Good Tech, Compassionate Healthcare

This podcast, brought to you by AMS Healthcare, explores the convergence of technology and compassion in healthcare today. Good Tech, Compassionate Healthcare will host conversations between leading researchers, scientists and healthcare providers, as well as patients and caregivers, as they confront the challenges threatening our healthcare system, especially in the face of the pandemic. Join us as they discuss the opportunities for digital health to innovate all aspects of our healthcare today, and tomorrow. They will share their hope for technology, and they will share some cautionary tales about what they are seeing in the field. We hope to foster open and frank discussions about how they think we should integrate technology into the health-care system in a way that enhances – and doesn’t diminish – compassionate care. Because ultimately, we want these discussions to help us all advance the cause of better healthcare for patients, caregivers, and healthcare providers everywhere. If there was ever a time to uphold compassion as the bedrock and guiding principle of healthcare, it’s now! Join us for these illuminating conversations as AMS Healthcare explores “Good Tech, Compassionate Healthcare.

Virtual End-of-Life Care w/ Dr. Kieran Quinn and Dr. James Downar 03/27/2024

Virtual End-of-Life Care w/ Dr. Kieran Quinn and Dr. James Downar In this conversation, Kieran Quinn, a general internist and palliative care clinician-scientist at Sinai Health in the Department of Medicine and at the Institute of Health Policy, Management, and Evaluation at the University of Toronto, and James Downer, a critical care and palliative care physician in Ottawa, discuss virtual end-of-life care during the COVID-19 pandemic. - The Pan-Canadian Palliative Care Research Collaborative is a national network of researchers, healthcare providers, community stakeholders, and patient and caregiver partners who are passionate about palliative care research. Dr. Kieran Quinn is a General Internist and Palliative Care Clinician-Scientist at Sinai Health in the Department of Medicine and Institute of Health Policy, Management, and Evaluation at the University of Toronto and an Adjunct Scientist at the Institute for Clinical Evaluative Sciences (ICES). His research focuses on using advanced analytic methods and large administrative datasets to improve access and delivery of high-quality end-of-life care for patients with terminal noncancer illness, such as heart failure and dementia, and improving the recognition and care of people with post COVID-19 condition (long COVID). Dr. Quinn was awarded the Governor General’s Gold Medal for Academic Excellence and the John Charles Polanyi Prize in Physiology and Medicine. He is co-lead of Canada’s national research network on post COVID-19 condition and co-chair for the development of clinical practice guidelines for the treatment of post COVID-19 condition. He served as the Assistant Director of the Ontario COVID-19 Science Advisory Table, the Ontario Public Health Emergencies Science Advisory Committee, and as an Expert Member of the Chief Science Advisor’s National Task Force on the Post COVID-19 Condition. His early research success includes over $28 million in competitive grant funding and 7 CIHR grants as the nominated principal applicant. He has mentored 12 trainees who have published and won several awards for their work together. He has 103 peer-reviewed publications, including 52 as first author or senior author in high-impact journals such as JAMA, JAMA Internal Medicine, and BMJ. Dr. James Downar is a Critical Care and Palliative Care physician in Ottawa. He graduated from McGill Medical School and completed residency training in Internal Medicine, Critical Care, and Palliative Care at the University of Toronto. He has a Master’s degree in Bioethics from the Joint Centre for Bioethics at the University of Toronto. He is currently the Head of the Division of Palliative Care at the University of Ottawa and a Professor in the Department of Medicine. He is the chair of Palliative and End-of-Life Care at the University of Ottawa, the co-chair of the Pan-Canadian Palliative Care Research Collaborative, the chair of the Ethical Affairs committee of the Canadian Critical Care Society, and the co-chair of the Ontario Palliative Care Network’s Provincial Education Steering Committee. He has authored more than 100 peer-reviewed publications, has been principal investigator on more than 20 peer-reviewed grants, and is a former Associated Medical Services Phoenix Fellow. Dr. Downar also led several provincial and national efforts to respond to the COVID-19 pandemic. He was involved in planning for medication shortages for both critical care and palliative care and led the development of a critical care triage system for the event of major surge in critically ill patients His research interests include communication and decision-making for seriously ill patients and their families; Palliative Care for the Critically Ill; and Palliative Care for Noncancer Illnesses. /episode/index/show/goodtechcompassionatehealthcare/id/30562598

Leveraging AI to Enable Compassionate and Equitable Community Care and Nursing 02/14/2024

