Kingston Builds Health-Technology

FEATURE REPORT: ANALYTICS AND ARTIFICIAL INTELLIGENCE — PAGE 12 Publications Mail Agreement #40018238

CANADA’S MAGAZINE FOR MANAGERS AND USERS OF INFORMATION SYSTEMS IN HEALTHCARE VOL. 26, NO. 3 APRIL 2021 INSIDE:

FOCUS REPORT: VIRTUAL REALITY PAGE 8

Put down the pagers Clinicians at the Huron Perth Healthcare Alliance, in southwest Ontario, are setting aside their pagers for smartphones and a web-based messaging and shift scheduling solution. Page 6

Better procurement While cost is important, there are other elements to consider when acquiring healthcare technologies. Our columnists discuss some the most critical aspects of procurement. Page 11

AI in mental healthcare Artificial intelligence has made rapid progress in areas like radiology and administrative scheduling. Now, it’s appearing

in useful solutions for the PHOTO: COURTESY OF SPECTRA PLASMONICS diagnosis and treatment of mental health issues, such as depression and substance abuse. Kingston builds health-technology hub Page 12 Assisted by a $3 million investment from the federal government, the city of Kingston, Ontario is creating a health-tech cluster that aims to devise and market new technologies. The city’s Spectra Plasmonics has developed the Amplifi ID Kit, which produces near real-time analysis of opioids and other substances. Pictured are co-founders Malcolm Eade, Christian Baldwin and Tyler Whitney. SEE STORY ON PAGE 4

PEI to create ‘medical neighborhoods’ using new EMR

BY JERRY ZEIDENBERG cians. She is also the medical leader of the “neighbourhoods” to connect patients and province’s EMR project. physicians to other allied professionals, such rince Edward Island recently an- The additional capabilities she men- as diabetic care nurses and dieticians. nounced it will invest $8.4 million tioned include embedded video, which has The patient’s family doctor will become to provide family doctors through- proved so important to clinicians during the his or her “medical home”, while the net- out the province with the Telus COVID-19 pandemic, data analytics for work of allied health professionals will make PHealth Electronic Medical Record (EMR), a quickly determining patient trends, outliers up a “medical neighborhood”. Using the se- project that will result in a common plat- cure electronic medical records, each of the form for community-based practitioners. The Telus Health EMR will be caregivers will have access to the patient’s in- As well, Canada Health Infoway is con- formation, enabling them to better coordi- tributing an additional $3 million to the used to connect community and nate services. project, largely to establish e-Prescribing be- hospital clinicians with patients. Moreover, by using the Telus Health tween physicians and pharmacists. EMR, caregivers will have a secure method “We evaluated several EMRs, and we were and physician performance, and secure of quickly communicating with each other – impressed with the core capabilities of the communications among users. one that is much more effective than the tra- Telus system, but also by several additional Not only will the EMR be used by all ditional methods of phone and fax. functions that will be very valuable,” said Dr. physicians once they express their interest but The EMR will also be integrated with the Kristy Newson, a general practitioner who is the province is also embarking on a unique province’s hospitals, which use their own president of the PEI College of Family Physi- project that will build medical “homes” and CONTINUED ON PAGE 2 Prince Edward Island to create ‘medical neighborhoods’ using EMR

CONTINUED FROM PAGE 1 ical informatics officer and vice-president, The system will allow them to send pre- Collaborative Health at Telus Health, ob- scriptions through their EMR, connecting Cerner electronic health record. By connect- served that PEI’s project, which creates sys- primary care doctors with pharmacies. ing to the Cerner system, physicians and al- tems of physicians and other caregivers all And instead of seeing just the prescribed lied professionals will have access to the collaborating on patient care through an medication, the pharmacist will be able to medical laboratory results of their patients, EMR, “could become a model for other access the patient’s electronic record and along with diagnostic imaging test reports, provinces.” list of medications. discharge reports and clinical notes. Dr. Ramsey recently joined Telus Health In this way, he or she will be able to check Other Canadian jurisdictions have after his own company, Input Health, was for possible adverse reactions and to con- started to create groups of clinicians and acquired by the larger corporation. duct a medication reconciliation, if needed. allied professionals working together, such For his part, Dr. Ramsey created an in- “We know that medication reconcilia- as the Ontario Health Teams in Ontario. novative technology that allowed patients tion is a complicated problem,” said Dr. However, Dr. Newson said the teams in to fill out digital questionnaires before their Ramsey. “An e-prescribing system helps to Prince Edward Island are likely to be the encounters with doctors, reducing the time make sure that the patient is getting the first in the country to be connected by a needed during the appointment to fill out right medications.” common electronic medical record that is forms. This, in turns, speeds up the en- He noted that pharmacists and doctors also tied into the hospital system. counter and promotes the efficiency of the Dr. Kristy Newson can see all the medications that a patient “It will be the first ‘all-in-one’ network practice. is taking and can determine whether in Canada to combine care-givers, patients As well, the system can be used by pa- Health EMR,” said Dr. Newson. “It’s key to there might be a problem before an acci- and an EMR,” she observed. tients to contribute electronic forms after gathering data that can be used to improve dent happens. She noted that the Telus Health EMR the encounter, to report on their outcomes. the quality of care and for planning.” As well, by using the same electronic will be rolled out to community physicians In this way, doctors can see how various She added, “It gives us a window on pa- platform, communication between phar- in July, initially as pilot projects in a few lo- therapies perform in the “real world”, and tient care that we haven’t had in the past.” macist and doctor becomes much easier. cations, and then throughout the province they can establish best practices using an Dr. Ramsey noted the EMR project, Instead of communicating by phone or during the second half of 2021. The medical evidence-based methodology. through Canada Health Infoway, will also fax, electronic messages can be exchanged. neighbourhoods will be established at the “The self-assessment feature using ques- provide PEI doctors with e-prescribing There are about 240 physicians on PEI same time as the rollout begins, she said. tionnaires was seen by our doctors as one tools that will improve their communica- who are eligible to acquire the Telus Health Dr. Damon Ramsey, the new chief med- of the most beneficial aspects of the Telus tion with pharmacists. EMR (about 160 other doctors work primarily in hospitals, where they use the Cerner health information system). Dr. Newson said that PEI has trailed other provinces in the use of physician I.T. systems, and that only 30 percent are already using EMRs. Infoway Insights. However, she predicts that most will switch to the new system, as it offers so much more connectivity. “Instead of hav- Essential Research ing to go from one system to another for clinical data, for lab information and diag- about Digital Health. nostic imaging, the Telus Health EMR will integrate it all. It makes sense for them to use it, because it offers one place to go for Our new Infoway Insights website all information.” The common platform will also enable puts comprehensive data about fast, secure electronic communication between clinicians – something that isn’t avail- digital health attitudes, behaviours and able if a doctor uses a different EMR. VWPUPVUZYPNO[H[`V\YÄUNLY[PWZ;OPZ Additionally, the province will be paying for the implementation, so doctors won’t easy-to-use website is available to have to pay for it out of their own pockets. As part of the project, doctors who were L]LY`VULHUKVќLYZLZZLU[PHSPUZPNO[Z using a different EMR will have their data into key topics like virtual care, digital migrated into the new system. Dr. Newson stressed that adopting an OLHS[OILULÄ[ZLTLU[HSOLHS[O EMR is a major undertaking for physi- LWYLZJYPIPUNHUKTVYL cians, especially if doctors haven’t been using an electronic system. For this reason, the stakeholders are putting a good deal of effort into change management. “We don’t want to over- Explore Infoway Insights today. whelm our physicians,” she said, noting insights.infoway-inforoute.ca that support teams will be visiting physician practices to help them – and their staff members – with the transition to working with digital systems.

Publisher & Editor Contributing Editors Art Director CANADA’S MAGAZINE FOR MANAGERS AND USERS Jerry Zeidenberg Dianne Craig Walter Caniparoli OF INFORMATION TECHNOLOGY IN HEALTHCARE [email protected] [email protected] [email protected] Volume 26, Number 3 April 2021 Office Manager Dianne Daniel Art Assistant [email protected] Address all correspondence to Canadian Healthcare Technology, 1118 Centre Street, Suite 204, Thornhill ON L4J 7R9 Canada. Telephone: (905) 709-2330. Neil Zeidenberg Joanne Jubas Fax: (905) 709-2258. Internet: www.canhealth.com. E-mail: [email protected]. Canadian Healthcare Technology will publish eight issues in 2021. Feature [email protected] Dr. Sunny Malhotra [email protected] schedule and advertising kits available upon request. Canadian Healthcare Technology is sent free of charge to physicians and managers in hospitals, clinics Twitter: @drsunnymalhotra and nursing homes. All others: $67.80 per year ($60 + $7.80 HST). Registration number 899059430 RT. ©2021 by Canadian Healthcare Technology. The content of Canadian Healthcare Technology is subject to copyright. Reproduction in whole or in part without prior written permission is strictly prohibited. Norm Tollinsky Send all requests for permission to Jerry Zeidenberg, Publisher. Publications Mail Agreement No. 40018238. Return [email protected] undeliverable Canadian addresses to Canadian Healthcare Technology, 1118 Centre Street, Suite 204, Thornhill ON L4J 7R9. Dave Webb E-mail: [email protected]. ISSN 1486-7133. [email protected]

2 CANADIAN HEALTHCARE TECHNOLOGY APRIL 2021 http://www.canhealth.com Integration of XERO® with Teams enables clinicians and specialists to share images

New solution streamlines Physicians participating in a consult can view communication among the images and communicate with each other using audio, video and chat. Also available is radiologists and other a markup tool allowing clinicians to interact providers, improving with the images using their cursor and to clinical collaboration share the markups in real-time.

