Improving health outcomes in Canada’s North: A U of T graduate student's practicum experience

Arriving in Yellowknife, with its rural landscape, slightly cooler temperatures and the summer sun shining an average 22 hours a day, Allie Margaret May expected to find a health-care system that was different from Southern Ontario’s urban centres. Instead, the Master of Health Informatics student found that the two regions are more similar than she first thought.

“As I delved into my project, I realized that many of the challenges my patients faced in Ontario were similar to those of the Northwest Territories. Access to the right medical care at the right time is an incredibly universal issue,” said May, who embarked on her practicum placement with the Northwest Territories government this past summer.

As part of the Master of Health Informatics degree at the University of Toronto’s Institute of Health Policy, Management and Evaluation, students are expected to complete a four-month practicum placement with a health-care organization and report on their experience. May worked with N.W.T. chief medical information officer Dr. Ewan Affleck to analyze effective communication models such as eConsultation in order to improve health outcomes.

May (pictured right) participated in the team’s shift to an entirely different model of communication and health information exchange, which was aimed at developing better communication between clinicians and patients.

“It became clear to us that eConsultation was one piece of a much bigger puzzle,” said May. “We realized that we needed to first implement a system that would be able to function on a more robust level as the territory expanded its programs.”

The new system provided clinicians with the ability to access more patient-centred technology that would improve the patient experience.  

One example involved the implementation of secure mobile devices. If patients needing assessment were cut off from treatment or access to a health-care provider because of extreme weather in a rural area, they would not need to be medically evacuated into the city in order to receive treatment. Instead, by utilizing portable technology, they would be able to speak with or have their symptoms assessed by a care provider remotely.

With this new framework in mind, May was given the task of spearheading a health information exchange strategy that would restructure the way clinicians communicate with each other. She surveyed people from all over the Northwest Territories and its surrounding jurisdictions, from nurses in remote rural regions to neurologists in Edmonton, making sure that patient advocacy groups and patients themselves were able to have their voices heard throughout the change process.

“They were very open in allowing me to participate in the decision-making process,” said May. “It was empowering for me as an emerging professional and made me even more passionate about universal access to care, as well as more cognizant of barriers that inhibit that, such as the social determinants of health, which are not always identified.”

May said she will build what she has learned into a business case to make recommendations for next steps in the development of an information network platform.

She called her experience “eye-opening.” Though it was challenging to move outside of her comfort zone, and beyond the familiarity of her surroundings, choosing to accept this practicum in Yellowknife was an exercise in personal development.

“Health Informatics is a dynamic field,” said May. “If you are willing to become an adaptive person with an ability to enter a new environment and succeed, your chances of performing successfully as a health informatician are that much greater.”