The First Mile

Supported by the SSHRC-funded First Nations Innovation Project

Cowichan Tribes and the Mustimuhw Health Data Management System Cowichan Tribes - British Columbia

Mustimuhw (pronounced: Moose-tee-mook) is a Coast Salish word meaning "all of the people". It is also the name of a community electronic medical record (cEMR) management system developed by Cowichan Tribes on Vancouver Island. It is currently used by First Nations across B.C., Saskatchewan and Manitoba, and will soon be used in Atlantic Canada.

Cowichan Tribes developed the Mustimuhw cEMR system to fit specifically within the Aboriginal context of a First Nations Health Centre. It allows for collaboration between community members and the health care team in achieving health care goals. This helps create a more personal relationship between health care providers and community members. It seeks to increase First Nation community control over health data, and so aims to support Nation building.

The Mustimuhw system was designed to meet the unique technical context of First Nations, including a lack of connectivity in many rural and remote communities. Mustimuhw can be used in disconnected mode on a portable device such as a laptop. This means that health care providers can use the system during home visits in remote areas. It can also be adapted to the Internet connectivity and technology conditions of remote and rural First Nations. Users can either connect to a remote server over a broadband connection in ‘real-time’, or work from a local computer and upload data later on, if connectivity is unavailable.

Mustimuhw also offers remote user-group training sessions through videoconferencing, and online training tools. This allows health care providers to increase their knowledge while remaining in the community. This saves time, and allows them to focus on providing care to community members.

Mustimuhw is dedicated to meeting First Nations Principles of OCAP, which stands for Ownership, Control, Access, and Possession. OCAP principles seek to ensure that ownership of member health data remains within the First Nation. First Nations Health care providers have struggled to overcome challenges around ownership of health data. The Mustimuhw cEMR system seeks to standardize health records management in a way that meets the needs of First Nations communities. Through Mustimuhw, First Nations hope to gain more control over how member health data is accessed, transferred and used.

As the new evolving First Nations Health Authority advances its vision of establishing a province wide health network for First Nations health, it is the hope of Mustimuhw users that this will further provide a strong foundation to ensure both the ownership of First Nations health data and the integration of the Mustimuhw cEMR with other aspects of health information management in BC.

Health Canada’s First Nations and Inuit Health Branch (FNIHB) also works closely with Mustimuhw as part of its emerging eHealth strategy. Mustimuhw operates on a not-for-profit basis, and all revenues earned go towards the provision of core services such as readiness assessments, deployment, ongoing training, and continual product enhancement. Any additional revenues are contributed to educational bursaries for First Nations people entering the Information Technology (IT) field. For more information on these bursaries, please contact Tammy Johnston: tammy.johnston@mustimuhw.com.

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