The integration of Agfa HealthCare’s XERO® The solution can be customized to meet the diagnostic imaging viewer with Microsoft needs of specific hospitals or clinicians. For Teams allows for easy sharing of images example, a COVID button can be added to among groups of healthcare professionals. the navigation bar in the XERO viewer and Save time tracking down colleagues in the programmed to transmit images to a hospital when a review of images is needed— ‘channel’ of predetermined specialists, days of productive time per year. The app can instead, images can be sent quickly and including pulmonologists and infectious also be life-saving, if a patient has COVID-19 securely in a way that is already used by disease experts. Channels can be added for and needs to be placed in quarantine before many physicians and allied professionals. critical care and cardiology specialists, infecting someone else. ophthalmology, dermatology, and others. Physicians requesting a consult can tag Installation is via a simple plug-in with no specific members of the channel to review The XERO/Microsoft Teams app can save downtime or interruption to viewer use. an image. If they fail to respond, the request valuable time over the course of a week, Following successful implementations in the can be escalated via email and repeated month or year. Agfa HealthCare estimates UK, the companies are now offering the notifications. that with a time saving of 10 minutes per solution to North American customers. consult, an average hospital could save 75

BY NORM TOLLINSKY ences. “It was a general sensing technology that could be used for a variety of applica- ingston, Ontario, a mid-sized city tions. When we came in as co-founders, we of 137,000 people almost halfway decided to take it and build a product between Toronto and Montreal, around drug sensing and analysis.” is leveraging its research and aca- The kit, currently being trialed at the Kdemic infrastructure to emerge as Canada’s Kingston Consumption Treatment Centre, newest health technology hub. a supervised consumption site, detects fen- Kingston City Council identified the idea tanyl, benzodiazepines and fentanyl ana- of creating a health tech hub two years ago, logues, including carfentanil, which is 100 said Craig Desjardins, the City’s director of times more potent than fentanyl and strategy, innovation and partnerships. 10,000 times more potent than morphine. “We did a mapping exercise to identify The mixture of benzodiazepines and the assets, the organizations, the infra- fentanyl is an especially dangerous combi- structure and the human capital in the nation that has been causing a lot of fatal community, and found that we had a seri- overdoses, said Eade. ous cluster in the health innovation space.” Last year, Canada recorded more than Thanks to an investment of $3 million 4,000 deaths due to opioid overdoses, from the Federal Economic Development while the United States has been recording Agency for Southern Ontario in January, approximately 70,000 opioid related the means to realize the objectives of the deaths per year. hub are now in place. Staff at the Kingston Consumption The city’s assets are impressive. Queen’s An employee at the Kingston Consumption Treatment Centre preparing an opioid sample for analysis by the Treatment Centre test the drugs brought to University itself boasts the Centre for Ad- Amplifi ID Kit, which was developed by the Kingston,Ontario startup company, Spectra Plasmonics. the site and are able to educate users about vanced Computing, one of Canada’s lead- any additives that can cause bad outcomes. ing high performance computing environ- ject lead for the hub, ideally someone with Economic Development Corporation and Results take five minutes – most of which ments. There’s also the Queen’s Ingenuity 25 years of experience in the health inno- partner organizations in upstate New York, is related to sample preparation. Labs, specializing in artificial intelligence, vation space who is close to retirement but will be leveraged to access markets in the “It definitely has a lot of potential to robotics and human machine interaction looking for an opportunity to put their United States and attract foreign invest- revolutionize how communities respond to and the Queen’s Partnership and Innova- knowledge and expertise to good use. ment to the region. the overdose crisis in Canada,” said Eade. tion Group, which offers services to sup- The majority of the $3 million, however, Kingston has already produced a num- “Now, most of the testing is done in labs, so port entrepreneurs and startups. will be used to support startup businesses, ber of health technology startups. One ex- we think this can become the new portable Other assets in the city include Kingston to fund the projects they’re working on, and ample is Spectra Plasmonics, which has standard for drug analysis in Canada.” Health Sciences Centre, St. Lawrence Col- to make available the resources and exper- developed the Amplifi ID Kit, which pro- Spectra Plasmonics is aiming for a na- lege and GreenCentre Canada, which oper- tise to help them scale, noted Desjardins. duces near real-time analysis of opioids. tionwide rollout in 2022. ates a state-of-the-art lab focused on St. Lawrence College and Queen’s Uni- The cell-phone sized device identifies Another company that has emerged chemistry solutions for industry and the versity will engage frontline healthcare harmful additives in street drugs likely to from Kingston’s health tech hub is Me- environment. workers to identify healthcare challenges result in drug overdose and death. shAI, which uses artificial intelligence to “A lot of these pieces weren’t as con- and match them with local entrepreneurs. “The technology was initially developed produce staffing schedules for hospital, nected as they could be and, without those New products and ideas will be tested and in the Department of Chemical Engineer- clinics and public health agencies. connections, we weren’t harnessing and validated through use of the labs at ing at Queen’s University under the super- Founded by Dr. Sean Yousefi, a PhD in leveraging the potential synergies,” said Queen’s and GreenCentre Canada. vision of Dr. Aris Docoslis,” said co- Electrical Engineering and Communica- Desjardins. Uniquely, the Kingston-Syracuse Path- founder and CEO Malcolm Eade, a recent tions, and Dr. Ethan Heming, PhD in neu- The City is currently recruiting a pro- way, a collaboration between the Kingston Queen’s graduate with a degree in Life Sci- CONTINUED ON PAGE 13

Michener Institute creates new program in digital health and analytics

ORONTO – The Michener Institute derstand how healthcare systems work cluding personalized medicine and ethics; Students can sub-specialize in areas of Education at UHN is creating a and how healthcare is now delivered.” • Project management, product devel- such as artificial intelligence and robotics, Tnew full-time program to meet Catherine Wang is the vice president, opment and change management; and can exit after four successful semes- the needs of the healthcare system for Clinical, at the University Health Net- • Design thinking, including user ters, having met their Post-Diploma Cer- digitally literate healthcare professionals. work (UHN), and administrative lead for experience; and tificate requirements. Those students con- The new Digital Health and Data Ana- the Joint Department of Medical Imag- • Hands-on learning, including tinuing with the program will have two lytics Program is designed to be pragmatic, ing (JDMI), which encompasses medical practicums and placements. semesters of workplace practicum experi- practical and job oriented – anticipating imaging across UHN, Women’s College ence, in addition to a possible sub-spe- the needs of the workplace of the future Hospital and Sinai Health System. She cialty course in order to complete the six- and using the best education science and says she is seeing the need for this type of semester Advanced Diploma program. methodologies to meet those needs. professional in her daily practice. The Digital Health and Data Analytics A combination of in-class teaching and “In the past, it has always been about programs will begin in September 2021. hands-on learning at high-profile public how to make a better tool, but the con- Enrolment for the full-time program institutions and businesses will give grad- versation is no longer about equipment,” will open in April 2021. Interested candi- uates the skills and knowledge to care for said Ms. Wang. “Now the next frontier is dates can visit Michener.ca/choose for patients in an increasingly machine and taking the imaging and manipulating more information. data-driven healthcare environment. and extracting better data, taking analyt- As Canada’s only “school within a “If we look at what’s happening in ics and mapping the patient journey in a hospital” dedicated exclusively to health- healthcare currently, digital health, tech- longitudinal approach ... all of which re- Harvey Weingarten Catherine Wang care education, Michener is uniquely po- nology and artificial intelligence are al- quires data science.” sitioned to prepare healthcare profes- ready changing clinical practice and Key components of the curriculum The program is geared toward health- sionals in these emerging fields. Mich- healthcare delivery,” said Harvey Wein- include: care providers, graduate students and IT ener’s new program will support health- garten, principal of Michener’s School of • Digital health, including virtual care, professionals who want to advance their care professionals at every point in their Applied Health Sciences. “Our consulta- simulation and virtual reality; careers in healthcare and work on cut- career pathway through virtual learning, tions have continually reinforced that • Data science, including the analysis ting-edge digital, analytics and AI workplace learning, data simulation and there is a serious need for digitally liter- and use of clinical data; healthcare initiatives. The program will modelling, micro-credentialing and col- ate and data savvy individuals who un- • Machine learning, AI and robotics, in- be delivered entirely online. laboration with other institutions.

4 CANADIAN HEALTHCARE TECHNOLOGY APRIL 2021 http://www.canhealth.com SPONSORED CONTENT INNOVATION PHC collaborates with Microsoft and UBC to mitigate spread of COVID-19 The project uses leading-edge Artificial Intelligence technology, combined with sensors, to determine if patients, staff and visitors are respecting social distancing guidelines and using protective equipment.

ANCOUVER, BC – As Canadian health officials continue to double down on mitigating the spread of COVID-19, a multidisciplinary collaboration has begun between Providence Health Care (PHC), Microsoft Canada and Vcomputer vision researchers at the University of British Columbia (UBC). Together, these organizations have developed an artificial intelligence (AI) powered solution to monitor the effectiveness of COVID-19 social distancing policies and guidelines at PHC’s St. Paul’s Hospital campus in Vancouver, B.C. This solution will help them plan for and maintain daily operations and routine procedures in the coming months. Following the initial outbreak earlier this year, PHC began planning in expectation of a second wave of COVID-19 infection rates with a mission to improve patient outcomes, particularly among the most vulnerable in long-term care and acute care settings. By leveraging Microsoft’s expertise in the Internet of Things (IoT), edge computing and AI platforms in combination with UBC researchers’ capabilities in algorithm development, PHC has implemented – in pilot – deep learning AI tools to further prevent the spread of COVID-19. These tools are designed to monitor personal protective equipment (PPE) use, social distancing and occupancy counting for the continued safety of patients, staff and visitors. First rolled out in the hospital’s emergency and radiology waiting rooms, and laboratory services, the project is facilitated using cameras that detect face mask usage and social distancing levels with a goal of eventually scaling to hundreds of cameras within gent Edge enabling superior inferencing perfor- “AI-driven computer vision has come a long way, high-traffic areas. Although they enable real-time mance while ensuring privacy for hospital patients yet reaching the levels required for robust and wide- compliance, the cameras do not collect personally and staff; spread deployment in an ever-changing real world identifiable information. • Microsoft Power BI: Data visualization tools to in- still holds many open challenges,” says Helge Rhodin, “Multidisciplinary collaborations with industry gest real time data from the cameras and quickly Assistant Professor, Department of Computer Sci- and academia expedited our development process, generate reports; and ence, UBC. “This joint project on handling the new thereby directly assisting our efforts to plan for the • Azure IoT Edge: Connecting the cameras and the normal yields a stimulating playground for algo- urgent and ever-evolving nature of the COVID-19 Azure cloud environment, all while running Azure rithm development within a framework of privacy crisis. Our collaboration with Microsoft and UBC machine learning modules to ensure personal identi- and ethical computing.” provided invaluable domain knowledge to help us fiable information is not collected. “It has been exciting to work with a multidiscipli- move quickly, safely and effectively to help all stake- “This initiative marks an exciting advancement nary team to see how we can best apply AI technol- holders involved,” says Soyean Kim, Director of Dig- for Providence Health Care in working to mitigate ogy in hospital settings to reduce the chance of trans- ital Products at Providence Health Care. “The project the spread of COVID-19 and improve patient out- mitting respiratory viruses in small spaces. The team could not have moved from inception to pilot at St. comes for all, including the most vulnerable. It’s also has been responsive to iterative improvements with Paul’s Hospital so quickly without this spirit of col- an important milestone for Microsoft, providing the goal of effectively monitoring adherence to mea- laboration for the common good.” major learnings for other healthcare environments sures we have in preventing the transmission of “The COVID-19 crisis has created new challenges regarding the deployment and adoption of AI and COVID-19 in some key areas at St. Paul’s Hospital,” and has placed unprecedented demands on Canada’s IoT technology in their operations,” says Moe Tan- says Dr. Victor Leung, Medical Director, Infection healthcare system. At Microsoft, we have been col- abian, Vice President and General Manager, Azure Prevention and Control, St. Paul’s Hospital. laborating with our partners throughout the pan- Edge Devices, Microsoft. In addition to adopting cutting-edge technology demic to solve big challenges by connecting data and to mitigate the spread of COVID-19 among patients systems in the cloud and putting safety measures and and visitors, PHC has recently been approved for and health guidelines in place for our healthcare organi- begun working with Microsoft Azure Edge Devices’ zations to better support patients and healthcare new IoT DevKit private preview program. With this professionals,” says Dr. Helia Mohammadi, Chief technology, PHC plans to build and pilot new solu- Data Scientist and Healthcare Lead, Microsoft tions for non-contact patient monitoring and moni- Canada. “Microsoft’s cloud and AI offerings, in par- toring of hand hygiene. ticular solutions developed to address the COVID-19 While the chapter is not yet closed on COVID-19, pandemic, accelerate research findings and improve the lessons learned from PHC’s leadership imple- patient outcomes.” menting technology to control the spread of the

