Institute of Health Policy Management and Evaluation

Going digital to save lives: U of T grad student aims to eliminate barriers to health care

Christopher.Sorensen — Mon, 07 Oct 2024 13:40:31 +0000

Going digital to save lives: U of T grad student aims to eliminate barriers to health care

Christopher.Sorensen Mon, 10/07/2024 - 09:40

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Naturinda Emmanuel, a Mastercard Scholar who grew up in Uganda, studies intelligent medicine and electronic medical records at U of T's Institute of Health Policy, Management and Evaluation at the Dalla Lana School of Public Health (supplied image)

Tina Adamopoulos

Topic

Global Lens

Black Research Network

Institutional Strategic Initiatives

Africa

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Subheadline

Naturinda Emmanuel, a scholar and entrepreneur, says the digitization of medical records, when coupled with AI, will reduce errors in patient care and help spot public health threats before they occur

Growing up in Uganda, Naturinda Emmanuel aspired to be a medical doctor and health leader who eliminates barriers to health-care access for those in underserved, remote communities.

“I always wanted to address different health-care issues in my country – that is my motivation,” he says. “I want to gain the skills and expertise to strengthen health-care systems to ensure that those who need care can receive it.”

Naturinda (his surname) is now a graduate student at the University of Toronto, where he studies intelligent medicine and electronic medical records in the master of health informatics program at the Dalla Lana School of Public Health's Institute of Health Policy, Management and Evaluation (IHPME).

He’s also actively involved with the startup community, having launched a successful, impact-focused enterprise in Uganda and training other entrepreneurs.

Naturinda joined IHPME with the support of the Mastercard Foundation Scholars Program, a global education initiative focused on the next generation of African leaders, and Africa Higher Education Health Collaborative (AHEHC), a partnership between U of T, the Mastercard Foundation and leading African universities. The AHEHC was established in 2022 to drive primary health-care workforce education, entrepreneurship and innovation across Africa.

This is Naturinda’s second time studying abroad with the Mastercard Foundation. He became the first in his family to study outside the country when he was awarded a scholarship to pursue an undergraduate degree in laboratory medicine at the Kwame Nkrumah University of Science and Technology in Ghana.

He later returned home during the COVID-19 pandemic to volunteer in the clinical microbiology and immunology departments at a local hospital. The experience prompted him to think about how to improve systems that were suddenly facing new pressures at already burdened hospitals – namely the continued use of paper records.

Medical records are the building blocks for developing efficient and effective intelligent medicine models, he says, while intelligent medicine refers to the use of machine learning models to process medical data and reduce errors in patient care. Large datasets may also allow medical professionals to spot health patterns – an emerging epidemic, for example – to better prepare for public health threats.

However, low-to-middle-income countries face many barriers to digitizing medical data, including limited access to technology and the absence of standardized data formats. The use of paper records also causes delays in retrieving laboratory results and makes it difficult to understand patients’ medical histories efficiently.

“The digitization of medical records is essential for developing and training predictive models,” Naturinda says. “Unique electronic datasets from these communities provide the more accurate and reliable information needed to account for unique socio-cultural factors and effectively develop models tailored to address those specific challenges.”

Naturinda will work under the guidance of Karim Keshavjee, an assistant professor and director of the master of health informatics program. In addition to intelligent medicine, Naturinda says he also has a key interest in implementation science, or the study of methods to ensure research is translated into policy, programs and startups.

One of Canada’s few professional graduate programs in the field, the master of health informatics program provides students with the skills and strategic vision to take on leadership positions in health-care landscape.

The opportunity to learn industry-specific knowledge from health leaders is what made the program a perfect fit, Naturinda says.

“One of the reasons I chose the MHI program is because it is training us to be leaders, innovators and policymakers. I wanted to seek mentorship from people who were making a big impact in strengthening health-care systems in Canada.”

Public health isn’t the only field where Naturinda is hoping to make an impact. He also wants to help others as an entrepreneur – a journey that’s already well underway.

During his undergrad, he co-founded the Nugget Poultry Farm to help smallholder farmers in western Uganda raise poultry more effectively and improve food access back home. The venture aims to support 1,000 farmers in 20 communities by 2027 and has received a Social Venture Challenge Award from the Mastercard Foundation and the Resolution Project.

Naturinda enhanced his business knowledge through the Jim Leech Mastercard Foundation Fellowship on Entrepreneurship at Queen’s University. Now a program coach, he has trained more than 500 entrepreneurs from Africa-based startups addressing various issues in agribusiness, climate change and health care.

Naturinda is eager to tap into U of T’s network of entrepreneurs and has wasted no time reaching out to various groups, including the Black Founders Network.

“When I train entrepreneurs, I see the impact of them pitching their ventures or winning a grant. It’s the type of impact that I want to see with my research, and bridging those two passions is an ideal step forward,” Naturinda says.

