Work to Date
Connexion Nordique was born when Dr. Michelle Kwok, then an Allergy and Immunology fellow in training, joined Dr. Johanne Morel, a dedicated pediatrician serving the North since 1981, on a pilot trip to Nunavik. During their visit, they met with local family physicians, head nurses, and most importantly, patients. A clear need emerged - consistent access to allergy care. Specifically, concerns focused on drug allergy de-labeling, crucial for managing conditions like ear infections (otitis media), asthma, and food and environmental allergies, all prevalent in the region.
The McGill University Health Centre (MUHC) has successfully employed teleconsultations with Inuit and First Nations patients during the COVID-19 pandemic. We seek to expand and improve allergy care in Nunavik through a hybrid model of virtual care. Teleconsultation serves as a valuable tool for initial screening, followed by the possibility of in-person visits at MUHC for advanced procedures such as food or drug challenges.
However, our efforts face challenges, notably a high no-show rate for both in-person and telehealth visits. Furthermore, due to prolonged wait times for travel down South and lack of access to local medical charts, traditional initial in-person consultations are often challenging due to lack of a thorough medical history. We recognize the need for a solution to ensure timely consultations whereby patients can actively participate in their healthcare, fostering better communication and understanding.
Purpose of the study
Building upon the success of our pilot initiative and in collaboration with the McGill University Health Centre (MUHC) Allergy Division, we propose implementing a virtual care model connecting allergy specialists at MUHC with patients at local Northern CLSCs. This approach involves initial consultations via video conferencing combined, when appropriate, with locally performed allergy testing.
Initial consultations conducted via video conferencing will enhance access to specialized allergy care, bridging geographic distances between patients and specialists. This model ensures timely and culturally appropriate care for Indigenous patients.
Virtual Consultations
We will train local physicians and nurses at CLSCs to perform essential allergy-related procedures, including skin prick testing (aeroallergens and food allergens), management of anaphylaxis, and drug-provocation testing (e.g., amoxicillin). This empowers local healthcare professionals and reduces unnecessary patient travel.
Local Expertise
In-person visits at MUHC will be reserved exclusively for cases requiring advanced procedures or specialized care. This strategy optimizes resource use and ensures that patients receive the most appropriate care without unnecessary travel.
In-person Visits
As a future step, we aim to recruit a dedicated full-time or part-time local liaison nurse. This professional will play a crucial role by regularly contacting patients, scheduling appointments, performing selected allergy procedures, and acting as an interpreter during teleconsultations. This initiative will enhance patient experience and contribute significantly to the program's sustainability.
Local Liaison Nurse
Employing video conferences for initial consultations will enhance accessibility and bridge the geographical gap between patients and allergy specialists. This approach ensures timely and culturally appropriate care for Indigenous patients.
Virtual Consultations
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In-person visits at MUHC will be reserved for cases requiring specialized attention or advanced procedures. This approach optimizes resources and ensures that patients receive the most suitable care without unnecessary travel.
Strategic In-person Visits
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We plan to train local MDs and RNs at CLSCs to conduct essential allergy procedures such as aeroallergen and food skin testing, anaphylaxis management, and amoxicillin/drug provocation challenges. This not only empowers local healthcare professionals but also streamlines the process for patients, reducing the need for travel.
Local Training
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As a future project, we aim to hire a full-time or half-time local liaison nurse. This dedicated professional will play a vital role in contacting patients regularly, scheduling appointments, performing allergy procedures, and serving as an interpreter during teleconsultations. This initiative not only enhances patient experience but also contributes to the long-term sustainability of the program.
Local Liaison Nurse
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Key Features of the Proposed Program
Anticipated Impact
Saputjiqatigiit is more than just a program – it's a bridge to better health for Nunavik's Inuit communities. Here's how we envision our multi-pronged approach making a positive impact:
1. Improved Access
Imagine eliminating the need for long-distance travel for allergy care. Saputjiqatigiit will bridge geographical barriers, ensuring timely and culturally sensitive consultations with allergy specialists right within Nunavik communities.
2. Financial Relief
Traveling for medical care can impose a significant financial burden. Our program aims to alleviate this stress by reducing the need for patients to travel south. This benefits both individuals and the healthcare system as a whole.
3. Quality Measurement and Publication
We will diligently track and publish the program's impact on the quality of care delivered. This data will be instrumental in creating a replicable framework – a blueprint for other specialties at MUHC to adopt virtual care approaches, ultimately transforming healthcare delivery in remote and northern regions of Canada.