Access to services is a major challenge in addiction medicine, particularly in regions far from large urban centres. This reality is particularly difficult and complex for Listuguj, a Mi’gmaq community located near Restigouche, on the south shore of the Gaspé Peninsula in eastern Quebec. This community faces a number of barriers in accessing specialised health services, particularly in relation to substance misuse care. Indeed, it is not always easy to get an appointment with a health professional with expertise in substance misuse for this population since the closest health facility offering this type of service is located in Maria, about an hour away by car.
In response to these needs, a research project led by Dr. Annie Talbot and Dr. Stéphanie Marsan has been initiated to develop remote care and follow-up services for clients with addiction-related problems. The goal is to be able to offer local services to avoid unnecessary travel and thus facilitate access to care. This initiative is being carried out jointly by the Listuguj community, the CISSS de la Gaspésie and the Centre hospitalier de l’Université de Montréal (CHUM).
From a clinical standpoint, this is a real innovation in the way things are done, since all the partners involved are working to build the new care pathway using telehealth tools, while taking care to consolidate existing services. More concretely, teleconsultations allow patients to have access to doctors specialised in drug addiction located at the CHUM without having to travel outside their community, while receiving administrative, social and cultural support in their own environment. Cultural safety and patient well-being are priorities in this project.
In terms of research, the work will evaluate the usefulness, effectiveness and impact of the new pathway compared to the previous situation. In this way, it will be possible to identify success factors and determine the impacts on quality, safety, costs and patient and community experience. This approach will be used to establish a model of care that could be deployed in other regions of Quebec. In this way, the research team will develop recommendations for the development of a sustainable and reproducible trajectory. It will also share the results of the project with potential partners, including other Aboriginal communities in the province. As part of its supra-regional mandate specializing in addiction medicine, the CHUM wishes to continue to deploy this type of initiative, particularly by developing teaching tools and communication mechanisms adapted to the real needs of Aboriginal patients in Quebec.
An innovation born of the collaboration of all the players
Access to care in addiction medicine is a complex priority health issue that requires the mobilisation and collaboration of all stakeholders. This innovative initiative will improve the planning and coordination of service trajectories using telehealth in this field. It will also promote the transfer of skills to the network’s actors regarding the Aboriginal reality and addiction medicine. Finally, the project emphasises the importance of developing clinical practices based on the needs of clients, communities and professionals, using inter-organisational, interdisciplinary and intercultural collaborative approaches.
Until the approach can be more formally extended to other regions, the project team remains available to offer advisory services to actors in the health and social services network who wish to develop care pathways in addiction medicine and connected health.
Dr. Stéphanie Marsan : stephanie.mari-anka.marsan.med@ssss.gouv.qc.ca
Dr. Annie Talbot : annie.talbot.med@ssss.gouv.qc.ca
Last update: November 3, 2022