The Canadian Northwest Territories are a vast region with harsh climate, an area of 1.17 million square kilometers largely covered by mountains, forests, tundra and lakes, and a population of about 42,000 people. There are long distances to travel between the 33 communities and a sparse communication network; in fact only eight communities are year-around accessible by road, nine have seasonable accessibility (for 8 weeks) by road and six of them are fly-in-only with 27 of all communities mostly being supplied by air.

It makes health care not only arduous for patients as well as doctors but also rather expensive. This is why the Government of the Northwest Territories in Canada (GNWT) decided early on to use the opportunities that telemedicine offers: delivering health and social service information, services and expertise over short and long distances by using information and communication technologies. The NWT telehealth pilot project dates back to 1998 when on three sites (Inuvik, Fort Smith, Yellowknife) services like Orthopedics, Internal Medicine and Urgent/Emergent x-ray consultations were offered. By 2004, ten sites were included in this WestNet telehealth program and more than 20 services were offered to remote communities.

In 2004 the Government chose to add Stat100 EasyPACS to further improve the health care situation. Together with our partner Aethra Inc. we installed the Stat100 EasyPACS telemedicine system in five different locations.

This makes it possible, based on DICOM 3 standards, to centralize the diagnostic process in this rural area, to automate the workflow, to centralize the storage of telemedical data, to archive and to access to the web. Satellite based point-to-point telehealth (b/w specialized center and health center) and multipoint telehealth (b/w specialized center and more than one health centers) are used. Now diagnosticians do not necessarily have to be on site to make their findings on a patient's exam. It is now possible for them to retrieve and send images as well as diagnostic findings.

The advantages are clear: NWT residents have improved access to health and social services and to specialist opinion / second opinion; there is a better timeliness of diagnostic, investigative and management decisions in patient/client care and a profound reduction in medical travel as health services are received closer to home. On the other hand, health professionals now have better access to continuing education, easier access to professional and second opinion and an increased availability of information to make medical decisions. Also communication has improved by providing real-time audio/video communications and the costs needed to provide sufficient health services are now much lower than before.