This past week I was able to experience counselling through telemedicine, which is basically talking to someone through video/webcam, for the first time. Telemedicine allows consults to occur in outlying communities without the practitioner having to travel to their location.
Telemedicine reduces barriers to accessing care, as it allows for more frequent and flexible scheduling compared to site visits alone. Since nurses are the only permanent staff at the health clinics outside of Moose Factory, this is especially valuable for any "specialized" service. Dietetics, physio, and any appropriate medical consults can use telemedicine to consult clients. That is not to say that telemedecine is a replacement for visiting communities, but with limited health care resources it is a valuable complementary service.
Where telemedicine lacks, is the difficulty in connecting with clients over a pixelated video screen. What I expected was somethign similar to skype, where you are basically face to face with the individual, but in reality it is closer to speaking to someone on the opposite side of a room. Since there is often multiple people involved in a consult, the cameras and screens are positioned some distance away from the person, and while you can zoom in, it still makes for an interesting dynamic.
The most difficult issue is sharing resources with clients. Holding food models to the camera, to show what a healthy plate of food looks like or to gain a sense of their pop intake, is far from ideal. In this sense the quality of care suffers when compared to an in person consult, but overall care is improved by greater access.
There is no doubt that telemedicine needs to be balanced with adequate in person care, but I wonder what the future of telemedicine looks like? Will we one day be able to do "home" visits via telemedicine, or maybe consults on smartphones, that would surely improve show rates!
Nutrition North update:
Olivier De Schutter the United Nations special representative on the right to food included a specific section on the Nutrition North Canada program. A couple of sections in paticular caught my eye:
Nutrition North Canada provides subsidies to retailers operating in NNC-eligible communities and to food suppliers operating in southern Canada. The subsidies are intended to be passed on to consumers through lower retail prices for eligible items. However, in the absence of adequate monitoring by those it is intended to benefit, it is unclear whether the programme is achieving its desired outcome.
Nutrition North Canada currently publishes the subsidy per kilogram for each eligible community, but it does not require retailers to inform Aboriginal Affairs and Northern Development Canada or the public of their airfreight costs. As such, the federal Government has no way of verifying if the subsidy is being passed on...
While monitoring of the program has been a huge critisicm from Northern food activists, other concerns surrounding implementation and efficacy of the program were also raised in the special rapporteur's report.
The Special Rapporteur recognizes that neither Nutrition North Canada nor the Food Mail Program could address other factors responsible for the high food costs in northern communities, such as the high cost of energy for heating and refrigeration, electricity generation, building construction, equipment maintenance, etc. Food costs remain higher in the North than elsewhere in Canada for legitimate reasons, but more needs to be done to improve the effectiveness of Nutrition North Canada.
Now that Canada has been investigated by an international organization, I wonder if the government of Canada will take note?
JK
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