As part of this project, PHC has implemented var- virus and inform best practices across their organiza- CARE. IMAGE COURTESY OF PROVIDENCE HEALTH ious Microsoft solutions including: Emergency Department Live Dashboard leveraging Microsoft tion’s operations will remain long after the pandemic • Vision AI DevKit: Smart cameras for the Intelli- Power BI to showcase real time detection and monitoring of PPE. has ended. http://www.canhealth.com APRIL 2021 CANADIAN HEALTHCARE TECHNOLOGY 5 NEWS AND TRENDS Clinicians using Hypercare to replace pagers and improve scheduling

BY NORM TOLLINSKY ally, there’s no way with a pager to tell if you have to do it all over again,” noted Annette need to return a page right away because it’s Stelmachuk, RN clinical analyst. “With Hy- linicians at the Huron Perth an emergency or if you can wait 10 or 20 percare, they can log on, make a change Healthcare Alliance in south- minutes because it’s just a simple question.” and it’s available instantly to everyone.” western Ontario are surren- Hypercare has an urgent alert function Physicians can also make use of Hyper- dering their pagers in favour that allows users to prioritize emergency care’s scheduling marketplace, said Ismail of a smartphone and web- messages and overrides smartphone silent Moola, Hypercare’s director of business basedC messaging and scheduling solution and do not disturb settings. development. “If I have a shift that I want from Toronto-based Hypercare Inc. “Another thing the staff like is that to trade with a team member or give away, “Pagers are old technology and aren’t be- there’s an indicator that tells you the physi- I can post it to the department using the ing fully supported anymore,” said Dr. Tom cian or the person you’re communicating marketplace function and someone else Haffner, an internal medicine specialist and with has seen your message,” said Brenda can pick it up. All of the changes in the physician champion for the Hypercare pro- Murray, an applications analyst and pro- Hypercare scheduling platform are up- ject. “We were running into issues with re- ject manager for the rollout. “That’s a great dated in real-time.” ception and missing pages frequently be- feature for nurses because they know the As a cloud-based solution independent cause of dead zones in the hospital. Medi- physician has seen the message and that he of the hospital’s existing communication cine is probably one of the last vestiges of or she is going to get back to you.” systems, Hypercare isn’t necessarily re- pager use, so it was really out of necessity Hypercare also accommodates consult stricted to hospital staff. Community that we began looking for a new solution.” messages. For example, nurses can select a healthcare organizations and general prac- Established in 2003, the Huron Perth simple, one sentence message requesting a titioners affiliated with the Huron Perth Healthcare Alliance includes the Stratford call back. and Area Ontario Health Team could also General Hospital, Clinton Public Hospital, “Physicians don’t want to see a whole sign up and connect with hospital staff and Seaforth Community Hospital and St. textbook on what’s happening with a pa- Dr. Tom Haffner, Internal Medicine Specialist each other. Currently, one of their OHT Marys Memorial Hospital. tient. That’s communicated verbally when partners, ONE CARE Home and Commu- Huron Perth acquired the Hypercare the physician returns the call,” said Murray. Hypercare,” noted Dr. Haffner. “We are en- nity Support Services, is undergoing a pi- app in the spring of 2020 and rolled it out Like other messaging apps, Hypercare couraging them to do so. You have to show lot with Hypercare as well. as a pilot project to the Internal Medicine users are able to include clinical images, them the benefits of the application and Hypercare notes that it is able to cus- group, the ICU and the telemetry stroke videos, and documents with their mes- have them come along rather than tell tomize the solution to address the specific unit in Stratford. In November, it was sages, but Huron Perth is taking it one them what they have to do, but that’s not needs of its customers. At Barrie’s Royal rolled out to the rest of the hospital, in- step at a time. to say that at some point we won’t ask Victoria Hospital, for example, it devel- cluding nursing units, pharmacists and al- “We’re not using the image feature yet,” everyone to sign up.” oped a messaging application to contact lied healthcare professionals. One month said Dr. Robert Davis, Huron Perth IT Resistance to change, added Dr. Davis “is the cath lab team in response to Code later, it was made available to the three physician lead. “We decided to get as many best addressed by having one’s peers say they STEMI activations. “A high priority mes- community hospitals. physicians on board and comfortable us- like it and spreading that kind of positivity.” sage is sent out through Hypercare to the Hypercare is a HIPAA and PHIPA-coming the app first, but this is a great feature As of mid-February, the Hypercare appropriate people based on the on-call pliant solution designed to meet the distinct to have if you’re in a wound clinic and the scheduling functionality was being used by schedule,” said Ismail Moola. At Michael needs of clinicians in the healthcare envi- physician isn’t there at the time. Once we the internal medicine and pediatrics groups. Garron Hospital – formerly Toronto East ronment, while still providing the ease of get the physicians and staff using Hyper- “Instead of calling the switchboard to General – an integration with the hospi- use that is similar to commonly used mes- care comfortably, that’s our next step.” see who’s on call for pediatrics, for exam- tal’s EMR alerts the most responsible saging apps in use by the general public. Huron Perth is looking forward to a ple, you can just check Hypercare on your physician and the infection control team It also addresses several shortcomings as- full rollout of Hypercare’s scheduling smartphone,” said Murray. through Hypercare when a patient tests sociated with pager use. For example, “it was functionality once more physicians make Currently, “physician admins and others positive for COVID-19 and when their not infrequent at all that a page would fail to the transition. responsible for paper-based scheduling blood oxygen level drops below a certain send and the nurse wouldn’t know that we “At this time, we have not made it have to fax out 20 different schedules to threshold. This informs the team that their didn’t receive it,” said Dr. Haffner. Addition- mandatory for physicians to sign up for different places and if there’s a change, they patient needs an urgent assessment.

Guardian Radiology to modernize workflow and reporting with AI o achieve productivity, effi- providers and communities they serve. This spring, the cloud-based Power- “We provide a broad array of ser- ciency, and quality improve- Until recently, the practice had relied Scribe One platform will become avail- vices here, and so we strive to imple- ments, Guardian Radiology on a traditional dictation-based report- able in Canada, and Guardian Radiol- ment new technologies and imaging plans to modernize its working system in conjunction with their ogy will become the first practice to de- techniques for all of our locations in a flowT with a suite of AI-powered tech- RIS/PACS. In the fall of 2020, however, ploy this solution. synergistic way. PowerScribe One will nologies from Nuance. Together, the new they were ready to move to a new “Canadian healthcare organizations integrate our applications so we can be technologies will automate and augment RIS/PACS solution. continue to innovate and transform more efficient and effective,” com- the radiology reporting workflow with Concurrently, they wanted best of their technology strategies in ways that mented Dr. Young. speech recognition and natural language breed technologies that incorporated enable a multi-disciplinary, integrated PowerScribe One uses continuous processing capabilities. speech recognition and addressed overall learning and “context-aware language This practice will become the first in workflow and communication processes understanding technology” to automati- Canada to deploy both PowerScribe One to support their radiologists’ need for cally convert the radiologist’s unstruc- and PowerScribe Workflow Orchestration. enhanced productivity, faster turn- tured text into structured data. “We want to spend as much time as around times, and more robust work- A voice-enabled workflow control possible on what’s most important in ra- flow distribution management. turns free-form dictation into orga- diology – looking at the images. That’s Guardian Radiology expects the new nized, structured reports, making it eas- where our referring physicians and pa- solutions from Nuance – PowerScribe ier for radiologists to create accurate, tients benefit most, and that’s where the One, PowerScribe Workflow Orchestra- comprehensive, and consistent imaging Nuance solutions will help us most,” said tion, and PowerConnect Communicator reports that communicate a patient’s ra- Dr. Casey Young, medical director, – to deliver the quality, efficiency, and ac- diology findings. Guardian Radiology. curacy improvements they’re looking for. team approach to patient care. We are “Efficiency comes in many forms, but A community-based radiology Introduced in the U.S. in 2019, Pow- honored to partner with Guardian Radi- when it comes to caring for patients, it provider with locations throughout Al- erScribe One harnesses modern, user- ology in this endeavor and thrilled to be can’t just be about how fast you can get berta and Saskatchewan, Guardian Radi- centric design principles coupled with able to bring PowerScribe One to things done,” said Karen Holzberger, se- ology provides both onsite and teleradi- AI-driven clinical intelligence to auto- Canada,” said Ben Hebb, national direc- nior vice president and general manager ology services to meet the needs of the mate and augment radiology reporting. tor, healthcare diagnostics, at Nuance. CONTINUED ON PAGE 15

6 CANADIAN HEALTHCARE TECHNOLOGY APRIL 2021 http://www.canhealth.com SPONSORED CONTENT INNOVATION BC cancer researchers turn to the Microsoft cloud to meet fast-growing requirements The search for precision-medicine therapies is now assisted by unlimited storage and computing power that is shareable among different organizations.