“As I progress at U of T, I look forward to leveraging opportunities that speak to my background in entrepreneurship, health care and research to make sure that I implement them together.”

First 48 Hours: Documentary spotlights the journey of international students

Christopher.Sorensen — Tue, 01 Oct 2024 19:53:06 +0000

First 48 Hours: Documentary spotlights the journey of international students

Christopher.Sorensen Tue, 10/01/2024 - 15:53

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(supplied image)

Adam Elliott Segal

Topic

Global Lens

Institute of Health Policy Management and Evaluation

Centre for International Experience

Dalla Lana School of Public Health

Faculty of Kinesiology & Physical Education

Global

Graduate Students

Student Life

Subheadline

International Students: First 48 Hours will be screened across U of T’s three campuses this fall

The first few days of a new school year can be as frantic as they are exciting – but for several international students at the University of Toronto, there was an extra wrinkle: a new country.

The students are featured in a 22-minute documentary called International Students: First 48 Hours in Canada, which is directed by Cal Campos and was shot at the beginning of the 2023-24 school year.

It uses a combination of the students’ own footage and sit-down interviews to provide a behind-the-scenes glimpse of the excitement of packing, traveling and finally setting foot on each of U of T’s three campuses.

Obinna Ezeani (supplied image)

Obinna Ezeani, who is featured in the film and spent 17 hours traveling from Lagos to Toronto, says he is thrilled to see the final product come to life.

“It’s an opportunity to relive those moments and memories from a year ago and remind myself why I embarked on this journey,” says Ezeani, who is working on a master’s degree in health informatics and recalls his first few days in Canada as “exciting.”

A joint partnership between U of T’s Centre for International Experience and the Innovation Hub in the division of Student Life, the documentary is being screened across the three campuses in October and November – with the first screening scheduled at U of T Scarborough this week.

It will later be available for streaming on YouTube.

Julia Allworth, the Innovation Hub’s manager of innovation projects, says the goal of the project was to shine a light on the multitude of diverse global perspectives that make up nearly a third of the university’s student body.

“We wanted to zoom in on what it’s like for students when they first arrive in Canada. What challenges do they face as they step off the plane and into Canada? What decisions do they need to make along the way?” says Allworth.

“International students bring tremendous value to the university.”

The biggest challenge, according to Campos, was figuring out how to show the diversity and complexity of student life at U of T in just 22 minutes.

Jo Antonia Sepulveda Guzman (supplied image)

“The beauty of documentary is you think it’s going to go in one direction, and then it goes a totally different way,” says Campos, who was selected to helm the project for their thoughtful approach to equity and diversity.

Jo Antonia Sepulveda Guzman, who is from Chile and is working on a bachelor’s degree in the Faculty of Kinesiology & Physical Education, says she is looking forward to sharing the doc with her family.

“[They were] so excited when I told them I would be doing the 48 hours project,” she says. “My sister started giving me tips on how to record and took me to change my phone screen protector so that the camera was not blurry. My mom is expecting to cry.”

Sepulveda is nostalgic about the experience.

“The person I was then is completely different from the person I am today. I worked so hard to come here. Remembering the beginning will be emotional for me.”

Shraddha Prasad, associate director, international student experience and global fluency at the Centre for International Experience, says she couldn’t be prouder of the year-long project, which received support from U of T’s International Student Experience Fund.

“International students have such impact in the U of T community through the perspectives they bring to the university through their lived experiences and their cultural backgrounds,” she says, noting that funding is already underway for a second film project titled International Students: Life After Graduation.

“Being able to elevate these stories has been a huge highlight for us.”

Caution needed when drawing links between improving symptoms and unproven remedies: Study

Christopher.Sorensen — Fri, 06 Sep 2024 16:03:17 +0000

Caution needed when drawing links between improving symptoms and unproven remedies: Study

Christopher.Sorensen Fri, 09/06/2024 - 12:03

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(photo by Oleksandra Yagello/Getty Images)

Sunnybrook Staff

Topic

Breaking Research

Sunnybrook Health Sciences Centre

Temerty Faculty of Medicine

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Research & Innovation

Subheadline

"Post-hoc bias can play tricks on patients that can eventually lead to serious disappointments – and for health-care workers, it can ultimately lead to shortfalls in care"

People tend to continue with unproven treatments even if there’s no evidence to suggest an initial marginal improvement in symptoms is anything more than a potential coincidence, a new study has found.

"I've noticed many of my patients take unnecessary vitamins, pills or alternative remedies with little evidence to inform their choice, leading to a lot of distraction, wishful thinking and wasted money,” says senior study author Donald Redelmeier, a staff internist and senior scientist at Sunnybrook Health Sciences Centre, and professor in the department of medicine in the University of Toronto’s Temerty Faculty of Medicine.

“Perhaps even more concerning is a false belief that leads to a missed diagnosis that later becomes incurable.”

