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In May of 2005, Keewaytinook Okimakanak and Canada Health Infoway initiated a project to codify and document the processes and systems developed as part of the KO Telehealth implementation process and to summarize lessons learned and emerging best practices in delivering telehealth services – the use of secure videoconferencing to improve and enhance access to clinical and health education and training services – in isolated First Nations.

As Canada’s largest and busiest First Nation governed telehealth network, this work anticipates widespread roll-out of Aboriginal and First Nations telehealth initiatives and supports shared objectives of improving telehealth coverage in isolated Aboriginal communities, increasing clinical utilization of telehealth services and supporting the adoption and diffusion of telehealth innovations by health service providers and First Nations and Aboriginal people in Canada.

The project was led by the Keewaytinook Okimakanak Research Institute (KORI – http://research.knet.ca) and supported by KO Telehealth and K-Net managers and approved by the Keewaytinook executive. Brian Walmark led the project team at KORI and Krista Balenko at Canada Health Infoway. Products were developed by Jesse Fiddler, Cal Kenny, Wes McKay, Franz Siebel, John Rowlandson, Florence Woolner and Jennifer Morrow. KORI would like to thank community members in Sandy Lake and Keewaywin First Nation for their participation in focus group interviews and Community Telehealth Coordinators Ida Fiddler and Joshane Fiddler for their guidance and assistance during the community engagement sessions. ... Click here to read the entire PDF document (144 pages)

Table of Contents

PREFACE .... 1
PRODUCTS .... 1

PART 1: SUMMARY OF KO TELEHEALTH BUSINESS PROCESSES .... 2

SECTION A: ORGANIZATIONAL STRUCTURE AND HUMAN RESOURCES .... 3

• KO Telehealth Organizational structure .... 3
• KO Telehealth Job Descriptions .... 5
• KO Telehealth Start-up Roles and Responsibilities .... 16
• Major Human Resource Lessons Learned .... 25

SECTION B: COMMUNITY OUTREACH AND TRAINING .... 29

• Lessons Learned: Community Telehealth Coordinator Outreach .... 29
• Community Telehealth Coordinator Remote Training Plan .... 33

SECTION C: HEALTH SERVICE PARTNERSHIPS, DEPENDENCIES AND RISKS .... 40

• First Nations Partnership Development .... 40
• Effects of Nurse/Physician Turnover on Telehealth Service Delivery .... 46
• Telehealth Service Development Risk Mitigation .... 48

SECTION D: MANAGEMENT SYSTEMS .... 57

• KO Telehealth Governance Structure .... 57
• KO Telehealth Business Practices .... 59
• KO Telehealth Annotated Policies and Procedures .... 62

PART 2: FIRST NATIONS TELEHEALTH ENGAGEMENT .... 70

SECTION A: FIRST NATIONS ENGAGEMENT STRUCTURES, STRATEGIES AND COMPETENCIES .... 71

• Annotated Engagement Diagram .... 71
• Communication Tools and Approaches .... 75

SECTION B: EVALUATING EFFECTIVENESS AND COMMUNITY SATISFACTION .... 82

• Timeline and Diagrammatic Summary of Evaluation Framework Design .... 82
• Keewaytinook Okimakanak Indicators, Milestones and Benchmarks for Success.... 85
• Matrix of Evaluation Requirements .... 89
• Process Diagrams and Summary of Community Feedback .... 91

SECTION C: MIGRATING TELEHEALTH SOLUTIONS .... 92

• Migration Requirements with Lessons Learned and Considerations .... 92
• Overcoming Health Service Provider Barriers .... 103
• Observed Benefits of a Wellness Service Model .... 108
• Matrix of Community Health Needs and How Telehealth Addresses Needs .... 112
• KO Telehealth Development Summary .... 116
• First Nations Telehealth Development Glossary .... 120

SECTION D: Community Telehealth Coordinator Vignettes .... 123

PART 3: FIRST NATIONS TELEHEALTH NETWORK SERVICES MODEL .... 124

SECTION A: TELEHEALTH NETWORKING TOOLS AND SERVICES IN REMOTE FIRST NATIONS HEALTH CENTRES .... 125

• Interactive Multi-Media Flash Presentation .... 125

SECTION B: IMPLEMENTING AND SUSTAINING NETWORK SERVICES .... 126

• Sustainability Challenges and Lessons Learned .... 126
• Inventory of Network Services Delivered .... 130
• Partnerships Between KO Telehelath and First Nations Communities .... 133
• Network Security Measures .... 137
• K-Net/KO Telehealth Historical Development Timeline .... 138