cancer-free world – that’s the ambitious mission of BC Cancer. Based in Vancou- ver, the agency conducts leading-edge cancer prevention, screening, research, and treatment. Within the Department of Molecu- Alar Oncology at BC Cancer, the Aparicio lab focuses on precision medicine, which is far more effective than treating cancer patients as a homogenous group. It studies individual cancer cells because each type of cancer in each patient is different. The lab’s scientists do single-cell genome sequencing to understand the diversity that exists within a cancer, learn how those tumors become resistant to treatment, and create the most targeted treatment possible. The methodology is ground-breaking – and com- putationally intensive. The research creates a massive amount of data that the Aparicio lab stored and processed in an expensive on-premises environment. “We had millions of dollars of on-premises servers that we purchased through grant funding,” says Daniel Lai, Senior Bioinformatics Scientist at BC Cancer. “They powered our research for almost a decade, but they had limited lifespans and capabilities. We needed to move to the cloud to continue supporting research at the scale we need.” Data for machine learning: As the lab continued searcher team to understand its data requirements and 400–500 TB of data per year. “We would need to to generate a huge volume of data, it turned to AI and how it interacts with the data. “We wanted to en- buy a new hard drive every couple days and a new and machine learning to find patterns in its genome sure that the Aparicio lab had a method of cataloging server rack every couple of months just to keep up research. “By using machine learning algorithms, re- its data so the metadata was consistent and staff with this pace,” says Lai. “We’ve solved that com- searchers are able to rapidly create virtual machines could easily search it later,” says Craig Slack, Chief pletely with Azure because we have effectively limit- that are capable of pinpointing mutations in the Executive Officer and Co-Founder of Invero. less computational power.” haystack that is the human genome,” says Lai. The lab also worked with a team of Microsoft Those files must be processed every night after To store its data and support its computational cloud solution architects who answered Azure-spe- they’re uploaded. According to Lai, it ranges from needs, the Aparicio lab adopted the Microsoft Azure cific questions for the BC Cancer software developers several cents to several dollars per hour to run the cloud platform three years ago. Data experts at the and offered guidance and best practices. The Mi- virtual machines, which can add up quickly with lab create their own machine learning algorithms crosoft team held onsite training for the Aparicio lab thousands of machines. So, the lab adopted Azure that they run in Azure by using Azure Virtual Ma- on how to best administer the cloud environment Batch, a job scheduling service that triggers the tens chines. A 2019 paper published in a Cell Press scien- of thousands of jobs that are required to process tific journal detailed their sequencing methods and “Previously, we’d get held up for a year these files. Batch uses low-priority servers that are algorithms and how the lab solved computational idle in the datacenter and that aren’t immediately challenges with innovative tools and techniques. “Be- on something that we can now resolve in used or required. cause we use genomic approaches to study cancers in less than a month,” says Daniel Lai, Senior “On average, using Azure Batch costs about 10 newer and newer ways, we have to develop our own Bioinformatics Scientist at BC Cancer. percent of a normal virtual machine,” says Lai. “By algorithms,” says Samuel Aparicio, Chair of Breast using these low-priority instances with Batch, we can Cancer Research at BC Cancer. process tens of thousands of files every 72 hours and However, the lab still ran its clusters primarily in while also helping ensure that researchers could ac- do 10 times the work for the same price compared to an on-premises environment, and more of its hard- cess data they need. standard virtual machines.” ware was reaching end of service. The lab knew it Part of the lab’s vision around partnerships also Scalability and speed: The lab gained the scalabil- needed to move its entire genome database to the extends to other research institutes. A researcher ity and speed it needed by moving its genome data- cloud to get the compute power and scale that it from BC Cancer recently moved his lab operation to base, running its machine learning in Azure, and us- needed. Lai explains just how much data the lab Memorial Sloan Kettering Cancer Center in New ing Batch to trigger processing jobs. Ultimately, its works with: its single-cell sequencing approach cre- York, but he planned to continue collaborating with improvements in data management and analysis will ates a thousand input files every two days. In a week, former colleagues for several years. help inform cancer diagnoses and treatments as re- researchers face 4,000 individual novel files that its By moving its data to Azure, the Aparicio lab cre- search eventually moves into clinical applicability. system must analyze, which takes a few minutes to an ated a shared computing environment from which “With our flexible computing environment in Azure, hour each. “The amount of computation we need ex- many researchers in the field can benefit. “Thanks we now have a way to accelerate and scale our ploded and grew out of scale very rapidly,” says Lai. to Azure, researchers in different countries can processes so we can learn more by operating with “Our 600-core cluster of 40 computers couldn’t keep share knowledge and collaborate seamlessly on the more data,” says Aparicio. “The more patient infor- up anymore.” same datasets that could lead to treatments,” says mation we can aggregate, the more power we have to Collaborative migration and data sharing: The Aparicio. “Our field increasingly will need this type learn about important but subtle effects that are easy Aparicio lab began migrating its massive 1-petabyte of partnership with other institutions and a com- to miss without enough data.” genome database to the cloud. It received technical mon computing environment, so we’re trying to Adds Lai, “Previously, we’d get held up for a year support from local company Invero, a member of the lead the way.” on something that we can now resolve in less than a Microsoft Partner Network with Gold competencies Increased computation, reduced costs: The month. Our lab uses machine learning on Azure to and the Cloud Summit 2019 Canadian Microsoft Aparicio lab now processes the high volume of data make predictions about tumors with a speed and ac- Azure Partner of the Year. Invero met with the lab re- it needs, generating a terabyte (TB) of data a week curacy that humans can’t do.” http://www.canhealth.com APRIL 2021 CANADIAN HEALTHCARE TECHNOLOGY 7 VIRTUAL REALITY Nursing embraces virtual tools to keep skills sharp during pandemic

BY ROSALIND STEFANAC program, called CyberPatient, allows students to follow their patients through a ursing student Victoria Ah- continuum of care, take medical histories, madi hasn’t been able to par- perform exams, order tests and come up ticipate in any clinical rounds with a diagnosis and treatment plan. in the hospital because of At the Daphne Cockwell School of Nurs- COVID-19 restrictions. But a ing at Ryerson University, a virtual hospital Nvirtual reality platform allows her to experi- houses a series of simulation games to help ence life-like hospital scenarios with patients students develop skills in a way that is both directly from her home computer. fun and informative. (See https://de.ryer- “We’re even given scenarios that we son.ca/games/nursing/hospital) wouldn’t [necessarily] be able to experi- The first game on pediatric health as- ence as students, like this one patient with sessment was launched in 2013, and since an allergic reaction who broke out into then, the nursing program has launched hives while I was talking to her,” says Ah- games covering topics such as mental madi, who will graduate from Seneca Col- health, gerontology and medical surgery. lege’s School of Nursing in Toronto this “When we first started making these year. “It forced my critical thinking skills, games, we found a topic and then a and it was awesome.” course where it would work,” says Daria The platform offered through Oxford Romaniuk, associate director of the col- Medical Simulation is just one of several laborative degree program. “Now we’re ways nursing schools like Seneca and identifying areas of a course where a sim- other learning institutions across the ulation game would work and developing country are embedding technology into one to fit.” their curriculums to better prepare health The free games, offered in collaboration care graduates for what they’ll encounter with nursing schools at Centennial College in the workplace. and George Brown College, are open to “While the pandemic has been horrible anyone online. (See https://www.coursec- for the world, one benefit has been this ompare.ca/best-nursing-schools-nursing- push to VR platforms,” says Seneca’s Sharon A new generation of VR headsets and software enable nurses to learn in a safe and interactive way. colleges-and-universities/) They take up to Cassar, academic chair in the School of 60 minutes to play, can be repeated several Nursing. “When we come back to campus that’s stimulating them to think like setting. “But now we can standardize the ex- times to improve responses, and provide and do in-person simulations with man- nurses,” she says. periences our students will be exposed to so the user with a summary report with sug- nequins, we also have these VR headsets “When a nurse walks into a room, they can do it again and again – until it be- gested links to further reading modules as where students can immerse themselves in they’re quickly gathering data like skin comes part of their muscle memory,” she needed. “We’ve certainly seen an uptake a room and safely engage in scenarios.” colour, bed position and how a patient is says. “It’s exciting for educators because throughout the pandemic and have lots of Developing nursing instincts: Cassar breathing. This platform is fostering that we’re helping build a stronger nurse.” inquiries from different faculties about our says much of students’ online learning ex- ability to synthesize multiple data points The University of British Columbia is games,” says Romaniuk. periences in the past have been one-di- and formulate them into a decision.” another innovative university using a web- The latest stats from October 2020 mensional, watching videos and exploring In a typical nursing program, Cassar says based learning platform – developed in- show the mental health assessment game the web. “With this, they’re in a platform it would be impossible to give every student house – to help medical students gain con- was played by 97,000 people a total of where they’re forced to do something and the same practical experiences in a clinical fidence with patient encounters. Their CONTINUED ON PAGE 15

Cerner collaborates with partners to improve digital healthcare in Canada

BY JIM SHAVE During the past year, the goals of the ities in Vancouver Coastal Health, the most up to date EHR functionality Infoway Alliance have been more impor- Provincial Health Services Authority and available. Concurrently, we are also erner is proud to be a tant than ever, as we all came to terms Providence Health Care. working with Infoway to develop Pre- member of the Canada with the COVID-19 pandemic. During Patient portals are proving to be a scribeIT integration within health infor- Health Infoway Alliance, this busy and tumultuous time, Cerner very effective tool to engage with pa- mation systems, to ensure safer medica- helping healthcare organi- Canada’s COVID-19 task force has been tients in support of a virtual care model. tion dispensing. zations across the country holding regular calls with Canadian Many of our clients, including CAMH, Cerner is working closely with AWS, Cto accelerate their adoption of digital healthcare organizations to keep abreast Island Health and Northern Health, are our long-term hosting and transforma- health solutions. of new learnings and push relevant infor- taking it a step further than the standard tion partner, to better leverage the bene- The focus of the Infoway Alliance is mation updates to frontline care workers. results viewing fits of the Software-as-a-Service model improving access for Canadian citizens – Cerner’s commitment to encouraging portals. They are and further investigate the possibilities making sure that medications are dis- better adoption of digital health solutions advancing to a of AI and machine learning. The value of tributed more safely and linking individ- in Canada hasn’t just been about more interactive, this model has already been proven uals and their healthcare providers with COVID-specific innovation. Other ele- bi-directional inte- through the rollout of some of Cerner’s the right digital health information ments of healthcare still need to be at- gration to the elec- cloud solutions in Canada, including whenever and wherever they need it. tended to during a pandemic and we have tronic health HealtheLife patient portal, Command Cerner has served the Canadian been able to ensure that our clients have record (EHR). Centre dashboard, PowerChart Touch healthcare sector for more than 35 been able to better support their obliga- Northern Health is mobility, CareAware Connect Nursing years. The experience gained over that tions to provide safe, effective care in a currently working and CAMM7 image archive. time puts us in the ideal position to virtual environment wherever possible. on integrating Embracing the cloud in Canada will, partner with the Infoway Alliance to In 2020, COVID-19 did not halt our Jim Shave video visits to among other things, enable infrastruc- make this shared vision a reality. We progress in HIT-enabled transformation make these virtual ture expansion and the delivery of up- work with more than 400 sites in nine and we supported large implementation interactions more seamless and in con- dates for client adoption, as well as pro- provinces. We have worked in concert projects remotely with the TransForm text to the clinical record to ensure posi- vide resource savings and give clients the with numerous Canadian healthcare or- Shared Service Organization – five hos- tive provider and patient experiences. ability to use Cerner HealtheDataLab to ganizations to help them adopt new, en- pitals in Erie St. Clair, Ontario – and the Across the country, we have been support broad clinical research and ad- abling technologies that support their Clinical & Systems Transformation pro- working with clients to focus on our Get vance learning and innovation. drive to improve the quality and safety ject, which continued to go live with new Current, Stay Current campaign, so they of patient care. enabling technology support across facil- and their patients can benefit from the Jim Shave is President of Cerner Canada.