The study, published in the journal JAMA Network Open, explores “post-hoc bias” – a tendency in reasoning that causes many patients to continue taking dubious or unreliable treatments. The bias encourages a popular misconception: that because one action preceded another later event, the first must have caused the second since it occurred in sequence.

But medical science, the researchers note, stresses that the order of two events does not prove a cause-and-effect since coincidences are frequent. The implication for medical care is that a patient who improved after a treatment is not necessarily a patient who improved because of the treatment.

Instead, other potential explanations include withdrawal from an adverse activity, added rest or the body’s own healing powers.

To test bias across a variety of clinical cases, the researchers ran multiple experiments using hypothetical clinical scenarios administered by a randomized survey of pharmacists and members of the community.

The scenarios described a patient with fatigue or another vague symptom who feels a bit better after trying a vitamin, shampoo, sugar pill or other treatment.

“We found that most respondents suggested continuing the treatment indefinitely even though the change in symptoms might be pure random chance," says Redelmeier, who is also affiliated ICES and the Institute for Health Policy, Management and Evaluation in U of T’s Dalla Lana School of Public Health.

"The post-hoc bias can play tricks on patients that can eventually lead to serious disappointments – and for health-care workers, it can ultimately lead to shortfalls in care."

While attributing an initial improvement in – or lack of – symptoms to a treatment is a quick and intuitive approach, the researchers say the study reinforces the need for both patients and clinicians to be cautious when drawing conclusions.

“An awareness of post-hoc bias will not make it disappear, however we suggest patients and clinicians need to think twice and stay mindful of alternative explanations.”

The study was supported by the Alfred P. Sloan Foundation, a Canada Research Chair in Medical Decision Sciences, Canadian Institutes of Health Research, the PSI Foundation of Ontario and the National Science Foundation.

This story was originally posted at Sunnybrook Research Institute

U of T community members recognized with Order of Canada

bresgead — Thu, 04 Jul 2024 16:49:13 +0000

U of T community members recognized with Order of Canada

bresgead Thu, 07/04/2024 - 12:49

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(photo by Sgt Johanie Maheu, Rideau Hall, OSGG-BSGG)

Adina Bresge

Topic

Our Community

Temerty Faculty of Medicine

Unity Health

Institute of Health Policy Management and Evaluation

Alumni

Chemistry

Dalla Lana School of Public Health

Faculty of Applied Science & Engineering

Faculty of Arts & Science

Faculty of Music

Hospital for Sick Children

Leslie Dan Faculty of Pharmacy

Order of Canada

Political Science

St. Michael's College

University College

University Health Network

Victoria College

Subheadline

"The Order of Canada recognizes individuals who have made positive and lasting impacts on communities here in Canada or who have brought honour to our country abroad"

An innovator in chemical catalyst development. A global leader in cardiac surgery and care. And a public health expert who led the rollout of Canada’s first colon cancer screening program.

These are a few members of the University of Toronto community who were recently honoured with appointments or promotions within the Order of Canada.

The Governor General recently announced 83 new appointments to the Order of Canada, including two promotions within the Order.

They include Doug Stephan, a University Professor of chemistry in the Faculty of Arts & Science; Lee Errett, a professor in the Temerty Faculty of Medicine’s department of surgery, and Linda Rabeneck, a health executive and professor in the Temerty Faculty of Medicine and the Dalla Lana School of Public Health.

Established in 1967, the Order of Canada is one of the country’s highest honours, recognizing extraordinary contributions across all sectors of society.

“The Order of Canada recognizes individuals who have made positive and lasting impacts on communities here in Canada or who have brought honour to our country abroad,” Gov. Gen. Mary Simon said in a statement.

Here is a list of U of T faculty, alumni and supporters who were appointed to, or promoted within, the Order of Canada in the latest round of honourees.

Current and former faculty

Edward Cole, a staff nephrologist at Toronto General Hospital and professor in the Temerty Faculty of Medicine’s department of medicine, was named a Member of the Order for his dedication to advancing and delivering care to people living with kidney disease, his instrumental role in establishing a globally impactful kidney-paired donation program and his leadership as former physician-in-chief at the University Health Network.

Lee Errett, a professor in the Temerty Faculty of Medicine’s department of surgery, was appointed a Member of the Order for his transformative leadership in cardiac research and care, including his role in establishing St. Michael’s Hospital as a world-class centre for cardiac surgery, his dedication to educating future medical leaders and providing care in underserved areas worldwide.

Franklyn Griffiths, a professor emeritus and George Ignatieff Chair Emeritus of Peace and Conflict Studies in the department of political science in the Faculty of Arts & Science, was appointed a Member of the Order for his scholarship on Russian affairs which has advanced the Western world’s understanding of Soviet politics. An expert in Arctic international relations, Griffiths helped create the Arctic Council and pushed for Indigenous voices to play a central role in the council’s workings.

