Travelling for healthcare
WHY TRAVEL FOR HEALTHCARE?
Typically, people travel for their health to obtain routine or emergency medical care that is not available where they live. This appears to be overly simplistic; however, is it truly so?
Across Northern Canadian Provinces and Territories, residents must travel long distances by road, sea, or air for simple medical procedures. Even to receive medical procedures such as eyes, dental or ear exams. And then the seriousness to travel only escalates for procedures like cancer treatments or pregnancy follow-ups.
MODELS OF TRAVEL
As examples, in Northern British Columbia there is a dedicated bus that provides free or subsidized healthcare travel. In the Nunavut Territory, residents use commercial airlines with destination accommodation, bus transfers and food all paid for. In Alaska, various government and First Nations Organizations provide air travel and lodges for the Alaska Native and American Indian people.
Medical transportation uses a vast array of transportation modes. Among them are, taxi, band vehicles, snowmobiles, boat, ferry, commercial / charter air-to-air ambulance and medevac aircraft. People living in the north use just about anything to get the northern inhabitants medical services. A stark difference for someone in the south who may call an Uber, taxi or take public transit to a hospital.
What are the logistics behind healthcare travel?
NORTHERN AIRLINE SUPPORT
Aviation services are the backbone in northern transportation and life savers for remote and land-locked communities. Aviation virtually opened the north in the last 100 years and continues to be vital. Today, aviation is an integral part of the Canadian and US economies. Scheduled and Charter airline passenger service, airmail/freight connect northern communities to the world.
Medical Air Travel is unique, and performed in a challenging environment where failure can have direct consequences. Therefore, considering the high level of specialty needed to perform this form of transportation, only northern air service specialists support it. Airlines like Alaska Airlines, Air North, Air Inuit, Calm Air, Canadian North, and PAL Airlines are all examples. They provide a mix of charter and scheduled services.
In addition, there are many specialty medevac operators that provide both Helicopters, Bizjet, and Turboprop aircraft. Typically, these aircraft have stretchers, oxygen, and onboard medical staff.
Accommodation in ALASKA NATIVE MEDICAL CENTRE (ANMC)
Did you know that ANMC is an acute, specialty, primary and behavioural healthcare provider? They provide comprehensive medical services to Alaska Native and American Indian people living in the state. ANMC includes a 182-bed hospital, as well as a full range of medical specialties, primary care, pharmacies, and laboratory services.
ANMC works in close partnership with Alaska’s rural health facilities to support a broad range of healthcare and related services. As the statewide referral centre, ANMC operates both the Quyana House and ANMC Patient Housing facility. Together, these facilities provide a combined 258 rooms for out-of-town patients and their escorts.
Accommodation in LARGA BAFFIN – ONTARIO
One may wonder, what precisely constitutes a Larga in Canada? It is a medical boarding home for individuals and families located in major cities across Canada. This facility is similar to the one in Alaska. It is an essential and specialized accommodation service that also provides meet & greet, transport to appointments, meals, and other support services.
Larga Baffin is an example of such a specialty accommodation focused on medical travel and located in Ottawa, Ontario. It supports clients from the Baffin Region of Nunavut, Canada. This facility is Inuit owned and operated. It is also expanding to 350 beds with a new special purpose facility scheduled to open by 2025-2026.
How do healthcare benefits work for First Nations and Inuit?
INDIGENOUS SERVICES CANADA’S FIRST NATIONS and INUIT
Indigenous Services Canada’s First Nations and Inuit Health Branch (FNIHB) and the Assembly of First Nations have undertaken a joint review. This review concerns the Non-Insured Health Benefits (NIHB) program, including the medical transportation benefit. The first objective of this collaborative process is to enhance client access to benefits. It also serves to identify and address gaps in benefits and improve service delivery to be more responsive to clients needs.
This updated NIHB Medical Transportation Policy Framework is an interim measure to clarify existing policy in some areas. It also responds to preliminary issues identified through joint review discussions to date. We anticipate further revisions to this policy framework once the proper authorities complete the joint review of the medical transportation benefit.
PATIENT ESCORT
Everyone knows or may have firsthand experience travelling alone to a medical facility. However, for individuals residing in northern regions, the challenges are notably more formidable. For example, consider an elderly person who only speaks Inuktitut and may be travelling on an airplane for the first time. Navigating airports perhaps with a pre-existing condition or mobility issues is extremely challenging.
Most governments have defined policies to allow escorts to travel with the client/patient. Generally, the physician, nurse practitioner, or specialty clinic would complete the paperwork accordingly. In the Yukon there may even be two escorts if conditions warrant, like multiple underaged infants.
What are the financial and human costs of medical travel?
TRAVEL EXPENSES
Access to required health services may include financial assistance to the client. With the proper conditions met, it also involves arranging for the provision of services from the reserve or community of residence. But there are many other factors that we may not take into account. Such as parents or partners who must take time off work while they must still pay their regular household bills.
Often, if the medical condition is too severe, families must move south. The toll on travel and family displacement can just be too much. Travel duration frequently spans from 5 to 10 hours in each direction. This can put a strain on both patients and escorts.
JORDAN PRINCIPLE
Jordan’s Principle is a child-first principle to ensure First Nations children get the services they need. It is a legal rule in the memory of Jordan River Anderson. He was a First Nations child from Norway House Cree Nation in Manitoba, Canada.
Born with complex medical needs, Jordan spent over 2 years needlessly in hospital. The Federal and Provincial governments could not agree on who would pay for his home care. Jordan died at the age of 5 years old, never having spent a day in a family home.
Jordan’s principle passed in the House of Commons of Canada on December 12, 2007, and subsequently has had many refinements. Essentially, all First Nations children living in Canada can access the products, services, and support they need, when they need them. Funding helps with a wide range of health, social and educational needs. These include the unique needs of First Nations Two-Spirit and LGBTQQIA children and youth, and those with disabilities.
MEDICAL TRAVEL IT SOLUTIONS
Since 2001, Nomadis, based in Montreal, has provided Medical Travel Solutions to First Nations and Territorial Governments from Canada to Australia. Nomadis offers a travel management system perfectly adapted to the healthcare sector’s needs. Moreover, our software solution is ideal for both patient and healthcare workforce logistics.
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