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Nunavut Department of Health and Social Services:
IIU Telehealth Network
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Providing a virtual highway between patients and timely, responsive medical care
The mission of the Nunavut Department of Health and Social Services is to promote, protect and provide for the health
and well being of Nunavut residents, in support of leading self-reliant and productive lives.
Challenges
At just under 2 million square kilometres, Nunavut is the largest jurisdictional landmass in Canada, extending along
the northern boundaries of Quebec, Ontario, Manitoba, Saskachewan, Alberta and the Northwest Territories. Nunavut
has a land that is one-fifth the size of Canada, where the 25 communities are separated by thousands of kilometres
of tundra and ice. Travelling to and within Nunavut, without the benefit of roads and with weather as a constant
deterrent, is a monumental task. Providing healthcare and diagnostic services to its residents is both extremely difficult
and costly.
Traditionally, the only way for a resident of Nunavut to receive treatment from a medical specialist was to be flown
thousands of miles to the south for a face-to-face visit. This system took a toll on both the patient, who was being
separated from family, and the government, which absorbed the patient’s transportation and accommodation costs.
Objectives
The Ikajuruti Inungnik Ungasiktumi (IIU) Telehealth Network was developed with the objective of providing increased
access to healthcare in a manner that is cost-effective and timely, while decreasing many of the high costs associated
with transporting patients to see a physician or specialist. Ikajuruti Inungnik Ungasiktumi is an Inuktitut phrase meaning "a tool to help people from far away".
Solution
The technical and operational difficulty of such an undertaking cannot be overstated. Issues of applying high-bandwidth videoconferencing and telehealth applications via satellite in Canada’s high arctic are difficult. In the south, the
standard delay for telehealth satellite transmissions is only one quarter of a millisecond, whereas there is a
three-second delay affecting the signal to and from Nunavut. Without technical modifications, the transmissions between
doctor and patient could easily become stilted, resulting in a mismatch between sound and image. The need for patient
privacy when using technology and the logistics of dealing with six legal jurisdictions across three time zones also
made this a monumental task not previously faced by any Canadian healthcare organization.
"Eighty-five percent of our population is Inuit," explains Victor Tootoo, Assistant Deputy Minister, Nunavut
Department of Health and Social Services, "so there are often language and cultural differences between the patient and the
healthcare provider. To bridge this gap, the IIU site located in each community health centre is staffed by a technician
or translator who is Inuit."
Launched in three stages, the IIU project began in 1999 with the linkup of three sites.
During the second stage of the project, 15 sites were networked and the original equipment installed at the first three
sites was replaced. Now, in the third and final stage, all 25 communities will be linked to the IIU Telehealth Network by
the end of this calendar year.
To develop the network, the Nunavut Department of Health and Social Services worked with the Digital Group of
Telehealth Companies to implement and train 30 local Inuit staff as well as test and install the equipment in 15
communities from 2000 to 2002. This venture was jointly funded by the Nunavut Government and Health Canada.
Innovative Use of Technology
The IIU Telehealth Network connects clients living in remote locations and communities to providers of medical, social
and educational services via video and teleconferencing, thus improving access to a broader range of services for
the residents of Nunavut. The creation of this network has enabled the establishment of a comprehensive Telehealth
Program that supports the delivery of primary and secondary healthcare and related social services.
"People don’t appreciate that we created a new province and started the program at the same time," remarks Tootoo.
“Our government was building its infrastructure from the ground up just as we were trying to build capacity in
Nunavut and adopt a primary care model. The fact that this project was accomplished is truly incredible."
The network allows for real-time transmissions (audio/visual/data) via satellite among Nunavut communities and
provides key communication links to healthcare service providers at the main hospital in Iqaluit and outside the territory
in Alberta, Manitoba, Ontario, Quebec and NWT. The IIU Telehealth Network is also used as a vehicle for delivery of
educational material and provides staff access to professional development.
As a result, there has been a decrease in non-emergency patient transportation because medical professionals can
conduct ‘virtual visits’ with patients. Using the network, physicians can often diagnose the severity of a medical
situation prior to actually seeing the patient.
In many cases, telehealth provides the opportunity to keep the patient in the community and with families during
diagnosis and even treatment. When patients have no alternative but to ‘go south’ for care, the IIU Network connects
them with their families in the community from the attending hospital. This can have a tremendous impact on the
patients’ access to care, the care they receive and their recovery time. The IIU Network enables families to connect and
communicate in their own language while supporting each other even though they are separated by vast distances.
This communication tool has not been rejected by a client in the five and half years this service has been available
in Nunavut. This is truly a remarkable and innovative way to provide access to clients in Canada’s most remote and
isolated region.
A 2004 CIPA Winner!
For its exceptional and innovative application of Information Technology to solve real-world business problems and
bring greater benefit to all its stakeholders, the Government of Nunavut was awarded a 2004 Canadian Information
Productivity Award of Excellence in the Mobile Solutions category.
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