Abstract

Choosing Wisely holds a slightly different meaning in the rural and remote communities of the Northwest Territories (NWT), Canada. Choosing Wisely is about effective conversations between healthcare providers and patients to reduce unnecessary medical testing and improve the appropriateness of care. However, Choosing Wisely Northwest Territories (CWNT) goes beyond reducing unnecessary tests and seeks the reduction of unnecessary patient travel. Limited local medical resources often require patients to travel long distances, away from the comfort of their home communities, to receive care. Since the launch of CWNT in 2018, many enablers have led to successful implementation of Choosing Wisely recommendations, namely, the single electronic medical records system for the NWT. Conversely, barriers exist that also prevent CWNT from reaching its full potential in optimizing the efficiency of care, most significantly, cultural and Indigenous language barriers and limited  internal capacity to move the campaign forward and encourage clinical practice advances. This commentary shares the unique development of CWNT as an example of implementation in rural and remote communities and highlights areas of focus to be considered for future initiatives to successfully improve the efficiency, effectiveness and appropriateness of healthcare in northern Canada.