Dr. Ewan Affleck is a physician practicing in Canada’s Northwest Territories. The remoteness of communities, the vast distances and the inhospitable climate all make health care access a special challenge there.
“Last year we moved 27 per cent of our patients for health-care purposes,” he says. “The question is, can we move information to the patients to provide better care, rather than moving the patient?”
So Dr. Affleck deployed a digital charting system that now serves over half of the Territorys’ residents. It is also attracting attention of healthcare networks worldwide. He started with health informatics at an outreach clinic he runs at a women’s shelter.
Leaving charts in that facility, with its issues of security and privacy, was impossible, so he carried boxes of charts on a trolley. “I thought to myself, there has to be a better way.”
He and his team set up a universal patient-centered clinical charting system to share. For example, a person discharged from a NWT hospital can have hospital providers communicate with caregivers at home, including family physicians, homecare providers, and mental health services.
The NWT has 42,000 people and 33 remote communities. “There’s a real lack of equity of care for those in rural and remote locales,” says Dr. Affleck. “We’re moving people over long distances when what we really need to do is share information over long distances. With things like diagnostic imaging, labs, ongoing expert support, and support tools we can begin to design information systems that allow groups of service providers to furnish services both in person and virtually.”
They plan to put the entire region on this charting system and most health-service divisions. The model can also work in urban centres. Says Dr. Affleck, “It’s not unique to remote settings; it just becomes more compellingly evident in a place like this.”
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