INTRODUCTION: Geographic access to emergency treatment remains an important public policy concern as rural emergency medical systems respond to various pressures to centralize services. Geographical Information Systems (GIS) are effective tools to determine what proportion of a given population is adequately served by existing or proposed service distributions.METHODS: This study compares 2 GIS approaches to determining whether recent standards of emergency care access established by the British Columbia Ministry of Health Services are being met in Northern British Columbia. In particular, we compare results obtained using the more commonly used straight-line, or "as the crow flies," method with those obtained using a more sophisticated method that estimates travel time using digitally referenced road network data.RESULTS: Both methods reveal that provincial standards of emergency access are not being met in Northern British Columbia.CONCLUSION: In terms of comparing the 2 approaches, the network technique indicated a lower level of access and was more accurate in identifying populations residing inside and outside the "golden hour" of emergency care.