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A safe space: Indigenous doctor creates online platform to empower racialized patients in health system

The Joule Innovation grant program offered funding, professional support and mentorship to physicians and medical learners making a difference in health care. This is part of a series of stories about the 2020 recipients and their innovations.

In April 2021, during the COVID-19 vaccination rollout, many Indigenous patients in parts of British Columbia faced a struggle within the health care system to get their shot. Some reported being denied access to clinics, while others were told they weren’t currently eligible for vaccines, despite clear provincial guidelines.

Frustrated with the process, many turned to their local Friendship Centres for help. There, they were encouraged to report their negative experiences using Safespace Networks — an online platform that empowers marginalized patients to navigate health systems. As patient data accumulated, Safespace was able to pinpoint the vaccine trouble spots in the province, so patient advocates could reach out to clinics in those areas to explore the issue and work out a solution.

 “I believe Safespace is a pathway for us to minimize and mitigate patient harm as much as possible and ensure everybody — regardless of culture, race, religion or gender — has the same positive experience.” – Dr. Alika Lafontaine, Co-founder, Safespace Networks

Identifying a better reporting system

The idea for Safespace had been percolating for years in Dr. Lafontaine’s mind. As co-lead of the Indigenous Health Alliance — a five-year health transformation project involving 150 First Nations and several national health organizations — he’d heard repeated concerns about the difficulties in reporting incidents of patient harm. Among them were concerns that patients weren’t always sure who to tell; that when they did voice concern, it was often ignored; and that a complaint would negatively affect the patient’s relationship with their health care provider.

“Existing reporting systems often pitted the patient against the doctor, against the hospital, instead of focusing on fixing the harm and making sure it didn’t happen again,” says Dr. Lafontaine.

Dr. Lafontaine’s desire to develop a better patient reporting system was further solidified after his younger brother, Kamea, had a health emergency and felt his questions about treatment weren’t taken seriously.

“What Kamea told me crystallized the need for this type of approach,” explains Dr. Lafontaine. “He said, ‘No matter what I do or how I contribute to my community, the health system sees me as just another Indian.’ And I think that experience of just being a number or just being a caricature that people project onto you is an experience shared by many patients.”

Anesthesiologist Dr. Alika Lafontaine, and his brother Kamea, a dentist, launched Safespace Networks

Visualizing patterns of care

Together, the two brothers launched Safespace Networks, first in BC and then in Saskatchewan. Partnerships with existing community groups, like the BC Association of Aboriginal Friendship Centres, have been critical to the pilot program’s success. The association hosts the Safespace software on its website, and the various Friendship Centres help collect patient information, review data and, with Dr. Lafontaine’s support, work with local health care systems to proactively reduce patient harm.

“The data we’re collecting have the opportunity to provide earlier awareness and intervention,” he says. “They allow patients, stakeholders and health care providers to engage in a way that’s less hostile and that builds trust.”

In addition to its reporting function, Safespace is also a learning platform. When patients submit their anonymous experiences through the web-based app, they are published onto maps. The data can help other patients navigate the health system by differentiating between locations where they are more likely or less likely to be racialized.

“For patients who experience this type of harm, it’s best to avoid it,” says Dr. Lafontaine. “But, if the health care service is only provided at one location, for example, patients can at least prepare for how to engage within that environment.”

Creating a national reporting model

With his $100,000 Joule Innovation grant, Dr. Lafontaine has been able to grow Safespace Networks faster than expected and is now looking to expand into Ontario. In the next year, with the support of more community organizations, he and Kamea hope to introduce the platform across Canada.

“If we can collect these data, create these patterns and help inform both patients and the system on how things can get better — that’s really the basis for all quality improvement,” says Dr. Lafontaine.

The 2020 Joule Innovation grant program provided $500,000 to support physician-led innovations in the areas of sustainable health care, physician health and wellness, health care solutions and access to care.

Read about the other innovations funded through the program:


About the author(s)

CMA Joule supports physicians and medical learners in the pursuit of clinical excellence. As a subsidiary of the Canadian Medical Association (CMA), we support the profession with continuing education and other learning opportunities as well as leading evidence-based clinical products and research.