Telemedicine and surgical coordination for Indigenous children from remote communities in northern Quebec

Background: Pediatric patients from remote Indigenous communities in northern Quebec face substantial challenges accessing surgical care, often requiring lengthy air travel to urban hospitals. We sought to quantify time spent away from home for surgical care and explore telemedicine use during the perioperative period for this population.

Methods: We conducted a retrospective chart review of children from Nunavik and Terres-Cries-de-la-Baie-James who received surgical care at the Montreal Children's Hospital between 2011 and 2021. Dates of preoperative consultation, surgery, and postoperative follow-up were recorded, along with encounter modality.

Results: Of 914 patients identified, 40.9% required urgent surgery. For elective procedures, 59.1% of patients waited 14 days or longer for surgery after initial consultation. Postoperatively, 46.8% had follow-up appointments within 7 days of discharge, while 26.1% waited more than 14 days. Telemedicine was used in only 2.2% of elective consultations and 5.5% of follow-up appointments.

Conclusion: Wait times for surgery and initial follow-up appointments often exceeded 2 weeks and required return trips to Montréal, while telemedicine adoption remained limited across departments. Efforts to reduce wait times, increase telemedicine adoption, and enhance culturally safe practices could improve access and care experiences for patients from northern Quebec.