The Compassion Code, Promoting Fairness in AI for Mental Health 01/17/2024

The Compassion Code, Promoting Fairness in AI for Mental Health In this conversation, Laura Sikstrom, a Medical Anthropologist and Project Scientist at The Krembil Center for Neuroinformatics at the Center for Addiction and Mental Health, and an AMS Healthcare fellow in Compassion and AI, speaks with Sean Hill, the Director of The Krembil Center for Neuroinformatics, Senior Scientist at the Center for Addiction and Mental Health, and Professor at the University of Toronto. They discuss the meaning of fairness in mental health and the concepts used to support. Dr. Laura Sikstrom is also an assistant professor (status-only) in the Department of Anthropology at the University of Toronto. Dr. Sikstrom also co-leads the Predictive Care Team at CAMH, which focuses on the intricate intersection of artificial intelligence (AI) and mental health care. By integrating computational techniques with ethnographic insights, this team investigates the potential and challenges of incorporating AI into mental health practice, with a focus on compassionate and equitable care. Dr. Sikstrom received funding from AMS Healthcare, Google, SSHRC and CIHR and is also a nominee for the prestigious Governor General’s Gold Award. Dr. Sean Hill is also a computational neuroscientist with experience in building large-scale computational models of brain circuitry. The Centre collaborates with clinicians and researchers, employing neuroinformatics, artificial intelligence, and multi-scale modeling, to develop data-driven definitions of brain disorders, predict patient trajectories, and transform mental health care. Dr. Hill applies large-scale data integration, neuroinformatics, multiscale brain modeling and machine learning to improve our understanding and treatment of mental health disorders. The Centre’s mandate is to accelerate global collaborations in brain science using the power of big data and brain modeling to fundamentally change how mental illness is understood. Resources: Sikstrom, Laura, Marta M. Maslej, Zoe Findlay, Gillian Strudwick, Katrina Hui, Juveria Zaheer, Sean L. Hill, and Daniel Z. Buchman. 2023. Sikstrom, Laura, Marta M. Maslej, Katrina Hui, Zoe Findlay, Daniel Z. Buchman, and Sean L. Hill. 2022. What is ‘AI’ and what is it doing in psychiatry? A webinar presented at the RBC Patient & Family Learning Space, CAMH, November 2, 2022. What happens to our brains when we get depressed? The Walrus, 2021, by Simon Lewsen. /episode/index/show/goodtechcompassionatehealthcare/id/29525768

Generative AI in Healthcare 11/27/2023

Generative AI in Healthcare In this conversation Dr. Kumanan Wilson, speaks to Jaron Chong, discuss the opportunities for generative AI in healthcare diagnosis, efficiencies and education today and tomorrow. Dr. Jaron Chong is an Assistant Professor of Diagnostic Radiology at the Department of Medical Imaging at Western University. He completed diagnostic radiology residency training at McGill University with a Body Cross-Sectional Imaging Fellowship at Yale New-Haven Hospital and a Masters in Health Informatics at the University of Toronto. His clinical interests include cross-sectional abdominal imaging, Abdominal/GU oncologic imaging in MRI and CT modalities, with research interests in the appropriate utilization of medical imaging and AI-assisted augmented radiology. He serves as the Chair of the Canadian Association of Radiology Standing Committee on Artificial Intelligence and Ad-Hoc Member of the Health Canada Scientific Advisory Committee on Digital Health Technologies. Dr. Kumanan Wilson is a board member at AMS. He is the Interim CEO and Chief Scientific Officer, Bruyère Research Institute and VP Research and Academic Affairs, Bruyère Continuing Care. He had previously served as an innovation advisor for Bruyère. Dr. Wilson is also a specialist in General Internal Medicine at The Ottawa Hospital and a Full Professor and Faculty of Medicine Clinical Research Chair in Digital Health Innovation at the University of Ottawa. He is the co-founder and Chief Scientific Officer of CANImmunize, a science-based technology company specializing in immunization software. Dr. Wilson’s research focuses on digital health, health data, immunization, pandemic preparedness and public health policy and innovation. He has received support from multiple organizations including the Canadian Institutes of Health Research (CIHR), the World Health Organization (WHO), The Bill and Melinda Gates Foundation and Canada’s Immunity Task Force. /episode/index/show/goodtechcompassionatehealthcare/id/28799203