Beverley Johnston, an internationally renowned percussionist who is an adjunct professor in the Faculty of Music, was appointed an Officer of the Order for her work developing and promoting Canadian music to audiences around the world. Working in a male-dominated field, Johnston’s unconventional performances combine classical transcriptions, contemporary music and an element of theatre.

Daphne Maurer, a professor emeritus of psychology, neuroscience and behaviour at McMaster University who holds a status appointment at U of T’s Institute of Health Policy Management and Evaluation in the Dalla Lana School of Public Health, was appointed an Officer of the Order for her research on visual and cognitive development in early childhood.

Linda Rabeneck, a gastroenterologist, health executive and professor in the Temerty Faculty of Medicine and the Dalla Lana School of Public Health, was named a Member of the Order for her leadership in colorectal cancer screening and prevention. Formerly the director of the Division of Gastroenterology at U of T, she led the rollout of ColonCancerCheck, Canada’s first province-wide screening program.

Stephen Randall, who earned his master's degree and doctorate at U of T and taught at the university from 1971 to 1974, was named a Member of the Order for his academic contributions and advisory role in international relations. A professor emeritus at the University of Calgary, Randall’s expertise in myriad issues affecting the United States and Latin America, notably Colombia, has informed Canada’s foreign policy.

Bibudhendra Sarkar, senior scientist emeritus at the Research Institute of the Hospital for Sick Children and professor emeritus at U of T’s department of biochemistry in the Temerty Faculty of Medicine, was named a Member of the Order for his achievements in advancing medical research in Canada and abroad. He discovered a novel treatment for patients with Menkes disease, a rare genetic condition, and led international efforts in South and Southeast Asia to address public health crises from contaminated groundwater.

Jonathan Scott Rose, a professor in the Edward S. Rogers Sr. department of electrical and computer engineering in the Faculty of Applied Science & Engineering, was named a Member of the Order for his pioneering work in architecture and software used in field-programmable gate arrays. Rose served as the chair of the department from 2004 to 2009 and received his PhD degree in electrical engineering from U of T in 1986.

Doug Stephan, a University Professor in the department of chemistry in the Faculty of Arts & Science, was named an Officer of the Order in recognition his world-leading research in inorganic and organometallic chemistry. His many achievements include discovering – and commercializing – a new class of catalysts that is now used in one of the largest chemical manufacturing facilities in the world. He also achieved global renown for founding the field of “Frustrated Lewis Pair” chemistry.

Alumni and friends

Sleight-of-hand artist David Ben, who graduated from University College in 1983, was named a Member of the Order for his four decades of dedication to the exploration, development and preservation of magic, including penning several books on the subject and co-founding the Magicana organization.

William Fox, a research fellow and adjunct professor at Trent University who earned his honours bachelor of arts and master of arts in archeology at U of T, was named a Member of the Order for his distinguished contributions to Canadian archeology, his leadership in the Ontario Archaeological Society, and his steadfast advocacy for the involvement of Indigenous communities in preserving their material heritage.

Martha Friendly, who founded the Childcare Resource and Research Unit at U of T’s Centre for Urban and Community Studies in the early 1980s, was appointed an Officer of the Order for her work with the now-independent non-profit and her advocacy for accessible, publicly funded early childhood education and care, and women’s equality.

Rosemary Ganley, a writer, activist, teacher and an alumna of St. Michael’s College, was named a Member of the Order for her lifelong advocacy for human rights, gender equity, and social justice, including co-founding Jamaican Self Help, an organization of Canadians working to support the development of healthy Jamaican communities.

Arnie Gelbart, a member of the Chancellors’ Circle of Benefactors, was named a Member of the Order for his decades-long leadership in independent film and television in his role as founder, executive producer and CEO of Galafilm Productions Inc.

Judy Kent was named a Member of the Order for championing sport as a catalyst for social change, her advocacy for gender equality and inclusion and her leadership in international support. Among her achievements: She was the first woman to serve as both president of Commonwealth Sport Canada and Canada’s chef de mission for the Commonwealth Games, and her paper on sport for international development laid the foundation for the SportWORKS program.

James David Meekison, with a 45-year career spanning investment banking, cable television and private equity, was named a Member of the Order for his extensive philanthropy. The Jim Meekison and Carolyn Keystone Foundation supported U of T’s Leslie Dan Faculty of Pharmacy’s efforts to launch the Discovery Pharmacy on the St. George campus.

Michael Perley, a U of T alumnus who completed a master’s degree in French language and literature, was named a Member of the Order for his lifelong dedication to tackling environmental and health challenges. He has been an advocate for tighter tobacco control laws, reducing second-hand smoke exposure and has led coalitions on acid rain and air pollution.

