Medly was recently featured in the Toronto Star. To read Theresa Boyle’s article, featuring quotes from Dr. Heather Ross and Mary O’Sullivan, click here.
A recent article in The Lancet looks at how telemedicine is being embraced like never before in the era of COVID-19.
Dr. Alex Jadad, founder of Centre for Global eHealth Innovation, was interviewed by Paul Webster for an April 2020 article in The Lancet on the use of telemedicine during COVID-19.
In the article, Alex talks about how the pandemic has presented an opportunity to overcome regulatory barriers and make virtual health care available to more people.
“Whether I’m deep in Malawi or deep in the Amazon, all I need is a mobile phone and a connection that allows me to talk to a clinician. That’s all it takes for a clinical encounter. These are god-like tools for medicine. There’s no need for us to wait for any more sophisticated infrastructure than that”, says Jadad, who is advising on virtual health-care adoption strategies for health groups in Colombia.
“The regulatory barriers that have held virtual health care back for all these decades were never justifiable”, Jadad avers. “[COVID-19] is an opportunity to blow all these barriers away. And the question now is ‘how far are we willing to go?’”
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CAN Health Network established to facilitate the adoption of Canadian health care solutions.
On July 29th, The Honourable Mary Ng, Minister of Small Business and Export Promotion, announced that the government of Canada will support a $20-million project proposal to scale up companies in both health and biosciences. This will see an initial $7-million investment to support the establishment of the CAN Health Network in Western Canada and Ontario, with further expansion of the network planned at a later stage for Quebec, Atlantic Canada, and Northern Canada.
Within Ontario, the CAN Health Network will be led by Trillium Health Partners and will further comprise of leading health care organisations, industry and thought leadership. The Network will enable MedTech Companies to work with health care providers in developing working innovative technological solutions on Canadian soil that address common Canadian health care challenges.
The University Health Network is honoured to be announced as an inaugural partner of the CAN Health Network. UHN’s involvement in the network with be supported by Dr. Joseph Cafazzo, who leads TECHNA Institute teams, the Centre for Global eHealth Innovation and Healthcare Human Factors. Familiar with the challenges of technology adoption within healthcare, Dr. Cafazzo believes the CAN Health Network is unprecedented and comes at a critical time for Canadians.
“Technology solutions will not address the needs of our patients if they are not informed by close collaborations between industry, healthcare practitioners, and most critically the patients we serve. The CAN Health Network is brilliantly conceived to address this and we look forward to engaging with our network partners and some of the best minds in Canada’s tech industry to set the course for the modern delivery of care in this country.” – Dr. Joseph Cafazzo, Lead, eHealth Innovation
“There is a lot of pent up demand for innovations to address our health system challenges. At the same time there is untapped capacity to address these challenges within both the public sector academic health sciences sector and Canada’s growing health technology sector. This funding will go towards facilitating the interactions between these sectors to bring products and services to market sooner and improve the overall quality of these innovations. We will see this network not only bringing in new existing solutions into the health sector but also knowledge and IP transfer from the academic health sciences centers, into Canada’s private health tech sector.”
“Technology solutions will not address the needs of our patients if they are not informed by close collaborations between industry, healthcare practitioners, and most critically the patients we serve. The CAN Health Network is brilliantly conceived to address this and we look forward to engaging with our network partners and some of the best minds in Canada’s tech industry to set the course for the modern delivery of care in this country.”
You can read the official CAN Health Network announcement HERE.
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Heart Failure Care Without Borders:
How one new technology is paving
the way for a new model of care.
Heart failure is the most rapidly rising cardiovascular disease in Canada, currently affecting more than 1 million people nationally, and with more than 50,000 new diagnoses annually. A complex chronic condition, people living with heart failure face symptoms of shortness of breath, swelling in the lower limbs, and fatigue, as well as frequent flare-ups often leading to hospital admission. The journey that follows heart failure diagnosis is undeniably challenging and for many, life altering.
Heart failure management requires patients to take an active role in their care by maintaining a low-sodium diet, restricting fluids and taking their medication as prescribed. Guideline directed care is a cornerstone of therapy. A major challenge in care is the lack of access to heart failure specialists. Currently, in Canada, clinics are facing high patient volumes that cannot be supported with traditional patient visits alone.
Within the Heart Failure Clinic at University Health Network’s Peter Munk Cardiac Centre , one program is helping pave the way to transform how care is delivered for heart failure patients and reduce the burden on the health system, and most importantly the patients themselves.
Medly, a heart failure management program,developed by the teams at UHN’s eHealth Innovation, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, is a first of its kind in Ontario and Canada. Medly is unlike traditional telemonitoring programs with its use of the Medly management algorithm, developed by heart failure clinicians to rapidly assess and triage patients, and the creation of a new role in the heart failure care delivery model: a Medly coordinator role.