8 CANADIAN HEALTHCARE TECHNOLOGY APRIL 2021 http://www.canhealth.com Same compelling content. 6OLJKWO\GL΍HUHQWVHWWLQJ

We can’t meet in person, but Canadian digital health professionals can still count on the annual e-Health Conference and Tradeshow to deliver valuable networking, quality content, great speakers, and multiple learning opportunities. This year, let’s meet online at three unique Pre-Conference virtual events and over two days of virtual Conference and Tradeshow activities—in an all-new interactive online environment! These days, making connections can be hard. e-Health makes it easy.

Early Bird Savings until March 30, 2021 Register at e-healthconference.com New systems emerge to help connect patients to care-givers by using online tools The systems are making it easier for care-givers to improve their operations and reputations

VIEWPOINT BY DR. SUNNY MALHOTRA Invigo’s third phase utilizes referral marketing and assist providers in achieving success by offering sales funneling to aid in achieving the right patient products like search engine optimization, online ad- hen choosing a medical prac- population for a medical practice to ensure growth vertising, reputation management, website manage- tice, prospective patients often through patient relations. The company offers health- ment, healthcare marketing, and more that work col- turn to online platforms to care consultations to implement the right tools for ex- lectively to enhance and promote medical practices. help them search for the right pansion and data analysis to help track development. PatientPop can guide patient satisfaction by fo- physician. These decisions are EverGenius, a software program developed to cusing on every aspect of the online platform that a based on reviews by other pa- scale and grow practices in the third phase, is another patient encounters. PatientPop does this by optimiz- Wtients on the services rendered and care received. service offered by Invigo. EverGenius can track ing practice presence from web profiles such as These reviews are imperative for practice growth prospects and patients in sales cycles, manage patient Google and Yelp, taking into consideration patient and development. Reputation management is here to reviews, practice website, and web listings. stay and provide accountability. Patients can access online scheduling to get in In the United States, healthcare organizations are Solutions are appearing that touch 24/7, have automated alerts for appointment starting to integrate digitally enabled medical prac- allow patients to self-schedule their confirmation, and automated patient surveys from a tice management solutions into their daily opera- appointments, receive reminders, and practice portal to advocate positive patient reviews. tions to grow their practices. As quality and patient- PatientPop improves patient retention through centred care takes off in Canada, such practices will send back quality surveys. strategic marketing emails that encourage future ap- likely make their way north of the border – especially pointment scheduling. It allows other sites to link to with the rise of group practices and corporate- retention through automated appointment follow- the medical practice website when referencing the owned medical practices. ups via text, e-mail, and voice calls. It can generate practice to accelerate search engine optimization, Invigo Media is a medical marketing business that insightful growth reports that pinpoint weak areas of publish and manage social media, leverage paid ad- offers comprehensive services to help medical practices the practice and track reviews across multiple vertising, and boost online reputation through reach their potential. Invigo uses a proven ‘C3 Process’ online sources to boost online presence and frequent patient review feedback. that follows a phase-by-phase approach which begins improve overall review scores. PatientPop also promotes efficient and secure by capturing the attention of the patient market This three-phase process allows Invigo data sharing, creates a practice portal that allows through the use of web design, influential copywriting, Media to target and promote businesses to practices to view performance metrics and ac- authority building, “direct-booking” medical pay-per- ensure growth and success in all aspects of tion incoming appointment requests, and allows click campaigns, Facebook advertising, and search en- reputation management and marketing. for the integration of EMR to gain more positive gine optimization on sites like Google. PatientPop is a company designed to online reviews, reduce no-shows, and streamline This is closely followed by the second phase of the administrative tasks. process in which Invigo works to connect patients with Dr. Sunny Malhotra is a US trained sports Solutionreach is a company dedicated to pa- the medical practice via e-mail, social media, and mo- cardiologist working in New York. He is an tient relationships and their management. bile marketing strategies that promote online existence entrepreneur and health technology Solutionreach focuses on technology and ease of access to information about the practice. investor. He is the winner of the designed to improve patient expe- Live chat availability outside of normal business national Governor General’s riences and promote lasting hours, video marketing that illustrates the goals of Caring Canadian Award 2015, patient-practice connections. the practice, and sales scripting that sells the practice NY Superdoctors Rising Stars Products at Solutionreach from the first encounter to end-of-visit further se- 2018 and 2019. aim to enhance medical cures patient satisfaction and retention. Twitter: @drsunnymalhotra CONTINUED ON PAGE 15

Managed Equipment Services effective solution to avoid lawsuits

BY DENIS CHAMBERLAND formance and interpretation of when she was examined in July 2018. clear through the legal proceedings breast imaging” at HSN. By mid-2019 the plaintiff discov- how much of the blame is put on ospitals in Canada are going A 2018 internal letter sent to the ered at another hospital that she had aged equipment or on substandard through trying times, and leadership of HSN and now in the grade 3 metastatic breast cancer. Her radiology practices which caused hu- Hnot always because of the hands of the plaintiff’s lawyers de- lawyers say man error, or very possibly both. pandemic. Perhaps nothing is as try- scribes how a group of physicians at that since the Managed Equipment Services: ing as being faced with a $22 million HSN expressed concerns relating to class action While human error can never be class action lawsuit related to breast systemic quality deficiencies in lawsuit was fully eradicated, much can be done cancer screening, which is what breast imaging at HSN. launched in about the state of the equipment. Health Sciences North (HSN) in The physicians note how the cur- December Managed equipment services (MES) Sudbury, Ontario, is facing. rent environment is “leading to sig- 2020 more are a viable solution for hospitals, The lawsuit, launched in mid-De- nificant impairments on their ability than 100 which are under enormous pressure cember against the hospital, several to deliver effective surgical care” to women have to cut costs while at the same time senior administrators and several patients. And separately, a senior ra- joined in, continuing to face the pressures of physicians, alleges “systemic negli- diologist filed a detailed complaint which means improving patient care, often work- gence of the radiology service … in with the College of Physicians and Denis Chamberland the claim could ing with aged equipment. Technol- the performance and interpretation Surgeons of Ontario citing concerns easily escalate ogy obsolescence is a serious prob- of breast imaging, including mam- regarding the quality and manage- well beyond $22 million. lem for most hospitals. mography, ultrasound and magnetic ment of the radiology service at HSN. The claim will take several years MES addresses many of the chal- resonance imaging (MRI).” The lawsuit was filed on behalf of to work its way through the courts lenges faced by hospitals in relation The claim alleges there was “an patients and their family members by before it is dealt with on the merits. to medical equipment. MES involves overwhelming, objective decline in a former HSN patient, who alleges If in fact the former patient’s cancer the outsourcing of all aspects of a the standards of practice in the per- that her breast cancer was missed was missed at HSN, it will become CONTINUED ON PAGE 13

10 CANADIAN HEALTHCARE TECHNOLOGY APRIL 2021 http://www.canhealth.com VIEWPOINT Technology procurement needs to consider more than price alone

BY LAURIE LAFLEUR on a ‘checklist’ of required functionality. into the rigid pre-defined requirements. ment models that reinforce collaboration AND SHIRLEY FENTON This approach looks for proven solu- If we are to make any impactful changes between vendors and the public sector tions and does not support creativity or to how healthcare is delivered, then an in- where focus is on the problems to be ealthcare innovation has been collaboration very well. In fact, vendors of- novative mindset that seeks creative solu- solved and how providers and innovators recognized as essential for im- fering novel solutions are often prevented tions and allows new technologies to be can best work together to achieve the proving the accessibility, scala- from or penalized for proposing capabili- considered is needed. This can be achieved greatest value and outcomes. bility, and quality of health- ties or features in an RFP that do not fit with innovative and value-based procure- CONTINUED ON PAGE 15 Hcare delivery in Canada. Unfortunately, these benefits are yet to be fully realized as procurement is often cited as a significant barrier to the adoption of innovative healthcare technologies within Canadian hospitals. Challenges include fragmentation of governance and funding across our healthcare system, tight budgets, and out- dated procurement models that tend to favour established solutions and penalize One-stop newer companies and technologies. So, how can MedTech innovators and healthcare providers better shopping. navigate procurement to enable faster, and more widespread digi- Canadian Healthcare Technology offers tal transformation of the country’s leading healthcare I.T. our healthcare system? Shirley Fenton The National Institutes publications. Are you getting all the news? of Health Informatics and McMaster Univer- sity Continuing Educa- tion present the answer to this question through a joint course, “Navigat- ing Healthcare Procure- ment”, which explores Canadian Healthcare Technology magazine updated procurement frameworks that em- Canadian Healthcare Technology breaks the news about important Laurie Lafleur phasize a value-based projects, programs and technologies, and provides hospital executives and mindset, foster collabo- senior managers with an excellent source of information for improving ration, and better enable successful diffu- the delivery of healthcare. It’s sent to over 5,200 readers in print format sion and adoption of innovation. This arti- cle introduces key topics that will be exam- and to 6,800 opt-in subscribers as a digital edition. ined in this course. The price-value paradox: Managing tight budgets and cost containment are typically top objectives for procurement agencies. Therefore, significant favour is eMessenger newsletter often given to vendors that are able to of- Canadian Healthcare Technology’s e-Messenger contains breaking news fer the lowest price. about important deals, installations and developments. Four blasts are However, price is not the single most important metric to consider when quan- sent each month, via e-mail, to over 7,000 senior managers and executives tifying value. Other factors including risk in hospitals, clinics and health regions. mitigation, quality improvement, patient outcomes, and others must also be considered alongside the dollars-and-cents asso- ciated with licensing and support fees, potential savings, and revenue potential. How can we ensure that a procurement project not only fits within cost con- White Papers straints, but also results in improved out- Canadian Healthcare Technology’s White Papers are sent out once a comes for patients over the longer term? One method is to build a value-matrix month, via e-mail, to over 5,000 senior managers and executives in that maps qualitative benefits to measur- Canadian hospitals and health regions. The monthly blast contains able results, resulting in a more complete summaries and links to White Papers issued by various organizations, and comprehensive cost-benefit analysis of providing cutting-edge information about topics of interest to competing MedTech solutions. healthcare decision-makers. The other is to ensure procurement processes reinforce communication and collaboration between vendors and providers to facilitate value-based conversations and enable creative problem solving. Moving from commodity to innovation-based procurement: Unfortunately, traditional procurement models (RFPs) are www.canhealth.com designed for acquiring well-defined and es- For advertising or editorial inquiries, contact Jerry Zeidenberg, Publisher, [email protected] tablished commodities and are often based http://www.canhealth.com APRIL 2021 CANADIAN HEALTHCARE TECHNOLOGY 11 12