Technology, Compassion and the Social Determinants of Health 09/21/2023

Technology, Compassion and the Social Determinants of Health In this conversation, Ibukun Abejirinde, a scientist at the Institute for Health System Solutions at Women's College Hospital, and Assistant Professor at the Dalla Lana School of Public Health at the University of Toronto, and an AMS Healthcare Fellow in Compassion and AI chats with Terence Tang, a General Internal Medicine Physician at Trillium Health Partners, a Clinician Scientist at the Institute for Better Health and an AMS Healthcare Fellow in Compassion and AI. They discuss social determinants of health, health inequities, and digitally enabled models of care. Ibukun Abejirinde is an Implementation and Evaluation Scientist who works with policymakers, patients, community organizations, and researchers to find practical solutions to persistent and emergent problems in healthcare. Her research focus on innovative models of care that use digital technology. Specifically, how they impact health equity and health service delivery. Ultimately, her goal is to improve access to high-quality care for everyone, irrespective of where they live or where they are from. Dr. Abejirinde is currently a Scientist at the Institute for Health System Solutions, Women’s College Hospital where her work informs the implementation, sustainability, and expansion of virtual care programs within and beyond Ontario. She is also an Assistant Professor (Status) at the Dalla Lana School of Public Health, University of Toronto. As a 2022 AMS Healthcare Fellow in Compassion and AI, her study is being conducted in partnership with three community partners, with the aim of understanding how immigrants and refugees to Canada experience virtual care and digital health compassion. AMS Research Team Members - Ibukun Abejirinde (Scientist/Principal Investigator) - Emily Ha (Research Associate and PhD candidate, UoT) - Marlena Dang Nguyen (Equity Specialist and Research Coordinator) - Kyla Gaeul Lee (PhD student, UoT) - Isabelle Choon-Kon-Yune (Research Assistant) - Mohaddesa Khawari (Peer Researcher) AMS Study Research Partners 1. FCJ Refugee Centre Website 2. Crossroads Clinic, Women’s College Hospital Website 3. Access Alliance Multicultural Health and Community Services Website AMS Research Advisory Team Members 1. Dr. Vanessa Redditt 2. Denise Zarn 3. Dr. Onil Bhattacharyya 4. Dr. Jay Shaw Readings and Resources 1. Abejirinde IO, Ha E, Nguyen MD, Kaur D, Redditt V. Beyond technology: Digital Health Compassion for Canadian Immigrants and Refugees. January 2023. Volume 19, Number 4. Canadian Diversity (pg. 10-12). https://km4s.ca/2023/04/beyond-technology-digital-health- compassion-for-canadian-immigrants-and-refugees/ 2. Panel Discussion. Digital Health Imperative - Equity and System Transformation. Access Alliance Multicultural Health and Community Services, Canada. All Staff Professional Development Day. November 2022. Summaries- blog and video clip 3. Hankivsky, O., Grace, D., Hunting, G. et al. An intersectionality-based policy analysis framework: critical reflections on a methodology for advancing equity. Int J Equity Health 13, 119 (2014). https://doi.org/10.1186/s12939-014-0119-x 4. Hodges BD, Paech G, Bennett J. Without Compassion, There Is No Healthcare: Compassionate Care in a Technological World. Edited by Brian D. Hodges, Gail Paech, and Jocelyn Bennett. McGill-Queen’s University Press; 2020. 5. Crenshaw K. Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory, and Antiracist Politics [1989]. In: 1st ed. Routledge; 1991:57-80. doi:10.4324/9780429500480-5 6. Singh P, King-Shier K, Sinclair S. The colours and contours of compassion: A systematic review of the perspectives of compassion among ethnically diverse patients and healthcare providers. Van Bogaert P, ed. PLoS ONE. 2018;13(5):e0197261. doi:10.1371/journal.pone.0197261 Want to connect? Are you attending the Metropolis Social Determinants of Health Conference in Gatineau Québec (October 2-3 2023)? Join our roundtable dialogue 11:00am - 12:15pm on October 2 nd titled “Reimagining Compassionate Healthcare for Immigrants: Lessons learned from Virtual Care” Contact: [email protected] Terence Tang is a General Internal Medicine physician at Trillium Health Partners located in Mississauga, Ontario, and a Clinician Scientist at the Institute for Better Health. He has training in informatics and has a passion of using digital technology to improve care delivery and population health. Links: Institute for Better Health (https://www.instituteforbetterhealth.com/) A tool to capture social determinants of health by Upstream Lab (https://upstreamlab.org/project/spark/) /episode/index/show/goodtechcompassionatehealthcare/id/28099382

