Overview
The Circumpolar Health Systems Innovation Team (CircHSIT) came together in 2013 and is one of a number of teams in Canada funded through the CIHR Community-based Primary Health Care (CBPHC) Signature Initiative. CircHSIT is designed to provide research evidence to enable the transformation of PHC in remote northern communities in Canada. It aims to achieve this goal through:
- Reviewing and comparing innovative PHC models in terms of context, system design, policy development, and service delivery in the northern regions of circumpolar countries;
- Designing, implementing and evaluating PHC interventions and technology innovations to reduce disparities in access and outcomes between northern and southern Canada;
- Investigating and adapting health facility design, work flow and performance to provide culturally sensitive and clinically effective care;
- Developing community capacity to contribute to and fully participate in health system improvements;
- Collaborating with decision makers in health care to ensure rapid translation and application of research outputs;
- Training the next generation of northern-based researchers and practitioners in PHC-relevant research and sustaining a research-intensive environment in northern institutions;
- Creating northern-oriented health system performance metrics to inform and enrich the national initiative in patient-oriented CBPHC Network.
CircHSIT is international in scope. It builds on considerable prior collaboration, particularly the just completed circumpolar health system review , which describes the key features of northern health care in 8 Arctic States and identifies cross-cutting themes for further research.
The team, which consists of several sub-projects across several Northern jurisdictions, is led and coordinated out of ICHR in Yellowknife. Partners include the Government of the Northwest Territories, the Government of Nunavut, and the Yellowknife Health and Social Services Authority.
The project is funded through CIHR’s Community-Based Primary Health Care initiative.
Sub-Projects
Case Study on Health Systems Stewardship in Circumpolar Regions
Lead: Susan Chatwood, Institute for Circumpolar Health Research & Dalla Lana School of Public Health, University of Toronto
Co-investigators: Adalsteinn Brown, Dalla Lana School of Public Health, University of Toronto
Region: Circumpolar
The data collection for case studies from government sources and the literature was initiated and a review of the literature related to health systems stewardship and performance was conducted. Indigenous values underlying health systems stewardship were highlighted through a workshop format. This work is now informing the case study analysis and circumpolar values underlying health systems stewardship and performance in circumpolar regions. Data synthesis and collection for case studies is ongoing.
Ethics: University of Toronto
Research license no.: NT: 15219; NU: 01 010 14R-M
Contact: katie.obeirne@ichr.ca
Pre-encounter healthcare emergencies – Review of media and Coroner’s reports
Lead: Kue Young, School of Public Health, University of Alberta
Region: NT, NU & Labrador
Northern and Indigenous communities in northern Canada engage in backcountry or ‘on the land’ activities such as hunting, fishing, or picking berries. These activities are often related to cultural practices, subsistence living and food security, and recreation. In the face of rapidly changing climatic conditions, these activities are accompanied by increased risks for navigational challenges and accidents and injuries. This study aims to examine the extent and nature of backcountry emergency events. This information can support communities with the development of infrastructure and dissemination of knowledge related to survival skills, land-based safety, cultural practices, and wilderness first aid. Northern media sources have been identified.
Contact: stephanie.young@ichr.ca
Using EMR to improve chronic disease care and monitoring
Lead: Kue Young, School of Public Health, University of Alberta
Co-investigator: Ewan Affleck, Yellowknife Health and Social Services Authority
Region: NT
This project involves the development of an alerting system through the Electronic Medical Record (EMR) that identifies patients who should be registered with a chronic disease, based on existing information within the patient’s EMR file. The study provides an opportunity to improve detection, follow-up, and ultimately the health outcomes, of patients with a chronic disease. These outocmes will be evaluated as part of the study. Yellowknife Health and Social Services Authority, Telus, and researchers held planning meetings. Software code configuration is currently underway.
Ethics: Stanton Territorial Health Authority Ethics Committee
Research license no.: 15452
Contact: stephanie.young@ichr.ca
Patient transportation and evacuations
Lead: Kue Young, School of Public Health, University of Alberta
Co-investigator: Arto Ohinmaa, School of Public Health, University of Alberta
Region: NT, NU
The patient transportation and evacuations project involves tracking referral patters for transportation and evacuations to identify existing patterns and develop new policies and models so that the referral system can be optimized to improve patient experience and outcomes. Nunavut medical travel data has been shared with researchers. Plans for analysis and further needs are underway. In the Northwest Territories, planning for a research partnership with the Department of Health and Social Services is underway.
Ethics: University of Toronto
Research license no.: NT: 15457 (not required for NU)
Contact: stephanie.young@ichr.ca
Scoping health care spaces
Lead: Gwen Healy, Qaujigiartiit Health Research Centre
Co-investigator: Mason White, John H. Daniels Faculty of Architecture, Landscape, and Design, University of Toronto
Region: NU
The Health Care Space project involves the development of new models for architecture and interior design that incorporate considerations of northern climate and cultures. Recommendations will be put forth to decision makers. Qaujigiartiit Health Research Centre, Government of Nunavut, and researchers are compiling information on existing health facilities to inform on needs in Nunavut.
Contact: taha.tabish@qhrc.ca
Rosie the Robot
Lead: Michael Jong, Labrador-Grenfell Regional Health Authority & Memorial University
Region: Labrador
In remote communities, patients with diabetes are managed by primary care nurses in the local community, in conjunction with family physicians at a distant. The family physicians visits the community every 4-6 weeks. Air-travel to the remotes communities can be challenging because ot the geography and weather. This project will assess whether telehealth via video leads to better management of diabetes. Diabetes management via Rosie (a remote telehealth video robot) started in Main. The evaluation of the project will be based on 2013 Canadian Diabetes Association guidelines.
Scaling diabetes management via telehealth to other remote communities will take place over the next six months.
Contact: nathaniel.pollock@med.mun.ca
Interprofessional Interactions
Lead: Gwen Healy, Qaujigiartiit Health Research Centre
Co-investigators: Josée Lavoie, University of Manitoba and Sabrina Wong, School of Nursing, University of British Columbia
Region: NU
The Inter-professional interactions project involves developing an understanding of the experiences of health care teams that are spread across large geographical areas. In particular, how do nurses in remote communities, and physicians in regional centres interact with each other? How do they carry out joint decision making about patient care? How can the processes be improved to enhance the patient experience and continuity of care? The work will begin with reviewing existing interview data to identify further areas of investigation.
Ethics and research license applications are underway.
Contact: taha.tabish@qhrc.ca