Dan Poenaru, a pediatric surgeon and professor at McGill University who earned two degrees at U of T, was named a Member of the Order for his contributions to pediatric surgery in Africa, including establishing a surgical unit and training program in Kenya, co-founding three medical schools and leading initiatives for children's surgery globally.

Vaira Vike-Freiberga, an alumna of Victoria College and the first woman to serve as Latvia’s president, was named an honorary Officer of the Order for her work enriching Canada-Latvia relations and for reflecting Canadian values abroad.

– with files from Mariam Matti and Rahul Kalvapalle

COVID-19 took a mental health toll on mothers, young women and adolescent girls: Researchers

Christopher.Sorensen — Fri, 15 Mar 2024 19:31:22 +0000

COVID-19 took a mental health toll on mothers, young women and adolescent girls: Researchers

Christopher.Sorensen Fri, 03/15/2024 - 15:31

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(photo by skynesher/Getty Images)

Chloe Panganiban

Topic

Breaking Research

COVID-19

Institute for Pandemics

Institutional Strategic Initiatives

Sunnybrook Health Sciences Centre

Temerty Faculty of Medicine

Institute of Health Policy Management and Evaluation

Centre for Addiction and Mental Health

Dalla Lana School of Public Health

Mental Health

Research & Innovation

Women

Subheadline

“The current road towards pandemic recovery needs to consider these at-risk populations. If not, there could be dire long-term consequences for the current generation and ones to come”

Two new studies supported by the Institute for Pandemics – a University of Toronto institutional strategic initiative – show that the non-pharmaceutical public health measures implemented during the COVID-19 pandemic were associated with increased mental health visits for mothers with young children, young women and adolescent girls.

As governments around the world imposed public health measures to reduce viral transmission, including stay-at-home orders, travel restrictions, and school closures, experts raised concerns about the potential lasting impact on the mental health of individuals, especially those belonging to vulnerable and at-risk populations.

In particular, mothers with young children faced obstacles related to parenting and caregiving, while young women and adolescent girls experienced major disruptions to school, social and daily routines.

The new studies – which built on previous research showing the COVID-19 pandemic had a larger impact on the mental health of men compared to women – aimed to examine how these pandemic-related non-pharmaceutical interventions have impacted the mental health of these groups.

“This work raises concerns about how to contain and address this issue,” says Geoffrey Anderson, a professor at the Dalla Lana School of Public Health’s Institute of Health Policy, Management and Evaluation (IHPME) and lead of the pandemic recovery theme at the Institute for Pandemics.

“The current road towards pandemic recovery needs to consider these at-risk populations. If not, there could be dire long-term consequences for the current generation and ones to come.”

The research team also included: John Moin, a former post-doctoral researcher funded by the Institute for Pandemics; Shauna Brail, an associate professor at U of T Mississauga who directs the Institute for Management & Innovation; and Simone Vigod, head of the department of psychiatry at Women’s College Hospital and a professor in the department of psychiatry in the Temerty Faculty of Medicine.

Both studies compared rates of doctor visits for mental health care in the pre-pandemic period from March 2016 to March 2020 to rates during the pandemic from April 2020 to November 2021.

The first, published in the Canadian Medical Association Journal (CMAJ) Open, found a rapid increase in doctor visits by mothers of young children for mental health care during the pandemic compared to the pre-pandemic period, with most of the care for mood, anxiety, depressive disorders and alcohol and substance abuse.

In the second study, published in the British Medical Journal (BMJ) Open, the team found an increase in doctor visits for adolescent girls and women aged 14 to 24 for mental health care largely driven by care for mood, anxiety and depressive disorders. Additionally, there was an increase in hospital visits for eating disorders for adolescent girls and women aged 14 to 19. There was no increase in doctor visits or hospitalizations for boys or young men.

Both studies show that the implementation of public health measures during the pandemic was associated with increased usage of mental health services among mothers of young children, young women and adolescent girls, and point to potential lessons for future public health crises.

“Our research raises concerns about the mental health impacts of public health measures on vulnerable women,” says Anderson. “We need to address these impacts as key part of any effective and equitable pandemic recovery strategy and we need to pay more attention to these consequences in future public health crises”.

"We saw the rapid and ongoing application of non-pharmaceutical interventions as public health measures throughout the pandemic,” says Moin, who was the lead author of both studies. “We also now know that they were associated with abrupt and prolonged changes in the utilization of mental health services. This association should be considered for future public health planning and strategy.”

Renzo Calderon, another post-doctoral fellow funded by the Institute for Pandemics, is leading a team that is further exploring this observed trend.

Despite nearly four years having passed since the beginning of the restrictions, the pandemic continues to alter the landscape of mental health. Hence, the researchers’ focus is not solely on exploring the overarching trends but also on better understanding if there are specific socio-demographic groups of women who were particularly affected.

Preliminary results indicate that the demand for mental health services around specific issues such as eating disorders and substance abuse, especially among young women, has not yet diminished.

