Project 444431

Indigenous children in remote Canadian communities are at risk, as access to specialized medical resources is challenging. In the absence of direct paediatric specialist care, children are often transported unnecessarily to distant care centres, separating them from their families and communities. As sick Indigenous children from these remote communities are presenting to their health centre, a solution that is culturally appropriate, community informed, and enables an early diagnosis, intervention and refined transport triaging must be sought. Virtual care has the potential to address these challenges. Building on lessons learned from our virtual care pilot platform in a remote Northern Indigenous community, the goal of our study is to introduce virtual technology to at least 13 other rural and remote Indigenous communities. Consistent with The Truth and Reconciliation Commission's Calls to Action, Indigenous children will receive timely and culturally safe paediatric healthcare. With 24/7 access to a paediatric intensivist, all sick children < 17 years will be virtually assessed, managed, triaged, and if necessary, receive virtual follow-up. Data from our pilot suggests that this should result in a decreased need for children to be transported out of their communities, and when necessary, expedited to tertiary care. Unfortunately the cultural appropriateness of virtual care in Indigenous communities is unknown, as they have been largely implemented without considering Indigenous notions of wellbeing. A community based participatory research approach will guide the creation of the platform, with subsequent modifications facilitated through perspectives from local care providers and family members post virtual encounter. Ultimately, recommendations will be suggested to guide future virtual healthcare initiatives in Indigenous communities.