Mary O’Sullivan, a registered nurse and the Medly coordinator at the Peter Munk Cardiac Centre, currently manages nearly 300 heart failure patients, a patient volume not typical of such a role. For Mary, her patient load is made possible and has the potential to grow with the support of the Medly Program.
“I am able to connect and give nursing care to patients across the province each day,” Mary says. “ Medly provides a platform for such a unique nurse-patient relationship. It allows me to gain insight into how their heart failure management fits into their daily lives and enables me to interact with patients in their own environment and develop long-term relationships with them. This personal element enhances the way that I assess, triage and provide education for these patients.”
“I am able to connect and give nursing care to patients across the province each day. Medly provides a platform for such a unique nurse-patient relationship. It allows me to gain insight into how their heart failure management fits into their daily lives and enables me to interact with patients in their own environment and develop long-term relationships with them. This personal element enhances the way that I assess, triage and provide education for these patients.”
The Medly Program allows Mary to assess, support, and provide education for her patients in real time from wherever they may be located. These patients use the Medly smartphone application to record their daily weight, blood pressure, heart rate and symptoms. These measurements are analyzed instantly via the Medly management algorithm. If the algorithm determines that a patient’s clinical status is deteriorating, an actionable feedback message is sent to the patient, and Mary is alerted through the Medly clinician dashboard. When alerts are received, Mary assesses the patient’s clinical need and can escalate to the patient’s cardiologist who then provides higher-level clinical expertise. Through this alert escalation process, more patients are able to access their heart failure specialist at the right time.
For one of Medly’s clinical champions, cardiologist and Division Head, Cardiology, at PMCC Dr. Heather Ross, the addition of Mary’s role to the Peter Munk Cardiac Clinic has proved to be invaluable. “Mary has allowed us to realize the promise of Medly, specifically being able to scale a remote monitoring intervention to a large population at reasonable cost.”
In a perfect world, Mary’s role and technologies like Medly would already be infused and easily deployed across the healthcare system. Product Owner at eHealth Innovation, Mala Dorai believes the program is unparalleled to any other heart failure management solution she has come across.
“The rapidly rising burden of heart failure requires us to think outside the box. We at eHealth Innovation are doing just that. We designed the Medly program with a team of engineers, researchers and human factors experts who understand the needs of heart failure patients, and consulting heart failure specialists with the practical clinical knowledge and processes of Canada’s leading cardiac care centre (PMCC). This is why I believe Medly is the kind of specialized yet scalable solution capable of addressing this critical need.”
For more information on the team behind Medly and the program itself, you can visit: Medly.ca/about
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On May 1, 2019, Kayleigh Gordon was presented with the sixth annual “Kevin J. Leonard Award” by Kevin’s widow, Sandra Dalziel (picture above with Kayleigh and eHealth Innovation Lead, Dr. Joseph Cafazzo) in collaboration with University of Toronto’s Institute of Health Policy, Management and Evaluation and eHealth Innovation, University Health Network. Sandra Dalziel reflects on the award, what it means and Kayleigh’s work below.
“I am very pleased to present the sixth annual “Kevin J. Leonard Award” to Kayleigh Gordon, PhD candidate, Health Services Research with a focus in Health Informatics.
Kayleigh is in the last phase of her research evaluating the impact of telemonitoring of health indicators for patients living with multiple chronic conditions including heart failure, diabetes and hypertension. Beginning Monday, this approach will be embedded in a new model of care, a Nurse Practitioner-led complex medical clinic comprised of a core team of interdisciplinary health professionals at the Peel Centre for Health and Wellness in Brampton. This clinic was set up to best meet the care needs of the patient population with multiple chronic conditions and to address the exceedingly high rates of Emergency Department visits in the community. Followed for 6 months to a year, patients are equipped with an understanding and ability to track and trend their multiple health indicators and to take action accordingly empowering them to be more effective partners in their own care.
As someone who lived with Crohn’s disease for over 40 years, and in later years, co-morbidities, Kevin advocated for patients to have timely electronic access to their health information for as he wrote, “patients can be more effective in managing their care because it allows them to work with their providers to respond earlier and more directly to the patients’ needs”. Patients know when ‘things are going south’ which, for Kevin, led to far too many ED visits as access to his health indicators was narrower in scope and care was silo-ed.
However, through this Nurse Practitioner-led clinic, an ongoing patient/provider connection is maintained through close patient monitoring, and patients can reach out to providers they know and who know them. For individuals with multimorbidity, their health issues do not always arise during traditional business hours, necessitating a 24/7 model of access to care while in the community. Quoting Kayleigh’s Award application letter, “…I wanted to explore technology solutions that might better monitor and manage patient care from home, before unnecessary exacerbations occur”.