Such a targeted approach aims to uncover nuanced insights into how the COVID-19 pandemic exacerbated these problems and lead to more effective interventions.

How AI will – and won’t – change health care in 2024

Christopher.Sorensen — Wed, 24 Jan 2024 18:54:54 +0000

How AI will – and won’t – change health care in 2024

Christopher.Sorensen Wed, 01/24/2024 - 13:54

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(photo by Sean Anthony Eddy/Getty Images)

Adina Bresge

Topic

Our Community

Temerty Faculty of Medicine

Unity Health

Institute of Health Policy Management and Evaluation

Artificial Intelligence

Dalla Lana School of Public Health

Leslie Dan Faculty of Pharmacy

Research & Innovation

Subheadline

Muhammad Mamdani, who has overseen the implementation of more than 50 AI-powered solutions into clinical practice, says "the potential is massive for patient care in several areas"

Muhammad Mamdani understands why people are wary of artificial intelligence having a say in their health care – but he’s even more concerned about the patients who are waiting to benefit from the potentially life-saving benefits of AI-assisted medicine.

As vice-president, data science and advanced analytics at Unity Health Toronto, Mamdani has overseen the implementation of more than 50 AI-powered solutions into clinical practice – from an early warning system that uses electronic medical records to predict a patient’s risk of death or requiring intensive care, to a brain-bleed detection tool that can help fast-track access to critical treatment.

And he says there’s more to come in 2024.

“I hope to see more AI being used for clinical decision making,” say Mamdani, who is a professor in the department of medicine in the University of Toronto’s Temerty Faculty of Medicine and the director of the Temerty Centre for Artificial Intelligence Research and Education in Medicine (T-CAIREM).

Yet, despite AI's potential to transform patient care, it isn’t a cure-all for the underlying problems in Canada’s health system, warns Mamdani, who holds cross-appointments in U of T’s Leslie Dan Faculty of Pharmacy and the Institute of Health Policy, Management and Evaluation at the Dalla Lana School of Public Health.

Mamdani recently spoke to U of T News about how AI will – and won’t – shape health care in 2024.

How do you expect AI will transform health care in 2024?

For the past few years, we’ve been in this era of AI hype in health care. A lot of talk, some people doing a few small things here and there, but not really a big splash – and I’m not sure we’ll see a big splash in 2024. A lot of organizations are actively getting into this space, but I would say we’re still at least a few years away from seeing really, really big changes. Instead, I think we’ll see a more gradual adoption of AI in health care.

In 2024, I hope to see more AI being used for clinical decision making. Right now, we’re seeing it used more for non-clinical or administrative tasks. For example, quite a few primary-care clinics and outpatient clinics are using AI scribes that can “listen” to a conversation between a doctor and a patient, transcribe the visit and provide a really good summary note.

[Doctors] are notorious for not writing everything down, and that’s very unfortunate because medicine is very data- and information-driven. When a doctor is talking with a patient, they’re focused on the patient – as they should be – but when the patient leaves, they might have forgotten many of the things that were discussed or didn’t have time to write things down. Then you have an imperfect data set the next time around.

We’re also starting to see tools that can take these transcriptions to suggest diagnoses or recommend medications and, with the doctor’s OK, send prescriptions to the pharmacy.

This coming year, [at Unity Health], we’re working on creating a multimodal data environment that incorporates not only clinical data, but also medical imaging data and waveform data from monitors and ventilators that we’re able to access in real time. For example, you could go into the ICU and constantly ingest data from ventilators to understand if a patient is going to have trouble breathing in the next 20 minutes.

What are some of the ways AI could improve patient care?

The potential is massive for patient care in several areas. One is around chatbot-style solutions where you can ask questions about health-related issues. There are many [clinics] now where you can go on to a website and say, “I have these symptoms. What do you think?”

The other area that I think will probably be more useful is around continuity of care when a patient leaves the hospital or clinic. Oftentimes, patients complain that they don’t have enough information or it wasn’t explained to them what to do next. You’re in this institution undergoing all of these tests and procedures, then when you leave, the doctor tells you all of these things you need to do, and you’re basically on your own – and you may not remember half of what you were told.

Poor post-discharge communication and management is one of the reasons we see a lot of patients being readmitted to hospitals. What if we had an AI chatbot that could stay in contact with the patient, summarize their treatment plan, answer their questions and tell them to call their doctor when necessary?

What are the most significant challenges you foresee in implementing AI technologies in health-care settings?

We should temper our expectations for AI, because when you deal with a health-care system, you have to try to solve the system problem first and use technology to enable appropriate solutions.

Take, for example, the problems we see because of a lack of information sharing between health providers. AI is only as good as the data it’s given, so if a patient goes to hospital X for a problem that was treated at hospital Y a month earlier – but the two hospitals don’t talk to each other, [hospital X’s] AI will be blind to what happened at hospital Y.

