Feasibility of paediatric postoperative telemedicine in Nunavik: A qualitative study

Children from Nunavik, a Northern Quebec region with a predominantly Inuit population, must travel by air for surgical care at urban paediatric centres. Telemedicine offers an opportunity for virtual postoperative visits for low-risk patients, though its feasibility remains unclear. This study aimed to assess the feasibility of paediatric postoperative telemedicine in Nunavik.

This qualitative study (August 2022-June 2023) included a rapid literature review on telemedicine use in rural and postoperative care, which informed the interview process. Eleven healthcare providers with experience caring for Inuit children from Nunavik were interviewed on telemedicine viability. Data was thematically analyzed. Technical and operational feasibility was evaluated using data on Nunavik's resources from the regional health board. The primary outcome was healthcare providers' perspectives on feasibility, and the secondary outcome assessed technical and operational viability through community resources.

The literature review yielded few sources. All participants agreed on the feasibility of paediatric postoperative telemedicine but identified key conditions for its success. The thematic analysis highlighted seven themes, including benefits, challenges, patient suitability, and resource requirements. While two regional hospitals and three health centres were equipped to support postoperative telemedicine, nine health centres had only partial capability, primarily due to limited high-speed internet access. Imaging and laboratory services were available solely at regional hospitals.

Postoperative telemedicine was deemed feasible from both provider and resource perspectives, with optimal utilization dependent on appropriate support to centres. Family and community involvement is crucial to expanding its use in Nunavik and respecting patient autonomy.