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David Willis



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  • OS25 - Connecting Care: Virtual Realities (ID 30)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 6/07/2017, 10:30 AM - 12:00 PM, Room 201EF
    • OS25.02 - Child and Adolescent Psychiatry Delivered to the Inuit of Nunavut (ID 154)

      David Willis, Clinical Informatics/Telemedicine, The Hospital for Sick Children; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: Participants will hear and discuss learning’s on service delivery from a Physician perspective on how models of care are evolving to address unique cultural, environmental and societal factors. Participants will have a clear understanding of the clinical needs and requirements in serving Inuit populations. Understanding program management perspectives on the funding, technical and contractual requirements needed when developing agreements and launching services with remote communities, regions and governments will be discussed. The experience from the recipient’s perspective will be presented through presentation and discussion of the territories, the communities and individual clinician needs and requirements. Participants will leave with a better understanding of programmatic needs, clinical requirements and cultural competencies needed when creating a sustainable long term partnership for the delivery of Psychiatric care with Aboriginal and Inuit partners.

      Methodology/Approach: Nunavut is Canada’s newest Territory, home to the Inuit people who have inhabited Nunavut “our land” over 1000 years. In the last 100 years this region has seen its greatest changes. Mental health issues such as Developmental Trauma, Suicide, Isolation and Addictions are exploding in most communities. Suicide rates for Inuit are among the highest in the world at 11 times the national average, rates for young Inuit men are 28 times higher. (Mental Health Commission of Canada, 2012) Aboriginal and Inuit people have a holistic view of mental wellness, a state of balance with family, community and the larger environment. European models of treatment that remove the person from their surroundings tend not to work. (Khan, 2015) Estimates suggest 30 to 40% of children in out-of-home care are Aboriginal, yet Aboriginal children represent fewer than five per cent of children in Canada. (Mental Health Commission of Canada, 2012) Despite this, there are experiences of collaboration, creativity and empowerment that are leading to successful outcomes for patients and families.

      Finding/Results: Through video conferencing technology Child and Adolescent Psychiatry was introduced to the Territory in 2013, partnering remote nursing stations, mental health teams, nurses and physicians to psychiatric expertise in southern Canada. Clinical assessments, capacity building and education are tailored to each community and clinician group to increase skill sets and support the continuum of care for patients with the goal of allowing patients and families to remain their community.

      Conclusion/Implication/Recommendations: Video conferencing has opened pathways to care previously non-existent within the territory. Relationship development, capacity enhancement, knowledge translation and communities of care are being supported across the territory allowing children and youth to remain in their communities while recieving specialist services. This partnership between Sickkids and the Government of Nunavut has opened the door to further expansion of clincial services delivered through technology to communities and health care organizations. Mental health workers are connected to leading Psychiatrirst as they support families who have historically been shut out of the health care system in Canada.

      140 Character Summary: Technology has enabled the delviery of specialized mental health services to the Inuit of Nunavut creating pathways to care for families, children and clinicians

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  • PS04 - PIA’s to Telehealth: A Journey (ID 13)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Panel Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 6/06/2017, 10:30 AM - 12:00 PM, Room 202CD
    • PS04.03 - The Toronto Telemedicine Colaborative - Strength in Numbers (ID 330)

      David Willis, Clinical Informatics/Telemedicine, The Hospital for Sick Children; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: Telemedicine is transforming the way healthcare is delivered, by breaking down barriers that limit access to care such as geography, maldistribution of expertise, and geography. Telemedicine, has evolved significantly over the past two decades, facilitated by improvements and access to technology, increased provider and patient comfort. Toronto is the largest provider of telemedicine in Ontario, delivering care to primary care sites, such as Family Health Teams, Community Health Centres, Nurse Practitioner-Led Clinics, as well as between tertiary care centres. Throughout Ontario, it has become evident that a collective approach to access and utilization of telemedicine would be beneficial. Toronto is well-positioned to lead innovations and support best practices in telemedicine. The Toronto Telemedicine Collaborative was created with representation from academic health science centres and community level healthcare with the goal of reducing isolated programs while addressing gaps in practice protocols, evaluation, and implementation. This presentation will describe how the Toronto Telemedicine Collaborative was established, the goals and how we are able to ignite the unique experience and perspectives of individuals in breaking down barriers while increasing evidence-based models of telemedicine.

      Methodology/Approach: In early 2014, informal discussions between colleagues at three large academic health centres, the University Health Network, St. Michael's Hospital and the Hospital for Sick Children, on existing barriers within their telemedicine programs illuminated the siloed nature of telemedicine To advance telemedicine in a coordinated way, a collective approach was necessary. An electronic survey was circulated in June 2014 to all the known Toronto telemedicine services. The result was significant interest in developing a collaborative with common goals and terms of reference,. Regular quarterly meetings were established and individuals were given the encouraged to contribute to the agenda of each meeting. Common concerns and opportunities were established, and eventually, government funders were invited to join ongoing meetings

      Finding/Results: The participation is high with over 50 individuals from 20+ organizations. One priority is the forming of a collective voice for government and policy makers, to inform decisions and drive system change. This grassroots approach to system reform shows great promise in becoming a source of consultation by stakeholders to discuss ideas, assess feasibility, and encourage system change. We have become an advocate against decisions negatively impacting the sector, and have become a consortium with significant expertise to inform best practices and evaluation models.

      Conclusion/Implication/Recommendations: Since the TTC collaborative commenced in 2014, there has been increased clarity in telemedicine practices and procedures within our region, a collective approach to addressing barriers and system challenges, an elevated interest in supporting decision/policy makers to understand system factors, and an improved ability to advocate and express concerns and opportunities to stakeholders. We sit as content experts within our sector with funders and policy makers. Future opportunities include development of validated tools, the contribution to collective research opportunities, advocacy to reduce barriers, development of best practices and protocols and a user level voice to ongoing development and expansion of telemedicine. In short, our voices in addressing systemic issues and burgeoning opportunities are stronger together than they are alone.

      140 Character Summary: The Toronto Telemedicine Collaborative has created a unique and powerful voice for Telmedicine best practices, research opportunities and collaboration

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