Despite recent improvements and supplemental health benefits, the quality of health care delivered to Canadian First Nations continues to be inequitable. Jurisdictional problems (e.g., lack of cooperation and coordination, etc.) have been reported since the federal, provincial, and local First Nations governments share responsibility for the delivery of health care in some remote and isolated First Nations communities. These jurisdictional problems have resulted in a lack of interagency communication and collaboration which may negatively impact the quality of health care delivered.
An initial needs assessment was conducted with First Nations-based health care workers of three remote and isolated First Nations communities of northern Ontario, Canada, during October 2010. Results indicated that introducing a collaborative health informatics system could be a viable option to improve the coordination of healthcare services. Thus, a follow-up needs assessment was conducted with one of the study communities to gather additional data.
Two focus groups and five semi-directed interviews were conducted with adult key informants representing the federally- and provincially-funded healthcare facilities in Fort Albany First Nation. Collected qualitative data were transcribed verbatim and analyzed using a modified grounded theory analytic approach. The results from this study indicated that there was an improved level of interagency communication and collaboration. Differing legislation, multiple jurisdictions, and the presence of unregulated health care workers were reported to impact the level of interagency health information sharing. Participants also mentioned difficulties (e.g., time-consumption, burdensome) with hand-written patient charting and reporting; thus, they suggested introducing health information technology to improve access and visualization of health information. Participants also suggested two initiatives (e.g., Circle of Care, amalgamating healthcare facilities) to overcome the jurisdictional barriers.
The role and organization of government agencies appeared to negatively influence aspects of health care delivery in the remote and isolated First Nations study community. By addressing previously noted barriers and improving access to health information, a collaborative health informatics system has the potential to facilitate interagency communication, collaboration, and health information sharing. Since legislation and the fragmentation of healthcare agencies impacts the ability of agencies to use the same health information technology, re-structuring the organization of health care delivery may be a potential solution to improve the delivery of health care in remote and isolated First Nations communities.
|Keywords:||Collaborative Health Informatics System, WIDE Toolkit, First Nations Communities, Health Information Sharing|
PhD Candidate, Department of Environment and Resource Studies, University of Waterloo, Waterloo, Ontario, Canada
Distinguished Professor Emeritus, David R. Cheriton School of Computer Science, University of Waterloo, Waterloo, Ontario, Canada
Professor, Department of Environment and Resource Studies, University of Waterloo, Waterloo, Ontario, Canada
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