Distance

In this episode, we meet Dr. Stacey Love, Director of Virtual Physiotherapy and Rehabilitation at Saskatchewan's Virtual Health Hub, and an Assistant Professor at the University of Saskatchewan's School of Rehabilitation. She's also involved with the Saskatchewan Centre for Patient Oriented Research.

You can see more of her recent publications here, along with links to her labs:

Musculoskeletal Health and Access to Care: https://cchsa-ccssma.usask.ca/mhac/

Virtual Care and Remote Presence: https://research-groups.usask.ca/remote-presence/index.php#Healthcare

Stacey Lovo remembers the bitterly cold day in December 2012, when two Indigenous women from northern Saskatchewan stepped off the bus in Saskatoon. One had traveled 12 hours, the other seven, both to see physiotherapist Stacey Lovo for back pain.

“It was a big undertaking for them,” said Lovo. She said one woman was forced cut her appointment short, to catch the last bus returning north.

The other woman stayed in Saskatoon to treat spinal pain stemming from what Lovo characterized as a ‘very difficult and scary problem.’

“This was devastating for many reasons,” said Lovo who remembered her patient was distraught, unable to return home to care for her young children.

That glaring disparity in healthcare access propelled Dr. Lovo into action. She returned to the classroom, and earned her PhD in Rehabilitation Science, specializing in low back disorders.

“If you're rural and remote resident or if you're Indigenous, your chances of having back pain are 30 percent higher than an urban person who's non-Indigenous,” said Lovo.

Lovo said long waits for care and spending up to twelve hours in a vehicle to attend a one-hour physiotherapy consultation often aggravate spinal damage — rather than healing it.

“When we're traveling that distance, we're undoing everything that's done in the session,” she said.

Working closely with people in Pelican Narrows and the Peter Ballantyne Cree Nation, Dr. Lovo began testing virtual consultations and in-person treatments, advocating for a hybrid model of healthcare.

"These projects are all community driven,” she said. “They’re led and driven by the strengths and knowledges from the communities."

Her team’s innovative use of Remote Presence Robotics in partnership with local nurse practitioners  in Pelican Narrows demonstrated a successful model of team-based virtual physiotherapy, connecting patients hundreds of kilometres away from health providers with care.

Local health providers are the key, Lovo said.

“Taking reflexes and testing for sensation and muscle strength are done by the nurse on the other side,” said Lovo.  “They have incredible rapport with the patients. They know their families.”

When the pandemic amplified the need for virtual care, Dr. Lovo, Dr. Brenna Bath  and Dr. Lovo's graduate students met the challenge with innovation.

Participants in her back pain study reported their outcomes were noticeably better. Many asked to continue with more treatments.

Dr. Lovo's work goes beyond healthcare delivery; it is a commitment to fulfilling treaty obligations and ensuring equitable healthcare access for Indigenous Peoples.

“Canada's promise to First Nations peoples was that medical care would be taken care of, and so we are  working with communities to try things out that will allow us to provide it,” she said.

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Dr. Ivar Mendez is one of the world's leading experts in neuroscience and robotics, neuromodulation, and remote medicine.

But nine years ago, the award-winning neuroscientist who founded Dalhousie's Brain Repair Centre faced a career dilemma.

Would he accept a senior clinician's position at Harvard University, or would he move to Saskatchewan, to oversee surgery for an entire province?

Today, Dr. Ivar Mendez says he's glad he chose Saskatoon.

"It's been a privilege for me to work with remote communities in Saskatchewan," said Dr. Mendez, provincial head of surgery and a clinical neurosurgeon with the University of Saskatchewan and the Saskatchewan Health Authority.

This spring, he published Sariri, a book of essays about his travels to remote communities in Bolivia.

He said there are 'commonalities' between Indigenous people in both Bolivia and northern Saskatchewan, in terms of their relationship with the earth and its teachings.

"They have a lot of knowledge and healing that we in Western medicine are not using, but it's very valuable," Mendez said. 

Mendez has made it his mission to bring 'remote presence' robots into nursing stations in 17 fly-in and remote communities across northern Saskatchewan.

In this episode, hear why being able to practice virtual medicine paid off during the Covid-19 pandemic, as lockdowns isolated Saskatchewan's poorest, most remote citizens.

In 2021, midway through the pandemic, Dr. Mendez took unpaid leave and returned to Bolivia where the coronavirus was ripping through hospitals, killing hundreds of health care workers and thousands of Bolivian citizens.

"There were no ICU beds, no beds at all," said Mendez. "Hundreds of thousands of people were dying."

After he arrived, Dr. Mendez sent countless families personal protective equipment, Bluetooth-equipped medical devices, and he set up real-time consultations with phsyicians so they could monitor sick patients at home.

"They were able to save many lives," said Mendez, noting a 'significantly lower' mortality rate for patients whose family members cared for them at home, compared to those admitted to hospital.  

In this episode, Dr. Mendez also describes a recent trip to Ethiopia, where prenatal care for rural women was nearly non-existent, until teams from Saskatchewan tried giving midwives portable ultrasound kits.

With supervision from obstetricians in urban centres, 17 Ethiopian midwives became 'expert sonographers' offering free pre-natal scans on market Saturdays.

Some women walked for more than ten hours, for their first chance to see their baby.

"When I went back to Ethiopia a couple of weeks ago, they'd done 3,800 ultrasounds -- more than ten times what we ever thought," said Mendez.

"They wanted to know if their babies were healthy." 

In this episode, hear more about Mendez' initial fascination with the human brain, his push to bring stem cell transplants to patients with brain injuries and disease, and why he cares deeply about bringing health care to impoverished communities.

Using 'doc in a box' virtual medicine, clinicians can 'see' patients in 17 remote communities in northern Saskatchewan including La Loche, Pelican Narrows, and Stony Rapids.

"We have built the most comprehensive remote presence robotic program in Canada, and one of the most advanced in the world," he said. "

Mendez predicts virtual care, robotics and artificial intelligence will 'revolutionize' health care.

"It will disrupt the way we practice medicine and I think we will be better, for the way we're using them," he said.