MEdical Remote Link Indian-health Network

Health Canada Telemedicine Project
Sioux Lookout, Northern Ontario

Throughout Canada's Northern Communities, life is filled with challenges on a daily basis, particularly when medical attention is required… help is rarely found a few blocks from home. Most residents are faced with difficulties of lengthy travel and harsh Northern weather conditions when they need to receive the proper medical attention most Canadians take for granted. Imagine if you will, slipping on a stethoscope with a 400 kilometer tube attached to its ends. Or better yet, imagine the EKG you are monitoring is hooked up to a patient via a 450 kilometer long patch cord!

Just as the bird Merlin covers great distances, a new medical project has embraced technology to enable remote Northern communities to be linked over great distances to provide effective, efficient health care. A new medical project initiated by Health Canada Medical Services Branch, developed with the University of Toronto Sioux Lookout Program, Nishnawbe-Aski Nation and Sioux Lookout First Nations Health Authority links communities separated by the vast lakes and forests of Northern Ontario.

The MERLIN network links the Sioux Lookout Zone Hospital, with:
The community of Big Trout Lake (440 km)
The community of Webequie (450 km)
The Indian Health Services Regional Office in Ottawa (1835 km)
over a high speed satellite network.

Using video-conferencing equipment and medical peripherals attached to a desk top computer, the system facilitates patient consultations and medical diagnosis. Initially, MERLIN has been designed as a pilot project to improve access to health care services within the Sioux Lookout area. Future expansion may enable interactive video medical consultations between physicians and nurses in more Nursing Stations and other Hospitals.

During an interactive session, a physician in the hospital can speak with, and see a nurse with a patient in a remote Nursing Station hundreds of kilometers away. The physician can examine a patient with a remote stethoscope, view the patient's X-rays, electro-cardiogram or zoom on injuries as they speak. Also, the attending nurse can capture these images to the electronic file and transmit this patient's file to the physician for later review. In an emergency situation interactive health care can be a life saving technology. Patients released from the hospital may have scheduled follow up appointments with physicians using MERLIN instead of traveling long distances. Patients may also be able to see physician sooner without travelling; this can be particularly helpful considering harsh Northern weather conditions. The confidentiality of each session is assured by using advanced scrambling technology on both transmitting and receiving parties.

The system is also capable of conducting Continuing Medical Education sessions from Sioux Lookout Zone Hospital to the remote Nursing Stations. This entails:
Receiving lectures in the Hospitals from the larger cities
Organizing meetings between participants in two small conference rooms with substantial savings on travel costs and time
Transmitting all manner of files, pictures or video recordings.
As well, preventative equipment maintenance can be aided with video conference, significantly reducing unexpected equipment breakdowns.

Two-way video/multimedia conferencing Patient/doctor face to face with confidentiality of session ensured by encryption device Continuous Medical Education sessions conducted without encryption High resolution detail of injuries, etc. "Live" interactive doctor/nurse consultations X-ray transmission to Hospital ECG transmission to Hospital "Live" stethoscope transmission

Technology for the MERLIN network was developed with assistance from the National Research Council Canada. Startup and development of the project was managed for Health Canada by H. Chrostowski of HC Data Systems. Medical peripherals and hardware were developed by TecKnowledge Healthcare Systems of Halifax, Nova Scotia. Communications equipment and satellite systems were developed by the SatCom division of Fifth Dimension Communications of Ottawa, Ontario.
Health Canada
National Research Council
Sioux Lookout and Northern Ontario Map
Sioux Lookout Pictures
HC Data Systems