CANADIAN HEALTHCARE TECHNOLOGY APRIL 2021 FEATURE REPORT W applied to any healthcare discipline, DARWEN is accuracy. degree of high sources avery with from to clinicalinformation digital extract ologies successfully several applying AI models and method- world (RWE) evidence to drive decision making–is andtheneedforreal healthcare (Darwin) lution of –calledDARWEN™gine to reference boththeevo- inaclinicalnote.mation wasburied routine medicalprocedure becauselife-saving infor- founder Steven Aviv, a whosemotherdiedduring sufferedpersonal tragedy by Pentavere CTO andco- making inmentalhealth. analyzed anddigested good decision to support to information allowing bemore easilyaggregated, texts, reports, andpathology labtests anddiagnostic ments such asclinicalnotes, transcription data from electronically inaccessible docu- sion to “quickly andeconomically” extract thepsychiatrist,”clinical notes of saidLeibtag. in drop-down boxes, isn’t inregistries, it’s inthe thedatawe haveson forthatissomuch of isn’t addiction, andtherea- theholeof down further ideation, and patientswhoare goingfurther pression, suicidal are patientswho dealingwith de- horrible areabout patientswho dealingwith sectors like finance. otherindustry is onparwith plying AI to ensure datautilizationinhealthcare Pentavere, growing company arapidly that isap- Leibtag, Toronto-based CEOandco-founder of have littledataonthesepeople,” very said Aaron ceed, andyet we know littlebecausewe very to commit suicideand11peoplesuc- and try andeven treatdiagnose mentalhealth. howchanging Canadiancliniciansunderstand, Group Inc., intelligence artificial isquickly Health andToronto’s Pentavere Research ative like Canadianstart-ups Montreal’s Aifred the horizon: With innov- theongoingwork of entist Dr. Tara Thiagarajan. est, sci- stated SapienLabsfounderandchief younger expected generations to behithard- demic onthementalhealthfront” with health impactfrom COVID-19. Canada have experienced themostsevere mental- in 2019to 26percent in2020, andthattheU.S. and jumpedfrom clinical-level risk 15percentdents with Africa, India andSingapore. U.S., Canada, U.K., Australia, New Zealand, South tool to obtaindatafrom roughly 49,000peopleinthe used theMental Health Quotientonlineassessment the Worldof 2020Report from SapienLabs, which Emerging as an AI-as-a-Service modelthat canbe asan Emerging AI-as-a-Service Five years later, thecompany’s AI en- proprietary inresponseThe ideawasborn to adevastating Launched in2016, Pentavere isonamis- “We know littlefrom very adataperspective “Every day inCanada, 200peoplewake up It’s ableakforecast, spotison yet abright This suggests “a long-term falloutfrom thepan- respon-The study foundthatthepercentage of That’s theInaugural Mental akey findingof State AI systems are assisting with thediagnosis AI systems with are assisting Computers are helping clinicians deal with the overwhelming numbers of people who are suffering. peoplewho numbersComputers of theoverwhelming are helpingcliniciansdealwith and treatment of mentalhealthissues of and treatment BY DIANNEDANIEL tinue to be–profound. con-tal healthis–andwill demic, toll onmen- theglobal lated to theCOVID-19 pan- oradversity re-encing trauma ith oneintwo peopleexperi- or notpsychotherapy wasreceived, forexample. lapsed; suicidalattempts and, orthoughts; whether ment; substance whether abusestarted, endedorre- received; treatments mographics; changes intreat- overtranspired thepastyear by analyzingpatientde- tency asDARWEN. accuracy andconsis- thesamedegree of data with ble” to comb through thatmany records to unlock versity, saiditwould “not have beenhumanly possi- Healthcare andassociate professor atMcMaster Uni- COVID-19 onmentalhealth.pact of 30,000 medicalrecords to better understandtheim- from information to roughly ing theplatform extract review. manual chart ciated with having to incurthetime, cost andinaccuracies asso- patientpopulationswithout ter understandingof empowering researchers andcliniciansto gainabet- for predictors of relapsefor predictors ordeathby suicide. of els andimprove outcomes forpatients, andto look beusedto healthcare helpdesign deliverywill mod- where are they today, sheadded. Theinformation received they the treatments andhow got to they apatient’spicture of healthcare journey, including thatprovides inatabularform arich and radiology mation from medicationrecords, labresults, imaging are real people, model.” notanexperimental when you’re peoplewho basingitonthousandsof theconfidenceimagine you have inyour conclusions more cannabisand alcohol? We thinkitdid, but tomake use worse? start suicidalthoughts Didthey COVID make people’s depression worse? Didit what isreally happening,” saidDr. Samaan. “Did Researchers belookingto understandwhat will Dr. Zena Samaan, apsychiatrist atSt. Joseph’s A project underway inHamilton, Ontario, isus- “It’s usuallyyears before you can geteven 10per- Researchers alsobelookingto gatherinfor- will “I can’t waitto getmy handsonthisdatato see navigation calledKip technology asanexample. Kip is area, pointingto theorganization’s recently launched tools ortools to predict responsiveness to treatment. therapy,ioural decisionsupport aswell asemerging like treatments to cognitive support designed behav- The study includedconversational agentsorchatbots research anddevelopment stage, evolving. butrapidly most AI applicationsinmentalhealthwere stillatthe verse useinclinicalpractice.” ties, thenit’s lesslikely to beaseffective forthat di- doesn’tgorithm thepossibili- reflect thediversity of and RapidResponse. theal- dataof thetraining “If HealthCADTH director Technology of Assessment sponse to atreatment,” Kamel, explained Chris thing happeningwhenyou’re to predict are- trying ferent ethnicgroups …soyou thesame canimagine – we wantto kept seewhat didn’t thepeoplewho de- one thingincommon –which isdepression disorder different indifferent people. thosepeoplehave But if stress could be from of thispandemicandtheeffect COVID. of pact DARWEN helpsto theim- paintaclearer picture of thecrisis.during Substance usehasalsoincreased. bility, casesthathave butalsoinknown destabilized due to distress finances over oremployment sta- lossof depression cases increase isnotjustinnewonsetof fordepression.mental healthservices, particularly The andrequests referrals for numbering agrowing of reading what’s init, thenotes.” andtakingdown human openingeachhad anindividual fileseparately, bigger questionsthanwe could have we answered if “(With DARWEN) we andanswer cangenerate much datacollection,”cent thatsize of saidDr. Samaan. Abbott identifiedKids Help Phone as aleaderinthe itsassessment,At CADTHfound that thetimeof “At themoment, thewhole world issuffering She’s excited aboutthepossibilitiesaheadas thepandemic, Dr. of Since thestart Samaanissee- tion software thatdoesn’t dif- work with “We’ve aboutface seenstories recogni- people, shesaid. lations, FirstNations, Inuit andMetis grants, popu- orracialized ethnocultural such asolderadults, refugees, immi- don’talgorithms reflect specificgroups them, theexisting training andmany of are onlyasgoodthedatathatforms usedin isthatalgorithms laboration AI One findingthatstood outfrom thecol- into mentalhealth.” and how itsintegration bestto support AI about theeffectiveness of andsafety team, saidthegoalwasto learn “more Access Mental to Quality Health Services Maureen Abbott, theMHCC’s managerof in Health (CADTH)in2019. dian Agency andTechnologies forDrugs andstakeholder theCana- view mapwith took anenvironmental scan, literature re- Canada(MHCC) under- Commission of health inCanada, theMental Health inmental AI andmachine learning of To better understandtheusesandtrends would beresponsive to change.” find somethingactionable, services better? I’m we optimistic thatwhen very crisis, canwe dodifferently? Canwe do result whilewe are stillgoingthrough this cline better,” shesaid. we cangetafast “If http://www.canhealth.com

ILLUSTRATION: LINDA WEISS ANALYTICS AND ARTIFICIAL INTELLIGENCE a chatbot designed to make it easier for any- McGill students entered the competition Patients use the app to answer standard her to digest a patient’s responses to the one seeking mental health resources to ex- and the only reason they even incorpo- questionnaires about their mental state questionnaires ahead of their scheduled plore and find support at their own pace. rated in August 2017, was because it was a and quality of life and their unique inputs appointment. An added benefit is that the “Organizations like Kids Help Phone requirement of the XPRIZE,” said Aifred are combined with the company’s propri- tool keeps patients interested in their diag- use AI to detect words in chats and text Health CEO Marina Massingham, who etary clinical treatment algorithms to nosis and care. messages that are then correlated to suici- came on board in 2019 to assist the start- guide treating physicians as they decide the “The decision-aiding tool is very help- dal thoughts, and they’re then able to triage up with financing and commercialization. best course of treatment. ful in closing gaps in terms of knowledge clients in that way,” she explained, noting The original four founders – Dr. David “It’s like having a consult with your col- for the patient and the physician, and the Benrimoh, Sonia Israel, Kelly Perlman and leagues where you need it: at the point of fact that it’s a tool that you’re using to- Robert Fratila – all have leadership roles as care,” said Dr. Fanny Hersson-Edery, a gether really engages the patient in a dif- Using Aifred gives doctors the company forges ahead on its journey, family doctor in Montreal and an early ferent way that wasn’t previously possible,” a better understanding of now one of three global finalists in the user of Aifred. said Dr. Hersson-Edery. the effectiveness of various competition with the $5 million prize to Similar to Dr. Samaan, Dr. Hersson-Ed- “I think mental health sometimes suf- be awarded this June. Regardless of the ery is also seeing a rise in the number of fers from this aspect of it’s not really a treatment options. outcome, Aifred is already making a differ- patients reporting anxious and depressive medical diagnosis but more of a social ence, said Massingham. symptoms related to the pandemic. construct; ‘You didn’t try hard enough’ or that much of the work takes place behind “Today 90 percent of patients within Using Aifred in her practice gives her a ‘Pull yourself up,’” she added. “Having a the scenes. “Many of us have virtual assis- Canada who have major depression only better understanding of the effectiveness tool that uses best evidence, as well as ob- tants at home, so I think it’s only natural ever get to see their family doctor; they will of treatment options, according to a pa- jective data, helps to reiterate the point that AI for mental health is also happening not get to see a specialist or psychiatrist,” tient’s specific symptomology, and enables that mental health is a medical diagnosis.” and helping to make our processes, knowl- she said. “Family doctors are wonderful, edge and prevention easier.” but they are not well equipped in the treat- One of the challenges in evaluating and ment of complex mental health conditions. understanding the effectiveness of AI in Our tool is designed to help physicians un- Kingston healthtech hub has on-ramp to US mental health is the speed at which the tech- derstand where the patient is in on the dis- nology is evolving, added Kamel. “The de- ease cycle and, based on the behavioural in- CONTINUED FROM PAGE 4 “MeshAI is democratizing that process. velopment cycle is quite rapid,” he said. “The formation of that patient, what to do next.” It allows everyone in healthcare to go into volume of different technologies and the Aifred Health has been running clinical roscience, MeshAI had its origins in a near the system and put in their preferences,” pace with which they change will be a chal- pilot projects in Quebec since October death experience caused by a medical error said Yousefi. lenge for the healthcare system broadly.” 2020. North American clinical trials are ex- that was a direct result of bad scheduling “Mesh AI builds the healthcare organi- Rapid change is something Aifred pected to start later this year, as the com- and fatigue. zation-wide needs into the system. You Health can attest to. Not that long ago, the pany begins the process of obtaining both “I was in hospital and being cared for by press a button and the engine first takes company’s four founders were McGill Uni- FDA and Health Canada approval as a someone who had been working 16 hours care of the needs of the organization, so no versity students who came together as a class II medical device. straight and shouldn’t have been there,” ICU or unit is left without the people they club to look at the issue of how mental Aifred replaces the traditional ‘trial and said Yousefi. “It really opened my eyes to need.” After that, the engine goes and finds healthcare gets delivered in Canada. Now error’ approach to treatment selection by some of the challenges in healthcare and solutions that take into consideration the they are poised to start clinical trials of a using a deep learning model to predict the the more I read about it, the more it be- preferences identified by staff. first-of-its-kind clinical decision support optimal recommended treatment for an in- came my passion.” If someone has an emergency and can’t tool in mental healthcare that uses AI to dividual patient. Predictive models are According to Yousefi, 500,000 people make it to their shift, the system suggests support better treatment management, trained on high-quality and reliable clinical die in the United States every year as a re- the next best choice, the schedule is updated matching patients to the right treatment. data sets and are continuously fed de-iden- sult of medical errors. and everyone gets notified by email or text. And it’s all because a professor urged tified patient outcomes to further refine “Of those, 60 to 65 percent are related The solution is currently being used by them to enter the global IBM Watson AI and improve their predictive capability. to stress and fatigue.” several healthcare organizations, including XPRIZE in 2016, a competition to acceler- Core to the solution is a clinician-pa- Scheduling in healthcare, he claims, has KFL&A Public Health serving Kingston ate AI technologies that are solving societal tient application that works in a browser been primarily a unidirectional process and area, Northumberland Hills Hospital grand challenges. on any device, with a downloadable ver- carried out by a chief of staff or someone in Cobourg and Louisiana Women’s “So, this very young team of brilliant sion expected soon. in management using a spreadsheet. Healthcare in Baton Rouge, Louisiana.

