Indigenous citizens in Canada have a long history of being underserved by the healthcare system – often living in remote locations, they must frequently travel to get proper care. Even then, the attention they receive may be inappropriate or culturally insensitive, as exemplified by the recent case of Joyce Echaquan, a 37-year-old Atikamekw woman who died in a Quebec hospital after taking a video of staff insulting her.
Later, Yvonne Boyer, a Métis lawyer and Canadian senator told the Canadian Press, “For every Joyce Echaquan that comes forward, there’s a hundred that have not been heard.”
What’s more, because of the distances that must be travelled, many Indigenous people who need attention simply don’t go – and instead experience a level of health well below that of other Canadians.
Now, an Indigenous organization called Saa Dene has partnered with Canadian telehealth leader Maple, creating a new corporation that will bring more virtual care right into the homes, communities and workplaces of Indigenous people. Called Maple Maskawâhtik, the partnership was first announced late last year and started providing services to a First Nations community in Alberta in February.
“We can treat a large number of people right across the country,” said Dr. Brett Belchetz, CEO and co-founder of Toronto-based Maple. “In Alberta, we have access to hundreds of practitioners, including mental health specialists, who will be available to treat Indigenous patients on an equal basis. We can bring high-level care to Indigenous patients that is otherwise only available in urban centres like downtown Calgary, Edmonton or Toronto.”
Dr. Belchetz noted that because Maple has been scaling up over the past few years, it is already serving over 2 million patients across the country and has many doctors ready to take calls within minutes.
Not only has Maple developed a platform that enables patients to access a doctor quickly; afterwards, the doctor can use the system to arrange lab tests or the delivery of prescribed medications. Maple has a close relationship with Shoppers Drug Mart – Canada’s largest pharmacy chain – and has links to drug stores across the country that can fill prescriptions for patients in remote communities.
Jim Boucher, former Chief of the Fort McKay First Nation and founder of the Saa Dene Group, said that Health Canada, along with the support of Indigenous Services Canada, has a network of nursing stations and facilities throughout communities that can provide lab tests and dispense medications. Maple Maskawâhtik will be working with these providers, too, to optimize care for patients.
Chief Boucher spoke to us in January from Fort McKay, which is near Fort McMurray – the heart of the Alberta oil sands. (When we chatted, he noted that it was a balmy 15-degrees below zero outside his window.) Boucher launched Saa Dene Group in 2020, and it already consists of eight companies, including Maple Maskawâhtik. The others include firms in a variety of sectors such as oil and gas, mining, renewable energy services, education, engineering, digital, and technological innovation.
Boucher commented that healthcare services are currently inadequate in First Nations communities throughout Canada, including the Fort McMurray area. “There’s a doctor shortage here, and we have trouble recruiting doctors,” he said. Maple Maskawâhtik could provide the region with good quality medical care, he asserted.
“Telehealth isn’t new to First Nations, but in the past, it hasn’t met the service needs of communities,” said Jauvonne Kitto, CEO of Saa Dene Group. “The services provided offered a small network and very little mental healthcare supports.”
She explained that it isn’t much help to a patient if a practitioner is only available in 2-4 weeks. In contrast, Maple Maskawâhtik will be providing “on-demand care”, with less than a couple minute waiting period, 24/7, 365 days a year.
“The Maple Maskawâhtik team has made it a priority to provide culturally appropriate training to the care providers, led by the appropriate stakeholders,” said Kitto. “Maple has agreed to make it part of their strategy.” She noted that this is unique among groups providing care in Canada.
Dr. Belchetz noted, moreover, “that Indigenous people are not one homogeneous group. There are many, many groups with different cultural practices and styles of leadership.” Maple will be taking this into consideration, he said.
Mental health is a major area of care – and currently a huge gap in care for Indigenous peoples – that will be given special attention by the venture. According to a 2020 Statistics Canada report, six in ten Indigenous people report that their mental health has worsened since the onset of physical distancing, due to the COVID-19 crisis.
For its part, Saa Dene has ties to many Indigenous groups across Canada and will help build the Maple Maskawâhtik virtual visit service in these communities.
Moreover, the effort won’t be limited to Indigenous groups. The idea is to also promote economic developments for Indigenous companies, including Saa Dene Group and others. These companies will work with Toronto-based Maple to extend virtual care into Indigenous and non-Indigenous communities across Canada.
Dr. Belchetz said at the moment, the biggest hurdle isn’t technological, as the company has the platform to bring services anywhere, anytime. As well, some form of Internet is available in most communities.
Instead, the main issue is a matter of getting the word out to patients that the service is available.
Funding in some cases is also a roadblock. While most provinces have provided funding codes for virtual visits to the practitioner, First Nations reserves fall under the jurisdiction of the federal government. On this front, the federal government is still playing catch-up, and in many jurisdictions Ottawa has yet to provide adequate support to services providers.
In the case of the Alberta Indigenous communities directly working with Maple Maskawâhtik, the communities have seen value in a more collaborative way of delivering and receiving care, said Kitto.
For its part, Saa Dene Group took the initiative in contacting Maple to jointly develop better virtual care in remote and rural communities.
“We did our research,” said Kitto. “We looked at who offers solutions for the entire continuum of virtual care. A Canadian company called Maple stood out, and we reached out to them.”
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