A vision of digital health for “all the people”

Hey there, time traveller!
This article was published 11/4/2019 (535 days ago), so information in it may no longer be current.

You don’t have to look very far to hear stories of health systems failing too many people in several First Nations communities across Canada. The long-standing lack of safe drinking water and mental wellness challenges faced by teens undoubtedly need and deserve relentless attention until there are viable and sustainable Nation-based solutions in place.

But what resides in the shadows of these issues of life and death are the overlooked strengths of First Nations health care — the unique way it’s delivered, its cultural foundation of inclusion and sharing as well as the inherent goal of empowering the individual.

While patient engagement may be a newer trend in hospitals and health care agencies across the country, this inclusive approach to health care is not new in First Nations communities. And it’s not by way of committee or policy posted to a website. It is quintessentially putting the individual and family at the centre of their care.

For example, from early on, communities on Vancouver Island like Cowichan Tribes and the Nuu-Chah-Nulth Tribal Council, have found ways to make health care a joint collaboration. This has included citizens and health care providers sitting down together, creating and sharing health goals, writing notes and charting in an inclusive, patient centric way.

The evolution of health care into the digital realm has only magnified the inclusiveness of First Nations health care. Mustimuhw is a Salish Coast word that means "all the people." It’s also the name of a community electronic medical record and corresponding citizen health portal that centres around the foundational service domains of First Nations health, including home and community care, public health, immunization, maternal health, chronic disease management, mental wellness, Jordan’s Principle and traditional healing. Moving away from paper, Mustimuhw literally puts health information into the hands of citizens by way of smartphone or tablet.

Importantly, it was designed by First Nations for First Nations, with the needs and cultural values of the communities it serves central to its development. It also supports citizens as custodians of their own health information. They have messaging access to their care providers for such things as appointments or questions regarding their health, and they can access information around diagnoses, medications, treatment plans, home care plans and clinical notes – making them more informed partners in their own care.

There is an opportunity to help more First Nations communities access their citizens’ integrated health information and ultimately increase citizens’ empowerment and improve health outcomes. This aligns with the focus of Canada Health Infoway’s movement for nationwide digital health — ACCESS 2022. Mustimuhw is an early partner in this initiative that brings together the collective expertise of an agile technology sector, the knowledge base of health system experts, and insights and experiences of patients and caregivers.

So, will digital health solve all of the challenges that First Nations communities face? Absolutely not, and there is no denying there is much more work to be done in a variety of areas. However, if more people are engaged and empowered in their own health it can only move us in the right direction.