It took Gloria Stoney five days to get medivaced from her home in Peawanuck to Toronto General Hospital this October when she started experiencing serious cardiac symptoms. She was in the nursing station as she waited: “I didn’t feel so comfortable, but my family was there to take care of me and make sure I wasn’t alone,” says Gloria.
Once she got to Toronto, she was admitted immediately for further work-up. Gloria was then able to go home for a short time with the Medly team managing her care remotely. She was flown out again to Kingston for more testing and finally returned home at the end of November.
Bringing care closer to home for community members like Gloria is at the heart of the partnership between the Weeneebayko Area Health Authority, or WAHA, and the University Health Network (UHN).
WAHA provides healthcare to six communities throughout the James and Hudson Bay region, including Peawanuck, where Gloria lives. The majority of people living in the region’s coastal communities are of proud Cree lineage.
Through the use of Traditional and Western strategies, WAHA provides care that is holistic, reflective of community needs, and as close to home as possible.
As many communities in the region are remote with limited access to specialized cardiac care, travelling to access care is a necessity; community members like Gloria must travel 850km south by a combination of boat, train, plane, and car.
“Leaving home for medical care is tough. It requires the coordination of many people and organizations, and for our clients, it can mean a lot of anxiety from having to navigate a different city and hospital, all while missing the comfort of home. It’s a journey of healing mixed with the struggle of being far away from what’s familiar,” says Lynne Innes, President and CEO, WAHA.
But what if we could improve access to culturally safe cardiovascular care in WAHA’s communities? TRANSFORM HF co-lead Dr. Heather Ross believes it could drastically improve patient care and outcomes in the region.
“Digital innovation is the key,” explains Dr. Ross. “It can provide access to healthcare services not historically offered in the region and that require clients to travel out of community.”
In fact, a recent community-based study in Moosonee found that community members are receptive to digital health tools, though they must be designed in a way that reflects their values and integrates Western and Indigenous approaches.
So, how do we get there?
New MOU to Support Cardiovascular Needs in James and Hudson’s Bay Region
WAHA and the Peter Munk Cardiac Centre at UHN just penned a 5-year Memorandum of Understanding (MOU) to support the cardiovascular needs of James and Hudson Bay communities with a focus on direct care and remote management.
This new agreement solidifies the WAHA-UHN partnership, which dates back to 2017. Through building local capacity and leveraging existing resources, the MOU supports both partners in bringing diagnostics and treatment as close to home as possible.
“Signing the MOU emphasizes WAHA and UHN’s joint dedication to enhancing cardiac care in the James and Hudson Bay region. Together, we’re working to improve cardiac care delivery, making it more accessible while enhancing quality of life. This partnership is a significant example of how health equity can be advanced in Indigenous communities,” explains Lynne Innes.
Coordinated clinical care will involve regular in-person visits to WAHA’s six communities with use of the Medly Program – a remote patient monitoring program for heart failure management. Currently, more than 30 WAHA community members are Medly users – including Gloria, who’s been enrolled since the summer of 2023.
“Medly has been helpful,” says Gloria. “It saves me running to the clinic every time something happens.” This is especially beneficial, as she explains that clinic can get very busy.
“You get a response right away, and someone reaches out to you when something is up.” Gloria also appreciates that her results are on file in the app, so when she needs to receive care out of community, she doesn’t need to re-explain her symptoms and management.
“I’m not the only one in Peawanuck with a heart issue. Medly benefits a lot of people here,” says Gloria.
The partners are also initiating a screening program for earlier detection and primary prevention of heart failure.
Additionally, the partnership will support ongoing community-based qualitative and quantitative research with a focus on field-testing digital devices, point-of-care testing and other innovations in community and on the land.
WAHA and UHN will also work together to build capacity in the community. Mentorship programs will facilitate exposure to clinical and research environments for the next generation of WAHA-based health care providers, and opportunities will be created for Toronto cardiology residents and fellows to participate in this collaboration through observerships.
“Working in community, with community, is so important – this MOU supports that,” says Dr. Ross. “When you add in the layer of digital health and remote monitoring, I think we can support WAHA in keeping their community members healthy at home.”
