the better,” says a patient interviewed for the evaluation report. “The experts were right there on hand. It gives great assurance for the patient that they were in good care with two doctors on hand and two doctors on video.”

Building Rural Capacity

Dr. Stefan Du Toit, who co-led the initial testing and use of the Robson Valley virtual medicine system, is also based in Valemount, but also handles emergency calls from McBride. He says with rural doctors consulting with emergency physicians using hand-held cameras or videoconferencing stations, the physicians acquire information directly, then decide if a patient needs to be sutured, for example, or undergo a more complex procedure.

Du Toit says during the pilot, for example, Robson Valley physicians had to do three electrical cardioversions in one week. In that procedure, atrial fibrillation is corrected with an electrical impulse to the heart which resets the heart’s rhythm. Thanks to support from Prince George emergency physicians, the procedures were done locally with no complications, and patients did not have to be transferred to Prince George.

“We usually get trained as students to deal with these types of cases but very few of us have to deal with them commonly as physicians,” says Du Toit. “And when you have someone who can guide you through the case, it helps with education and teaching.”

Adds Du Toit: “Where virtual care helps me significantly is when we’re on call on the weekend – just a doctor and a nurse. We have to keep our hands on the patient. So, if you have a video call linked, you can keep your hands on the patient, and have a conversation in the room. It’s that extra support that you need sometimes. Patients and physicians benefit.”

Embedding Virtual Support

With the pilot project completed, there is still work to do to ensure the virtual medicine project continues to thrive. Among some of the recommendations made by the evaluation team:

  • Roll out stable, easy-to-use technologies slowly, provide training, and ensure IT support;
  • Involve all members of a team-based care model in the virtual care process, including regional and provincial partners such as BC Ambulance Service;
  • Address physician compensation, workload, and time factors to encourage virtual care buy-in;
  • Conduct a cost analysis to verify the cost savings resulting from virtual care.

Markham says the new system has already resulted in improved communication, learning, and understanding between rural and emergency physicians and specialists. Virtual care has also led to improved collaboration between rural family physicians and nurses in Robson Valley communities.

Telemedicine in the North

The pilot project’s success has also resulted in NIRD receiving further funding from the General Practice Services Committee (GPSC) to advance the virtual care work. The GPSC is a partnership of the Government of BC and Doctors of BC.

“It’s evolving all the time and other pieces are being added on to it. For example, a link can be sent to a patient to access videoconferencing by phone, laptop, iPhone or Android device, which enables clinicians to do virtual home visits not only with local patients, but also those in outlying areas,” says Markham.

He adds that communities including Vanderhoof, Fraser Lake, Mackenzie, Burns Lake, and Quesnel have all expressed interest in the virtual medicine project, noting that CSFS communities such as Takla Landing and Tachet have been leading remote telehealth work for years. Du Toit is the co-lead, through NIRD, to get videoconferencing up and running across the north.

“It’s really centred around providing better care for our patients, and support for clinicians,” says Markham. “It’s providing appropriate care with confidence.”

Collaboration has been key to the implementation and success of the pilot project. In addition to co-leads Northern Health and the Northern Interior Rural Division of Family Practice (NIRD), other collaborators involved with the Robson Valley Virtual Medicine project are local physicians, several specialists, and the following organizations:

  • BC Emergency Medicine Network
  • Telus (assisting with telecommunications needs)
  • Northern Partners in Care
  • Rural Education Action Plan
  • Rural Coordination Centre of BC 
  • BC SUPPORT (Support for People and Patient-Oriented Research and Trials) Unit
  • UBC Digital Emergency Medicine Evaluation Team
  • St. Paul’s Hospital Redesign
  • Project Manager Georgia Betkus
Joanne MacDonald

About Joanne MacDonald

Joanne MacDonald is a communications consultant for Northern Health. Prior to joining Northern Health, Joanne worked in the journalism and communications fields in the lower mainland, Whitehorse and Ottawa. She keeps active by taking Zumba and spinning classes.

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Telehealth bridges the kilometers between patients and doctors: NH Board updated on 5-year plan

Healthcare professionals in a telehealth meeting.Imagine being able to see a specialist without having to travel away from your community. Picture your doctor being able to monitor your condition while you’re in the comfort of your own home. How would it feel to ask for a prescription refill without having to go to a clinic? Telehealth is making these possibilities a reality.

The Northern Health Board of Directors received an update on NH’s 2017-2021 telehealth plan for expanding the clinical use of telehealth to reach more people in more places. Telehealth uses different kinds of technology to provide healthcare right in people’s own communities, with no need for travel. Examples include talking to a specialist by videoconference, sharing tests electronically to another hospital, getting physiotherapy by digital monitoring, and sending data from a monitor (such as a heart monitor) directly to your doctor. Telehealth allows for prevention, screening, diagnosis, determining a course of treatment, and clinical advice – in a way that’s very similar to an in-person experience.

“Telehealth is a virtualization of new and existing services that allows for a more intimate experience than a simple phone call can provide,” said Frank Flood, regional manager of Northern Health’s telehealth department. “By using video and peripheral equipment to extend the reach of clinics and specialists, we reduce the physical and financial burden to our patients.”