higher standard of service at a cost-effec- jority of the patient care at HHS. Other is a complex undertaking because it in- Denis Chamberland tive price, usually well below the hospi- key benefits of MES at HHS include: volves a wide range of expertise and CONTINUED FROM PAGE 10 tal’s existing cost structure. • Access to new and advanced diagnos- skills set typically unavailable within a Some of the obvious advantages of tic equipment, with evergreen replace- hospital. Above all, the MES must be portfolio of medical equipment to a MES include significant financial bene- ment as technology evolves, again miti- customized to the hospital’s specific third party that specializes in providing fits, with capital and operational cost gating the risk of lawsuits; needs and objectives as MES is not a managed services. savings ranging from 10-15%, as well as • Increased accuracy, speed and stability commoditized solution. The MES provider procures, fi- many benefits to patients. of HHS’ diagnostic imaging processes, Given the rapid pace of change in nances, installs, trains users, manages These include ongoing access to achieving better diagnosis and treatment medical technology, hospitals can no and maintains the portfolio of medical best-in-class medical technologies for patients; longer by themselves hope to keep up equipment for a term usually ranging which improve patient standard of care • Faster urgent repairs and shorter with what is required to improve clinical from 15 to 25 years. and patient safety; procedures planned downtime of equipment, with outcomes for patients while at the same An important aspect of MES is that administered more quickly and time meeting the daily clinical and fi- the MES provider owns the equipment consistently; and ongoing staff training nancial pressures that confront them. for the entire term and makes it available which reduces risks to patients. All of Several large MES arrangements It is realistic to expect that MES will to the hospital as an integral part of a the foregoing will of course help to have now been put in place in continue to be on the menu of private managed service, which includes all the reduce the risk of being at the receiving Ontario, most recently at sector solutions available to hospitals necessary elements to support effective end of a lawsuit. and that by raising the bar on quality of use of the equipment. Recent MES success story: Several Hamilton Health Sciences. care, lawsuits such as the one HSN is The portfolio of equipment is re- large MES arrangements have now been now facing will become a thing of the placed by the MES provider on a pre- put in place in Ontario, with the most fewer procedure cancellations and past as risks are passed on to MES ser- dictable, pre-arranged basis, in accor- recent at Hamilton Health Sciences shorter wait-times for patients; vice providers. dance with terms set out in a compre- (HHS), which went live in the early days • Specialized training for staff, keeping hensive legal agreement. MES ensures of the pandemic last year. HHS teams proficient as technology Denis Chamberland is CEO of MES Group, that patients and clinicians always have HHS entered into a long-term part- evolves and as new equipment is intro- which works with hospitals on managed ser- access to best-in-class equipment, nership with an MES service provider duced into the facilities; and vices projects, including Managed Equipment thereby reducing risks to patients while to replace and maintain the hospital’s • Stable, predictable annual costs for Services and Managed ICAT Services. MES increasing productivity. extensive fleet of equipment, renewing new equipment, without the financial Group members were engaged on all of the Because of its market presence and critical and rapidly evolving diagnostic impact of unplanned downtime, equip- MES projects concluded in Canada. He can specialist focus on medical equipment, tools, such as X-ray machines, MRIs ment repairs or crisis replacement. be reached at [email protected]. the MES provider provides a much and CT scanners, essential to the ma- Putting an MES arrangement in place See www.mesgi.com.

http://www.canhealth.com APRIL 2021 CANADIAN HEALTHCARE TECHNOLOGY 13 ANALYTICS AND ARTIFICIAL INTELLIGENCE AI detects breast cancer in images produced through mass-spectrometry

BY JONATHAN WOODS from Queen’s School of Computing, mensional data and is typically used for fa- The next step is to determine whether demonstrates how a machine learning al- cial recognition and video processing. sparse subspace clustering can accurately he main advantage of a lumpec- gorithm typically used for facial recogni- Theriault says, “We thought, if the algo- classify tissue types across samples. Ambi- tomy for patients with early- tion can be repurposed to detect cancer rithm can capture the complex patterns in ent air pressure affects DESI-MS, and be- stage breast cancer is that it con- cells in breast tissue samples. video processing, it can probably capture cause air pressure is not a constant, scans serves the maximum amount of The algorithm analyzes metabolic pat- the tissue’s heterogeneity.” of a sample taken at different times can Thealthy breast tissue possible. The surgery terns in DESI-MS scans – images produced She and Dr. Ellis hypothesized that produce different image results. involves removing only the tumor and a through mass-spectrometry. Theriault’s re- sparse subspace clustering should be able Research must determine whether margin, a thin band of healthy tissue that search determined that the algorithm can to cluster pixels based on the similarities of sparse subspace clustering reliably detects surrounds the cancer. When successfully successfully distinguish tissue from an im- mass spectra (representing various ions) to metabolic patterns across such differing performed and followed by adjunctive age’s background and can detect enough identify tissue types results. therapy such as radiation treatment or metabolic difference between tissue types in the same way that Theriault continues this work in a mas- chemotherapy, the treatment can be just as to separate and classify malignant, benign, it clusters features ter’s program at Queen’s University, where effective as a mastectomy. and artifact tissues such as cauterized tissue like edges, shapes, or in addition to this project, she is also ex- However, success hinges on what’s in that and fibrous bands. When the researchers colourings in the ploring the application of sparse subspace margin. If a pathologist’s analysis reveals lin- compared the algorithm’s tissue classifica- pixels of an image to clustering to the analysis of skin, liver, and gering cancer cells near the margin’s outer tions to those made by pathologists on the detect objects or to prostate cancers. edges, the patient will likely require a second same samples, they matched. identify a specific To support her work, Theriault was surgery. This isn’t the odd case: an estimated These results mark important progress face. awarded a Vector Scholarship in AI by the 20%-25% of lumpectomies require re-exci- for computational analysis of cancer tis- The confirmation Vector Institute, a Toronto-based insti- sion to clear the margins. Unfortunately, be- sue. Previous efforts to apply machine that sparse subspace tute advancing AI development and cause a pathologist’s analysis can take weeks learning to classify breast tissues via DESI- Rachel Theriault clustering can treat adoption across Canada, with a strategic to perform, any remaining cancer cells have MS scans have fallen short due to the sheer ions as features to pillar dedicated to health-related re- the opportunity to grow in the interim, po- volume of metabolite-related data that distinguish and classify tissue types opens search and application. tentially requiring the removal of even more needs to be accounted for. Theriault ex- the door to using machine learning to ex- Ultimately, Theriault’s aspiration is that tissue in the second operation. plains, “There are lots of differences be- pedite the analysis of tissue samples from her work with sparse subspace clustering New machine learning research shows tween the tissues that are very hard to cap- lumpectomies. However, Theriault stresses can lead to real impact in a clinical setting. promise for speeding up this analysis and, ture, and the cancer itself is heterogeneous, that this remains fundamental research, She says, “When we have computational as a result, potentially reducing the so it’s hard to determine what is cancer and still requires significant study and de- strategies that can do intraoperative analy- amount of tissue requiring removal in re- and what is benign. We needed a complex velopment before it is ready for applica- sis or help guide a pathologist to do faster excisions. The research, led by Queen’s algorithm to solve this complex problem.” tion in a health care setting. analysis by flagging certain samples, we University master’s student Rachel Theri- That advanced algorithm is sparse sub- “These results aren’t the end. They’re hope that we can decrease the need for sec- ault in collaboration with Dr. Randy Ellis space clustering, which clusters in high di- just the beginning,” Theriault says. ond surgeries.”

