Quality primary healthcare for northern Canada…

Needs exceed existing solutions.First Nations communities suffer from a long history of being under-serviced by existing health systems, in spite of considerable fund allocation. The health status of First Nations people ranks consistently below the Cana-dian average, as measured by indicators such as rates of hospitalization, communicable diseases, suicide, and mortality. Diabetes and other chronic conditions such as mental health, addictions, cancer, and obesity are at epidemic levels.

Adherence to best practice standards of care is low. Physicians are rarely present in First Nations communities. Attracting and retaining qualified health professionals in remote northern communities is difficult, with nurs-ing stations and physician clinics often overwhelmed with demand. Lack of access to physicians often results in delayed diagnosis and treatment of medical issues. Unnecessary referrals increase cost.

Special programs often fail to achieve their goals because basic community and health infrastructure is too weak. Low community health status dimin-ishes local capacity for economic development significantly, and a lack of localized health infrastructure leads to an almost continual state of “crisis management” in healthcare service delivery.

Opening doors to better health…Amdocs is changing health status in numerous First Nations communities. Since 2003, Amdocs has operated as a group physician prac-tice and medical services provider, bringing clinical physician services to remote settings. This creates a foundation for improved local health, health services, and localized infrastructure development. With a population health and public health point of view, Amdocs targets patient populations in crisis, stabilizes their conditions, and then expands access to the entire communities for comprehensive primary care services.

Improving healthin remote communities…

Grand Chief David Harper Grand Chief of Manitoba Keewatinowi Okimakanak

It is without hesitation that I recommend Amdocs to other First Nation groups requiring healthcare consulting or expertise. Amdocs’ collective knowledge of the delivery of health services in First Nation communities is remarkable.

Evolving healthcare delivery…Provincial and Federal Governments have been working actively to support the evolution of primary care services—especially in under-serviced rural and northern communities. Amdocs’ Primary Health Care Strategic Plan aligns well with government strategies that identify objectives such as: • improved access to primary care services• development of comprehensive multi-disciplinary collaborative teams• establishment of improved linkages amongst various levels of care• skill building in the areas of quality improvement/leadership• access to and use of information systems• improved working environment for all primary care providers • demonstration of high quality care with a specific focus on chronic disease management.

Amdocs supports government primary care initiatives and facilitates the entry of primary care physicians into northern practice. Amdocs serves as the agent responsible for recruitment, placement, and scheduling of allocated physician positions and provides an administrative and clinical framework to ensure productivity and clinical excellence. Although Amdocs functions as an independent physician group practice, clinical standards and productivity are demonstrated and reported in accordance with government requirements. Amdocs physicians conform to current Canadian practice guidelines and standards, have university academic affiliations, and are developing collaborative partnerships with specialty programs.

Amdocs works collaboratively with Health Canada, Regional Health Authorities, and First Nation stakeholders to determine areas of need and to deploy available resources to maximal effectiveness. In order to effectively address shared or cross-jurisdictional issues as well as opportunities for effective collaboration, Amdocs meets regularly with northern RHAs and other partners, such as:• MB Telehealth to explore service delivery options• Manitoba Renal Program, for cont. education and program development• University of Manitoba, Faculty of Medicine• HSC Foundation in support of research (e.g. Aboriginal suicide and diabetes abatement)

Redefining the landscape…Comprehensive healing and ongoing wellness in Canada’s First Nations communities will result from effective primary care solutions supported by:• Government’s support of First Nations in accessing service, improvement in multidisciplinary collaboration, exploration of cost-effective solutions and new technology, and collaboration with the private sector in creating innovative care models and increased efficiencies• The desire of First Nations to increase health service delivery, enhanced control and self-determination, development of effective partnerships, and pursuit of economic development, employment, training and education opportunities• The goals of Regional Health Authorities to enhance quality of delivered healthcare and to maximize efficiencies within the current health services delivery infrastructure. Manitoba Health Minister Theresa Oswald

First Steps Towards A Family Doctor for Every Manitoban by 2015, MB Health Press Release, December 2010

We’ve made significant investments to improve access to family doctors and primary care… ensuring every Manitoban has access to care when they need it is not only good for patients and families, it’s also vital for the long-term sustainability of our public healthcare system.

Health Status Indicators Among First Nations in Canada

Compared to the general Canadian population, First Nations peoples:• anticipate shorter life expectancy• are more likely to die from suicide, unintentional injury or poisoning• are less likely to be fully immunized from vaccine preventable communicable disease• have higher rates of communicable diseases such as pertussis, rubella, tuberculosis, shigellosis and STI’s (including HIV)• are more likely to be under or unemployed• are often unable to access basic physician services in their communities.

First Nations people believe that healthcare disparities must be addressed with further investments from all levels of government and that healthcare resources should be allocated and available in communities close to the people who require them.

Amdocs Inc.77 Main StreetWinnipeg, ManitobaCanada R3C 2R1 Phone: (204) 934 1556Fax: (204) 934 1602Toll-free: 1 888 934 1556 info@amdocshealth.com www.amdocshealth.com

Amdocs provides community-based physician services through a group practice model. Our approach is proving successful in changing health outlooks for remote and northern Canadian communities.

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Dr. Dave Williams BSc, MD, FCFP, MPH

Chief of Staff and Medical Director, Amdocs Inc.

Reliable, consistent, sustainable healthcare solutions result from carefully considered long-term investments.

Improving health outlooks…2000 Dr. Anthon Meyer, a family physician from South Africa, arrives in Thompson, Manitoba. Confronted by the third-world health conditions he encounters in First Nations communities, he sets plans in place for positive change.

2003 Anthon Meyer Doctors Service (Amdocs) is formed, delivering in-situ physician services in Cross Lake, MB.

2004 On-call telephone assistance is provided to nurses working in the Manitoban First Nations communities of Oxford House, Shamattawa, Split Lake, South Indian Lake, Nelson House, Brochet, Lac Brochet, and Tadoule Lake.

2006 Amdocs begins servicing communities in northwest Ontario with a clinic in Pikangikum, followed by Big Trout Lake, Muskrat Dam, and Sioux Lookout.

2007 A clinic staffed by Amdocs physicians opens in Gods Lake Narrows, MB. Word of improving health outcomes spreads within First Nations leadership, fuelling additional requests for Amdocs to extend primary healthcare services to under-served communities.

2008 Amdocs’ program is introduced in Gods River, MB with a special focus on disease management and collaborative practice.

2009 Amdocs joins forces with The North West Company (NWC). NWC is Canada’s leading northern retailer and this country’s largest non-governmental employer of First Nations people. An expanded team of full-time staff concentrate on physician recruitment, support services including logistics, infrastructure development, and community relations, and expanding Amdocs’ service offer in remote communities.

2010 Dr. Dave Williams joins Amdocs Inc. as Chief of Staff and Medical Director. Planning and negotiations proceed with various stakeholders and groups of First Nations leaders with regards to introducing sustainable healthcare systems and solutions in remote communities.

Amdocs focuses on academic excellence with the launch of its own Continuing Medical Education (CME) program. Amdocs’ physicians’ university academic affiliation enables assistance with Manitoba’s Provincial Government initiative in family medicine resident training and support in northern, remote, and rural communities.

2011 Amdocs signs an MOU with Manitoba Keewatinowi Okimakanak Inc. (MKO), the political organization representing northern First Nation communities in Manitoba, identifying Amdocs as it’s preferred partner.

Amdocs Inc. and NWC’s Health Products and Services Division form a joint-venture partnership with MKO to create Muskehki Inc. in order to deliver pharmaceutical services to 30 MKO First Nations in northern Manitoba.