A telehealth cart.Many different kinds of health care can be provided by telehealth, including:

  • Mental health and addictions
  • Chronic disease
  • Kidney health
  • Child and youth health
  • Pharmacy services
  • Emergency services
  • Specialist consultations

These services and more will be available to Northern Health patients, depending on where they live (note that not all kinds of telehealth will be available in all communities).

Telehealth will improve care in rural and remote communities, and Northern Health will be partnering with the First Nations Health Authority to use telehealth to benefit Indigenous communities. Telehealth will also strengthen healthcare for the elderly and for people who need services around pregnancy, birth, or childcare. Likewise, it can help people living with chronic disease, mental illness, or addiction.

For the first two years of the plan, financial support for expanding telehealth capacity, including continued investment in staffing, tools, and capital equipment (such as refreshing videoconference suites) will come from NH’s existing operational budget. Funding for increasing the capacity of telehealth will also be sought from outside sources, including the Joint Standing Committee on Rural Issues.

Overall, telehealth will reduce the impact of distance and time in bringing health services to people and their families – Northern Health is excited to provide this new level of health care support to Northerners!

Sanja Knezevic

About Sanja Knezevic

Sanja is a communications advisor with Northern Health’s medical affairs department and is based in Prince George. She moved to Canada in 1995 from former Yugoslavia to Fort Nelson where she lived for a few years before moving to Prince George in 2000. Sanja enjoys photography, curling up with a good book, cooking and spending time with her friends and family.

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Overcoming a vast northern landscape

Magazine cover

The latest issue of Healthier You profiles people, programs, and ideas that overcome northern B.C.’s vast geography.

There’s no denying that northern B.C. is enormous! In fact, the area served by Northern Health covers about two-thirds of the province!

This geography brings with it all sorts unique recreation opportunities and, for many people, the chance to walk directly out of your front door into stunning natural environments.

That said, the size and remoteness of northern B.C. can create challenges, too. In the latest issue of Healthier You magazine, we’re looking at programs, ideas, and people who are taking on this challenge head-on!

Learn how technology, travel programs, partnerships, and northern ideas are “shrinking geography”:

In addition to sharing stories about all sorts of unique programs that connect people to services across our region, the magazine also lets you know how to access these services.

Take a look through the latest issue of the magazine online or look for a hard copy of the magazine in local doctors’ offices, clinics, and Northern Health facilities near you! All past issues of Healthier You are also available online.

Vince Terstappen

About Vince Terstappen

Vince Terstappen is a Project Assistant with the health promotions team at Northern Health. He has an undergraduate and graduate degree in the area of community health and is passionate about upstream population health issues. Born and raised in Calgary, Vince lived, studied, and worked in Saskatoon, Victoria, and Vancouver before moving to Vanderhoof in 2012. When not cooking or baking, he enjoys speedskating, gardening, playing soccer, attending local community events, and Skyping with his old community health classmates who are scattered across the world. Vince works with Northern Health program areas to share healthy living stories and tips through the blog and moderates all comments for the Northern Health Matters blog. (Vince no longer works with Northern Health, we wish him all the best.)

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TeleHealth: Bringing kidney care to remote communities

Health care team watching a monitor around a table.

TeleHealth care allows the Kidney Care Team to reach more patients in remote communities!

Within Northern Health’s vast geographical area, residents in rural and remote communities have limited access to specialist care. The vision of the Kidney Care Team (comprised of a physician, nurse, dietician, pharmacist, social worker and unit clerk) is to address this challenge by regionalizing a team-based TeleHealth kidney service, investing in technology, and providing services closer to home (similar to the face-to-face model of care) where patients no longer need to travel long distances to larger centres.

The team recognizes that TeleHealth care will not completely replace face-to-face consultations, but that there is potential to reach more patients in remote communities, including First Nations, and to increase patient engagement with specialist health care services.

Why TeleHealth?

Dr. Singh, a nephrologist on the kidney care team, recalls one patient’s experience:

A new immigrant worker was urgently referred from a remote rural community with very advanced kidney disease. The referral letter stated that he was adamant he was not leaving his community to go and see a specialist. I was able to see him the next day via TeleHealth and after meeting the renal team and receiving education about his condition, he was convinced to come to Prince George on the Northern Health Connections bus for surgery to prepare for dialysis. This gentleman is now doing home dialysis at night and is able to work and earn a living during the day without moving from his community. This is a great example where, connecting via TeleHealth, the kidney team was able to alleviate his fears, avoid unnecessary travel and stress but, above all, deliver the education about his kidney disease and motivate him for home-based dialysis. As a provider, this is immensely satisfying as timely intervention to address an urgent clinical and educational need was met to provide the best care for this patient.

What does “Tele-Kidney-Care” look like at Northern Health? Click the infographic below to download a full-size PDF.

Check out the full version of this article: Northern Kidney Care Team Leads the Way in Expanding Access to Specialist Care in Northern BC

infographic

Tele-Kidney-Care at Northern Health

Justine Derksen

About Justine Derksen

Justine works for Northern Health in Medical Affairs as the Coordinator, Physician Engagement Initiatives in Prince George. Justine loves the north and enjoys the seasonal activities with her husband and adorable Bernese Mountain dog any chance she gets. Justine is currently pursuing her masters of Public Health degree, which she was inspired to pursue through her work with Northern Health. When not at work, Justine enjoys cooking, outdoor recreational activities and crafting.

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