Enhancing access to system-wide data for Ontario’s healthcare providers ORONTO – Health system organization or provider. Since then, IDS more than 80 health service providers adding understanding of this important integration has been a long- has evolved into Ontario’s most mature across several regions. It has 900 plus piece of the patient journey. standing goal for both and widely used collaborative solution users and over 149 million encounters Timeliness of the data available healthcare providers and for sharing integrated health partner for more than 9.4 million unique through IDS is critical for providers’ Tgovernments alike. One thing is clear, data for planning, system-wide patients. analytics, and as such, any new data, beyond today’s model used to drive improvements, and analytics. Using a near real-time longitudinal when submitted, are made available integration – Ontario Health Teams and Earlier this year, IDS was acquired by patient record, IDS clients can follow the weekly in IDS, with most organizations bundled care being good examples – the Ontario Hospital Association patient from acute care (inpatient, ED, submitting new data each month. access to shared, linked, cross-sector (OHA) which has been a long-time and day surgery and medical day care) to IDS is continuously growing due to patient data, is a must if the province is vocal advocate for integrated care and post-acute care (inpatient rehabilitation, its unique ability to support Ontario to fulfill this vision. cross-sector collaboration. Coming acute mental health, and complex con- Health Teams (OHTs), integration However, access to these data has under the stewardship of the OHA tinuing care), to homecare, to commu- activities, and bundled care. Continued been a persistent and common marked the next level in IDS’ maturity nity health centres (CHC, including abo- expansion to a full provincial dataset challenge to integration and as such, by creating the opportunity to leverage would give all OHTs the benefits enjoyed the solution needs to be a collaborative the OHA’s provincial perspective, by current IDS users and provide one. The vital importance and power of relationships with key system partners Currently, IDS links patient limitless possibilities and opportunities coming together as a system has been and experience in scaling critical, data for more than 80 health to evaluate changes to programs and demonstrated most urgently by the province-wide initiatives. IDS will service providers across services as teams mature and bring on COVID-19 pandemic because of the maintain its collaborative approach to new partners. level of collaboration required to data collection and sharing, allowing several regions. Because it is a collaborative, provider- respond effectively to the many partners to continue to shape the led and locally developed solution – IDS complex issues that have emerged over network’s priorities so they realize the riginal and French language), to primary is able to be responsive to its clients’ the past year. greatest collective value with respect to care (FHT/FHO’s), and via EMS para- needs. This shared resource is a pathway Recognizing these frustrating data patient and client care information. medic data. for organizations who are looking to “blind spots”, over a decade ago, The IDS value-proposition: Because These data are used for system address data gaps which have impeded Hamilton Health Sciences (HHS) led patients have the right to choose where planning, performance management their efforts to integrate care. local partners in the development of they receive care, many times crossing and efficiencies, analytics, reporting, The more healthcare providers Integrated Decision Support (IDS), a regional boundaries, IDS offers viable patient transition tracking, outcome participate in the network, the richer the data sharing platform across a host of and effective tools that give providers a measurement and evaluation, and data available to improve health service subscribers, which today includes line of sight into the patient journey. population health management. delivery across the province. Ultimately, hospitals, home and community care, This equips providers with greater IDS also holds province-wide IDS has great potential in supporting the primary care, Community Health insight into potential solutions aimed Statistics Canada Population Census province’s vision of an integrated and Centres, EMS Paramedic Services and at generating efficiencies and enabling information and the Ontario patient-focused system of care. public health. better system planning – and most Marginalization Index, allowing Healthcare organizations that want to It offers quality improvement data on importantly, improving patient population health equity concerns to be learn more about IDS can contact shared-care patients across a continuum outcomes by being more responsive to married with healthcare data. Currently, Wendy Gerrie, director Integrated of healthcare services – not just what their needs. a project is underway with one region’s Decision Support at [email protected] occurs within the purview of a single Currently, IDS links patient data for community mental health data to pilot or 905-870-2437.

14 CANADIAN HEALTHCARE TECHNOLOGY APRIL 2021 http://www.canhealth.com sure safe and secure software storage. ical practices all-in-one web, reputation, to increase traffic to websites. Demand- Dr. Sunny Malhotra Health Performance Services also offers and communications solutions. Demand- force can offer products that can scan on- CONTINUED FROM PAGE 10 marketing analysis and planning through force allows medical practices to generate line platforms for inaccurate information online services like search engine opti- reviews by automating review requests to allowing for surveillance and control of practice growth through services that en- mization, e-mail marketing, social media patients and enabling practices to access a misinformation. gage patients like reliable communication maintenance, paid advertising, and reputa- review engagement dashboard that en- It offers a platform for patient satisfac- and patient satisfaction. The company of- tion management. sures every review is seen. tion by offering patient communications fers software that can send appointment Because Health Performance Services is through two-way text on patient portals reminders to cut no-show rates, automate led by a team of physicians, the company that are integrated on existing practice recall messaging to aid in bringing back can provide unique services to individual Health Performance Services, management systems, automating ap- patients with chronic conditions or fol- practices to establish successful training a physician-led company, pointment reminders, and sending ap- low-ups, and customize newsletters that methods and support systems for staff reviews patient experiences pointment confirmation to reduce no- are personalized to be relevant to patients. members to ensure high levels of perfor- shows. Demandforce also allows practices Solutionreach also improves the effi- mance. and outcomes. to retain patients with recall reminders to ciency of practices through secure two- In addition, Health Performance Ser- bring back patients that haven’t been seen way messaging, online patient scheduling, vices provides continuous evaluations and It also enables practices to compare on- for some time. digital patient registrations, and easy pay- benchmarks of practice data in compari- line reviews with competitors and works These businesses are some of the many ment options offered on mobile platforms. son to other practices to promote and es- with search engines like Google and all-in-one medical practice growth plat- Solutionreach can automate patient tablish top-performing practices. WebMD to increase reviews. Demandforce form solutions for healthcare organiza- surveys to track patient satisfaction and Demandforce, a business geared toward allows practices to optimize search engine tions that exist to ensure the success of automate patient review requests for feed- reputation management, also offers med- rankings by bulk updating business listings medical practices. back on services received. Combining these reviews and surveys can aid practices in targeted promotions, social media, and referrals through the So- Tech procurement needs to consider more than price lutionreach marketing platform that offers tools to further expand and develop med- CONTINUED FROM PAGE 11 gressing levels of invention, including: Learn more: In this 10-session course, ical practice presence. • Early conversations that enable procur- participants will learn about the procure- Another company, Health Performance Innovative procurement: Innovative ing healthcare organizations and MedTech ment framework and regulations, both in Services, is a physician-led firm with the procurement introduces collaboration and innovators to explore problem statements Canada and key international markets, var- primary objective to optimize the poten- solution design into the procurement and potential solutions before RFP re- ious procurement models and strategies for tial of medical practices. Health Perfor- process by allowing purchasers to seek and quirements are defined, allowing a design stakeholder engagement, and frameworks mance Services helps medical practice procure novel solutions that may not yet approach that focuses on identifying key for executing successful procurement and growth by reviewing patient experiences exist in the market or need to be adapted solution attributes – new or existing – that and outcomes and integrating strategic to meet the unique needs and create value best meet their needs. marketing in line with development goals. for the procuring organization. • Innovation and development partner- Navigating healthcare It offers EMR integrations with HIPAA There are a number of innovation ships that facilitate deeper collaborations procurement, a 10-session compliant document management to en- procurement models, each with pro- between MedTech and provider organiza- course, will be offered online tions, who work together to develop net- new, novel solutions – resulting in new, starting April 27. beneficial technologies. Nurses using virtual tools to keep skills sharp Success story: The feasibility and value change management processes. Special at- potential of innovative procurement was tention will be on the role of value-based, or CONTINUED FROM PAGE 8 tronic health record and conduct virtual demonstrated at Southlake Regional ‘innovation procurement’ as an agile model medication reviews with patients. Health Centre, which leveraged this ap- for adopting, or participating in the design 174,000 times. She says the faculty has “Our students now take a health infor- proach for procuring updated cardiovas- of, new and innovative healthcare solutions. plans to develop at least three more games matics course that’s designed to prepare cular technologies. Navigating healthcare procurement will over the next year and a half. them for the skills they need to operate in Their first step was defining value- be offered online starting April 27, 2021. Gearing up for virtual care: On top of the digital age,” she says. “We’ve also based objectives that focused on quality For more information and to register, using innovative technologies to train fu- brought in more e-health through our se- performance improvement, rather than please visit: www.nihi.ca. ture health care providers, colleges and ries of health system courses.” In fact, U of price alone. Next, they engaged in compet- universities are also ensuring graduates are T’s pharmacy faculty helped lead a na- itive dialog with potential vendors to iden- ready for a new era of digital healthcare. tional initiative to develop an e-resource tify opportunities to re-design workflows Laurie Lafleur is a director at Waterloo Natalie Crown, acting director of the related to topics in digital health informat- and implement novel solutions that were MedTech, a professor of Health Information Doctor of Pharmacy program at the Uni- ics for pharmacy students across Canada. focused on achieving those goals. Science, and Health IT consultant. Shirley versity of Toronto’s Leslie Dan Faculty of This effort led to measurable clinical Fenton is the vice-president of the National Pharmacy, says pharmacy students are be- Rosalind Stefanac is a freelance writer quality improvements, and financial sav- Institutes of Health Informatics and a co- ing trained on how to navigate an elec- specializing on healthcare topics. ings of $165,000 in the first year. founder of Waterloo MedTech.

that this doesn’t just mean taking waste PowerConnect Communicator, radiolo- ing workloads, assigning and prioritiz- Guardian Radiology out of the workflow to create efficien- gists at Guardian Radiology will soon take ing cases, and making sure things get CONTINUED FROM PAGE 6 cies, but it also means connecting all advantage of Nuance’s workflow orches- communicated correctly, the better,” stakeholders in ways that eliminate re- tration solution. PowerScribe Workflow said Dr. Young. of diagnostics at Nuance Communica- work – whether that means revising re- Orchestration applies artificial intelligence Further, PowerScribe Workflow Or- tions. “You need platforms with real- ports, managing denied claims, or even to automatically distribute exams to the chestration fully optimizes integration time intelligence, decision support, and re-imaging patients. right clinical resource at the right time. with Guardian Radiology’s RIS/PACS automation that are capable of balancing That viewpoint is part of what con- Once fully implemented, the team at environments for a more streamlined, efficiency with effectiveness – all while tributed to Guardian Radiology’s selec- Guardian Radiology will be able to focus comprehensive and synchronized experi- connecting people and applications. tion of PowerConnect Communicator. If ence for the radiologist. That’s what PowerScribe One is becom- a radiologist wants to consult with a col- With critical patient information at ing for Guardian Radiology.” league, this solution enables them to col- If an emergent case arises, their fingertips and robust interruption For Guardian Radiology, patients are laborate in real-time and within the nor- the solution will automatically workflow, radiologists can work seam- at the centre of their philosophy, and so, mal radiology workflow. match the case with the lessly between multiple exams, and all increasing access to imaging services, de- “In-context messaging allows the con- apps on the desktop will remain in sync, creasing wait-times, and building a flexi- sulting radiologist to launch the study, appropriate radiologist. so there’s no risk of dictating on the ble practice are paramount. view the specific image in question, and wrong exam. “When radiologists can collaborate respond right within the integrated chat on reading images, rather than managing “At the end of the day, the combina- and communicate in real-time while window. It’s not only more convenient, their worklists. If an emergent case arises, tion of Nuance solutions will allow for amplifying their potential with the but helps to better manage disruptions, the solution will automatically match the the real-time intelligence and collabora- power of AI, we can create the care path- which can really weigh you down in the case with the appropriate radiologist, and tion we need to position our practice for ways that are essential to quality patient day-to-day,” said Dr. Young. dynamically adjust their worklist. growth and expansion well into the fu- outcomes,” Hebb noted. He explained In addition to PowerScribe One and “The less time we can spend manag- ture,” explained Dr. Young.

http://www.canhealth.com APRIL 2021 CANADIAN HEALTHCARE TECHNOLOGY 15 152970-PrintAd-CF-B2H-CanadaHealthcareTech-F-o.indd 1 3/9/21 2:00 PM