As a province, if we got together and enabled these data sources to talk to each other in realtime, AI would be way more powerful.

What are some of the ethical considerations that need to be taken into account when deploying AI in health care?

Obviously, you have to have a robust environment to protect privacy and security for patients. But at the same time, you have to have a progressive data governance framework that allows that data to be accessed by the people who need it.

Another concern is making sure your algorithms perform well among various subgroups. For example, does it perform just as well among young versus old, sick versus not sick, males versus females? The problem is we don’t have data on all these subgroups. So how do we know that our algorithms perform just as well on one race versus another or across all genders when we don’t have such data readily available?

The other challenges are going to be scaling the solutions from one hospital to another or to an entire system. Patient care and processes may differ considerably and AI solutions may need to be tailored to local context. Further, while these AI solutions are really exciting, they can be very expensive. So who pays for them?

At Unity Health, we’ve deployed more than 50 AI solutions into clinical practice, with more going live soon. Other hospitals should have these kinds of tools, but not all of them have the resources to develop and deploy AI solutions and patients are suffering as a result.

What would you say to people who are apprehensive about “Dr. AI?”

That kind of apprehension is very much justified. I get it. There are going to be some failures as well as some successes. But I don’t think this is going away. The potential benefits are far too great to ignore. We need to deploy AI in health care thoughtfully and responsibly. AI is here and it will permeate health care – how it permeates is yet to be determined.

Mindfulness training can help doctors improve well-being and communication, study finds

Christopher.Sorensen — Fri, 24 Nov 2023 16:55:22 +0000

Mindfulness training can help doctors improve well-being and communication, study finds

Christopher.Sorensen Fri, 11/24/2023 - 11:55

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(photo by sturti/Getty Images)

Gabrielle Giroday

Topic

Breaking Research

Temerty Faculty of Medicine

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Faculty of Arts & Science

New College

Psychiatry

Research & Innovation

Subheadline

The research involved doctors who came from a range of specialities, including surgery, psychiatry, emergency medicine and family medicine

A new study involving researchers from the University of Toronto has found mindfulness training for doctors improved their communication with patients and colleagues, and led to positive cognitive and behavioural changes.

The study, by Elli Weisbaum, an assistant professor in the Temerty Faculty of Medicine’s department of psychiatry, was recently published in the Canadian Medical Association Journal. The research looked at the experiences of 28 doctors who received five weeks of mindfulness training.

“This study’s findings are encouraging for all health-care professionals interested in developing healthy and compassionate workplaces. My hope is that these findings contribute to both individual and systems-level change,” said Weisbaum, who is cross-appointed to the Dalla Lana School of Public Health’s Institute of Health Policy, Management and Evaluation and is acting program director for New College’s Buddhism, psychology and mental health program in the Faculty of Arts & Science.

Trevor Young, U of T’s vice-president and provost, as well as a professor in Temerty Medicine’s departments of psychiatry, and pharmacology and toxicology, and Nicholas Chadi, a clinical assistant professor at the Université de Montréal, co-authored the study.

The research involved doctors who came from a range of specialities, including surgery, psychiatry, emergency medicine and family medicine.

Over a span of five weeks in 2019, participants attended weekly in-person applied mindfulness training sessions, based on the teachings of scholar and Zen Buddhist monk Thích Nhất Hạnh.

Researchers then conducted interviews to understand how the training impacted doctors’ work and daily lives.

“Participants report that integrating brief mindfulness practices at the beginning and end of their workday can lead to more effective regulation of workplace stressors, which can lead to feeling more energized at the end of the day,” the study authors wrote.

“Participants also report that a brief mindful reset at the end of the day can reduce the transfer of occupational stressors, such as frustration, to their home environment.”

As well, participants told researchers that mindfulness training helped them to have better skills when it came to balancing their work and home lives.

They said the training assisted them with giving themselves permission not to rush in their work, while still being efficient and effective.

Participants also reported better communication with their patients and their colleagues as a result of mindfulness training. This included enhanced self-awareness and decreased reactivity when confronted with challenging situations, they told researchers.

The study also found mindfulness training increased focus for physicians during patient interactions, and resulted in a higher awareness by physicians of their own biases around patients.

Ultimately, participants said the skillsets developed through mindfulness training led to more patient-centred diagnoses and treatment plans.

“[Due to mindfulness training,] participants describe having a greater awareness of what they contribute to challenging interactions with patients and colleagues. Through this understanding, they can implement more compassionate communication styles, which helps them set and maintain clearer boundaries for themselves during frustrating or irritating interactions,” the researchers wrote.

Weisbaum says the study’s findings point to the value of mindfulness training for physicians, and that the study is a “call to action” for clinicians and policymakers.

She says there is more research underway to examine how applied mindfulness can help address and mitigate physician burn-out.