“With her knowledge and understanding of both the patient and provider side gained through her professional and personal experiences, Kayleigh is well-positioned to make a difference in enhancing the patient/provider partnership which in turn will optimize the patient and their caregiver’s experience.”
Kayleigh also well understands it’s not just about the technology but rather the care of the patient and the role technology plays in supporting care, particularly with the sharing of health information between patients and providers as well as among providers. Kayleigh knows of what she speaks for along with pursuing her PhD, she works as a registered nurse at University Health Network. She is passionate about her profession and her experiences have played an important role in informing her research.
It resonated for me that Kayleigh is a nurse. Countless nurses cared for Kevin throughout his life, in hospital and in the home, along the continuum of care. And Kevin’s nurses also cared for me. We counted on their skills and expertise for Kevin’s recoveries, and were uplifted by the nurses’ personal gestures and emotional support during difficult times.
In speaking with Kayleigh last week in preparation for today’s Award presentation, her passion, compassion and fierce advocacy for her patients are clear. With her knowledge and understanding of both the patient and provider side gained through her professional and personal experiences, Kayleigh is well-positioned to make a difference in enhancing the patient/provider partnership which in turn will optimize the patient and their caregiver’s experience.
Presenting this annual Award affords me the opportunity to share parts of Kevin’s story and advocacy work and I know Kevin would have been thrilled to see the progress being made in digital health since his passing in 2013″.
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“What now?” The prostate cancer survivor’s common refrain: Innovation Grant helps tackle the question with proposed new care delivery model
“What now?” The prostate cancer survivor’s common refrain:
Innovation Grant helps tackle the question with proposed new care delivery model
Last month, UHN was a successful recipient of the 2018 Canadian Cancer Society Innovation Grant, together with the support of the Canadian Institutes of Health Research (CIHR). The grant, awarded to only 10% of the applicants, aims to support unique and creative research ideas that will impact cancer diagnosis, treatment, and survivorship.
For the team at eHealth Innovation @ UHN, the grant comes at a perfect time, when advances are being made in their platform for Prostate Cancer survivorship, Ned. The creation of Ned, where the name is also a common clinician shorthand for “no evidence of disease” tackles the question many prostate cancer survivors have of “What now?” when they are faced with a prolonged and complex post-treatment phase. For many, physical and psychological side effects of cancer treatment are common and the path to recovery can become uncertain and anxiety provoking.
Conceptualized by Dr. Andrew Feifer and Dr. Joseph Cafazzo, and brought to life by the team of researchers, designers, and software developers at eHealth Innovation, Ned provides some relief for dealing with prostate cancer survivor issues and raises the bar for the level of patient care a clinician can provide. Ned does this specifically via combining key capabilities critical to a patient’s healthcare journey, such as graphical representation of personal outcomes, tracking of prostate-specific antigen (PSA) and other relevant lab results, personalized views of symptoms, self-care news feeds, and educational/support group links.
The success of the innovation grant means the team’s vision of Ned being at the center of a complete, holistic health delivery model are closer to reality than before. The funds from this grant will help transform the application into a digitally supported model of follow-up care and offer numerous capabilities which weren’t initially available with the standalone application. Specifically, e-visits will be possible which bypass face-to-face appointments and alleviate some of the challenges faced by patients who live in remote areas. There is also significant work going into ways of making data from the model’s technology interoperable with the existing Hospital’s electronic medical records.
In recent months, clinicians, Drs. Antonio Finelli and Alejandro Berlin partnered with the Ned team in the development of the proposed new care delivery model. Initially, their patients were being prescribed Ned in its standalone application form however they soon saw its potential to be at the center of an entire model of care. “This is an exciting project that responds to our patient’s most common requests: minimize commuting and waiting times, increase the control over their own health information and disease trajectory, and ensure high-quality standardized care agnostic of physical location or provider”, says Dr. Berlin. As the group of researchers shape the future of healthcare, Dr. Berlin also mentions the challenges for broader deployment “we have carefully envisioned this disruptive technology in a way that aligns physician and patient’s interests. We will also work to demonstrate the value proposition to payers and insurers to advocate for sustainability”.
“This is an exciting project that responds to our patient’s most common requests: minimize commuting and waiting times, increase the control over their own health information and disease trajectory, and ensure high-quality standardized care agnostic of physical location or provider” – Dr. Alejandro Berlin
The grant itself would not be possible without the input from a number of individuals who have been through the survivorship phase of prostate cancer and submitted letters of support for the team’s application.