Northern Medical Services University of Saskatchewan

2 Northern Medical Services Northern Medical Services is a Division of the Department of Family Medicine, University of Saskatchewan. It has a VISION of healthy northern Saskatchewan communities with a MISSION to improve the health and well- being of northern Saskatchewan residents through disease prevention and treatment, health promotion and health protection.

3 Tripartite Organization

4 Organization Although funded in a tripartite agreement between the University of Saskatchewan, Saskatchewan Health and First Nations and Inuit Health Branch of Health Canada, services are provided through a matrix of relationships including Northern Regional Health Authorities and the Departments of Health of Tribal Councils and individual First Nations.

5 U of S Col of Med DFM Athabasca Health Authority Catholic Health Corp. St. Joseph’s Hospital Prince Albert Grand Council Keewatin Yatthe RHA Peter Ballantyne Cree Nation Health Canada First Nations & Inuit Health Branch Sask. Health Northern Relations Branch Mamawetan Churchill River RHA Meadow Lake Tribal Council Lac La Ronge Band NMS Northern Inter Tribal Health Authority

6 Federal Health Transfer 1 st Level: CHR/CHE’s, NNADAP and related programs. 2 nd Level: RN’s, PCN’s, Community Health and Clinic programs (1992) 3 rd Level: NITHA Infrastructure development, CHSSU, MHO, Research, IT, Recruitment & Retention, Continuing Professional Development, TB Surveillance Athabasca Health Authority Transfer 2003.

7 Provincial Health Transfer Health District formation (1992) retained Northern Health Services Branch Northern Health Districts formed in 1998 Development of Athabasca Unanimous Members Agreement Northern RHA’s retained in 1992 restructuring. Athabasca Health Authority transfer 2003.

8 Primary Medical Care & Health Promotion Consultant Care Clinics & Referral Education FMR’s, Med Students CME, CNE Research & Development Population Health MHO Mandate & Roles

9 Clinical Services 4 MD’s serve the Athabasca; Fond du Lac, Stony Rapids & Black Lake from Stony Rapids (1984). 11 MD’s and a PCN serve MCRRHA; Wollaston Lake, Southend, Stanley Mission & Pinehouse Lake from La Ronge (1997). 6 MD’s serve KYRHA; Buffalo Narrows, Dillon, Patuanak & Beauval from Ile a la Crosse (1984). 1 MHO directs a co-managed provincial Population Health Unit. 152 Itinerant Consultant Clinics with 21 specialists.

10 Functional Organization Saskatoon Administration Education Population Health 1 MHO Research Development Itinerant Consultants >150 Clinics Ile a la Crosse 6 MD’s Athabasca 4 MD’s La Ronge 11 MD’s 1 PCN

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12 Development with Research Aboriginal health concerns, philosophy & community dynamics must be incorporated into the research process in order for it to be successful. The relationships & processes developed are therefore intrinsic to the research & an outcome in & of itself. Research findings & data are owned jointly by the people. Subsequent publication or release requires active involvement & consultation.

13 Research Projects 1 Diabetic Retinopathy Screening: A Comparison Between Direct Ophthalmoscopy and Digital Retinal Photography (2002) TL Enhancing Diabetic Retinopathy Screening with Community Based Digital Retinal Photography (2003) TL Peter Ballantyne Cree Nation Health Transfer Evaluation: Phase I & II (2002) PB Peter Ballantyne Cree Nation Medical Services Review (1999) PB

14 Research Projects 2 Audit of Existing Data on Northern Medical Services’ Clinical Positions, 1985-present. Primary Health Services: Cross-Cultural Learning and Applications between Northern Saskatchewan and Southern India The Management of Diabetic Foot Complications in Northern Saskatchewan (2000) PB Report on the Dorsett and Postl Review of Northern Medical Services. (2001) PB

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16 Research Projects 3 Twenty Year Review of Cancer Statistics in Northern Saskatchewan. JI Northern Saskatchewan Hospitalization Data JI Risk Factors for MRSA and Antibiotic Resistance Development. JI Determining Factors to Improve HIV/AIDS Support Structures in Northern Saskatchewan Aboriginal Communities. JI

17 Research Projects 4 Health Status Reports for the Mamawetan Churchill River RHA, Keewatin Yatthe RHA & Athabasca Health Authority. JI The Availability & Cost of a Standardized Food Basket in Northern Saskatchewan. JI Pediatric Ambulatory Sensitive Hospitalizations in Northern Saskatchewan. JI HHH Syndrome. JI Kids First North and Infant Mortality and Morbidity Needs Assessment. JI

18 Research Projects 5 Breast Cancer Screening in Northern Saskatchewan. JI Impact of Natural Radionuclides in Diet on Chromosomes. Uranium Mine Workers’ Epidemiological Study. Moose Radionuclide and Heavy Metal Survey. Abandoned Mines Study JI The Health Impact and Mitigation of Tailings Dust: Assessment and Mathematical Modeling. JI

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20 Development Projects 1 Primary Health Services: Integration & Evaluation (1999) Integrated Provincial & Federal Evidence Based ACN / PCN Formulary CDA CPG Diabetes Tracking Sheets (2000) Formalized Aboriginal Health Research Ethical Guidelines for Northern Saskatchewan

21 Development Projects 2 Facilitation of the Northern Inter-Tribal Health Authority Community Health Status and Surveillance Unit (1997) Ile a la Crosse CHDP’s Facilitation of a CIHR Indigenous Peoples’ Health Research Centre (2002) Northern Health Strategy: An integrated Federal / Tribal / Regional / Provincial Northern Health Forum (JI)

22 Development Projects 3 Northern Diabetes Prevention Coalition. JI Needle Exchange Programs: Ile a la Crosse & La Loche. JI Forest Fire Preparedness: Staged Community Evacuation. JI Northern Mines Monitoring Secretariat & Uranium Development Monitoring. JI Community Vitality Monitoring Partnership JI

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24 Education FMR I & II’s obtain northern Family Medicine training with CCFP preceptors at either Ile a la Crosse or La Ronge. Medical Students have access to all three sites; Stony Rapids, La Ronge or Ile a la Crosse. CNE or nurse training is provided to ACN graduates or students in co- operation with the health districts or tribal councils.

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26 The Future The transfer of increasing responsibility for health services, programs and development proceeds both federally to First Nations & provincially to northern regional health boards. Increasing levels of cooperation and integration between federal, tribal, provincial and regional health services through the Northern Health Strategy. Northern Medical Services will play a facilitative role in the development and delivery of medical & health services.

27 The Future 2 University affiliation with access to specific academic, technical, intellectual & research resources will 1) support, not drive, development with research and 2) provide enhanced levels of distributive teaching. The real challenge is finding neutral ground; that point of balance where not only competing but sometimes disparate, if not contradictory, perspectives can coexist in a functional paradox.

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