Risk Algorithms and Self-Management of Care in Older Adults 06/21/2023

Digital Monitoring of Stress Responses Among Nursing Professionals 05/24/2023

Digital Therapeutics Informed by Lived Experience 04/11/2023

Designing the Future of Aging in Place 12/13/2022

Designing the Future of Aging in Place Jen Recknagel Director, Innovation and Design, NORC Innovation Centre Jen combines a background in human-centered design to address challenges at the intersection of health and its social determinants. Experienced with executing a variety of service design projects, she is currently the Senior Design Lead at UHN OpenLab, and Director of Innovation and Design at the NORC Innovation Centre. Her work is focused on engaging a diverse set of stakeholders, and using participatory-led approaches to developing solutions to complex organizational and health system challenges, a national award-winning magazine focused on urban health in Toronto. Isabel Mannion RN, BN, M Sc,(A) , CHE Member of the Seniors Advisory Committee and The NORC Innovation Centre Advisory Committee Isabel Mannion has baccalaureate and master’s degrees in nursing with a particular interest and experience in gerontology, the study of aging. A retired senior, she enjoyed a long career working in, consulting, accrediting, speaking, and writing about the care of elders and others in long term, chronic and acute care, UHN’s NORC Innovation Centre, and serves on two of its committees. NIC Vision The NORC Innovation Centre at UHN (NIC) is a first-of-its-kind centre advancing new models of social connection and accessible care for older adults living in the community. Our mission is to support a new model of integrated health and social care in naturally-occurring retirement communities (NORC), and to develop health, social, and technology solutions that support healthy aging. Resources Stay Updated: | | Policy Paper created in conjunction with the National Institute for Aging “It’s Time to Unleash the Power of Naturally Occurring Retirement Communities in Canada” Women’s College Hospital and NIC have secured a 3 million research grant funding to study NORCs in Toronto. The objective of the research is to identify new solutions by successfully implementing community-driven NORCs enhanced with on-site access to health services and social supports (referred to as ‘enhanced NORCs’) that leverage and build on existing community resources. Definition: ‘Elder orphans,’ without kids or spouses, face old age alone. An overlooked segment of the population. /episode/index/show/goodtechcompassionatehealthcare/id/25311960

Digital Health Equity 10/17/2022

Digital Peer Support 09/15/2022

Developing Compassionate Chatbots 07/15/2022

Developing Compassionate Chatbots A Conversational Health Chatbot, Bringing Compassion to a Tailored Digital Health Intervention for Women with Heart Disease. Supervisors and Mentors Dr. Elizabeth Peter, Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto. Dr. Peter locates her work in feminist health care and will provide mentorship in compassionate care. Dr. Joe Cafazzo, Executive Director, Healthcare Human Factors, University Health Network. Dr. Cafazzo will provide mentorship on digital technologies that allow for self-care at home. Dr. Mustafa Al-Durra, Cloud Solution Architect, Microsoft. Dr. Al-Durra will provide mentorship in artificial intelligence, Chatbot innovation, and eHealth/mHealth trends. Four women with lived experiences will be advisors to this fellowship: - Ms. Nicole Nickerson had a heart attack while pregnant and contributed her lived experience in an at heart Her Stories . - Ms. Donna Hart had a heart transplant and contributed her lived experience in an at heart Her Stories . - Ms. Vincenza Spiteri DeBonis has non-obstructive coronary artery disease and contributed her lived experience in an at heart Her Stories . - Ms. Lise Owens has Takotsubo cardiomyopathy and contributed her lived experience in an at heart Her Stories . Proposed Compassion Technologies and Attributes for Chatbot ‘Holly’ . Relationship optimization – bidirectional, phased, actionable conversation (Authentic, Aware, Respectful). . Voice tone and/or responsive data points in the text of women used to assess mood/emotion (Aware, Empathic, Empowering). . A responsive Library (Credible, Trustworthy, Reliable). Customization and Branding. Personalization using colour, style, image, and language (Credible) Short Messaging Service (SMS) and Multimedia Messaging Service (MMS). Praise and offer support (Empowering). Select References 1. Virani T, Tait A, McConnell H, Scott C, Gergolas E. Nursing Best Practice Guideline: Establishing Therapeutic Relationships. Toronto2002. 2. Sinclair S, McClement S, Raffin-Bouchal S, et al. Compassion in Health Care: An Empirical Model. Journal of Pain and Symptom Management. 2016;51(2). 3. How Woebot Forms a Therapeutic Bond. UK: Woebot Health; 2021. 4. Parry M, Bjornnes A, Victor J, et al. Self-management interventions for women with cardiac pain: A systematic review and meta-analysis. Canadian Journal of Cardiology. 2018;34:458-467. /episode/index/show/goodtechcompassionatehealthcare/id/23716763