“This research shows that mindfulness training benefits physicians at an individual level, through more effective management of occupational stressors,” Weisbaum says. “It also shows potential benefits to [the] broader health-care delivery system.”

U of T's Data Sciences Institute partners with UNICEF to drive innovation in learning

Christopher.Sorensen — Wed, 09 Aug 2023 18:45:29 +0000

U of T's Data Sciences Institute partners with UNICEF to drive innovation in learning

Christopher.Sorensen Wed, 08/09/2023 - 14:45

Cutline

(photo by Biplov Bhuyan/SOPA Images/Lightbox/Getty Images)

Sara Elhawash

Topic

Global Lens

Data Sciences Institute

Institutional Strategic Initiatives

Institute of Health Policy Management and Evaluation

Computer Science

Dalla Lana School of Public Health

Education

Faculty of Arts & Science

Global

Research & Innovation

Undergraduate Students

The Data Sciences Institute (DSI) at the University of Toronto is partnering with the United Nations Children’s Fund (UNICEF)’s Frontier Data and Tech team to find new ways to use data to address complex challenges involving children.

Through joint research and training, DSI – a U of T institutional strategic initiative – will work with UNICEF to strengthen the international organization’s ability to use data science to drive innovation in learning.

That includes a partnership focused on using data and artificial intelligence, or AI, to predict student dropout rates and develop better early warning systems that inform decision makers in the development and humanitarian realm.

“This partnership is a significant milestone for our Frontier Data Network, a global community of practice that leverages data science to positively impact the lives of children worldwide,” says Yves Jaques, chief of the Frontier Data and Technology unit at UNICEF.

“Together, we are poised to unlock new insights, drive evidence-based decision-making, and pave the way to a brighter future for children everywhere.”

The effort aligns with DSI’s strategic goal of leveraging the potential of data to promote the greater public good.

As an initial collaboration, Zahra Shakeri, an assistant professor at the Institute of Health Policy, Management and Evaluation (IHPME) at the Dalla Lana School of Public Health, will partner with Manuel Garcia-Herranz, data principal researcher, and Karen Avanesyan, statistics and monitoring education specialist at UNICEF’s Division of Data, Analytics, Planning and Monitoring (DAPM) on a project that aims to revolutionize early warning systems in education through the application of cutting-edge AI technology.

As part of the 2023 Summer Undergraduate Data Science (SUDS) Opportunities Program, the project allows Ziqi Shu, a third-year student studying computer science, cognitive science and mathematics, to gain practical experience by working on fictional case studies focusing on social problems affecting children. By identifying at-risk students and schools with high dropout rates, UNICEF aims to support countries with a strong Education Management Information System (EMIS) and household survey data.

“Our aim is to develop a pilot tool that provides a comprehensive representation of the machine learning-based school dropout prediction landscape, bridging the knowledge gap in this area,” says Shakeri, who is also director of the Health Informatics, Visualization, and Equity (HIVE) Lab at IHPME. “This tool will utilize innovative data analysis and visualization techniques, benefiting researchers, practitioners and other stakeholders in exploring the factors influencing school dropout among children.

“The long-term goal of this project is to harness the power of data science and create an adaptable, publicly accessible system that could support countries in addressing the critical issue of school dropouts. By leveraging AI technology and early warning systems, our aim is to identify and support at-risk students and schools, ultimately safeguarding every child’s right to education.”

The UNICEF-DSI partnership paves the way for further research and training collaborations.

There will be opportunities to connect with the DSI community during its DSI Research Day on Sept. 27, where Garcia-Herranz will deliver the keynote address and Jaques will participate in a panel discussion on developing an effective data science workforce. The discussion will focus on equipping graduates with essential data science skills required in today’s diverse fields and industries. DSI Research Day aims to showcase the work of the DSI community, fostering connections and engagement among academia, industry and government stakeholders.

“By combining our community’s expertise in data science with UNICEF’s commitment to driving results for children globally, we have the opportunity to make a profound impact,” says Lisa Strug, director of the Data Sciences Institute.

“Through our joint efforts, we aim to strengthen UNICEF’s knowledge and capacities in utilizing data science methodologies, fostering innovation in learning and ultimately creating a brighter future for children worldwide.”

Researchers develop tool to help hospitals reduce loss and theft of medications

Christopher.Sorensen — Tue, 13 Jun 2023 15:34:56 +0000

Researchers develop tool to help hospitals reduce loss and theft of medications

Christopher.Sorensen Tue, 06/13/2023 - 11:34

Cutline

(photo by BackyardProduction/Getty Images)

Alisa Kim

Topic

Breaking Research

Opioids

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Hospital

Research & Innovation

University Health Network

Drug diversion in health-care facilities, when prescription medications are obtained or used illegally, is on the rise in Canada – and most Canadian hospitals do not have sufficient safeguards in place to detect and deal with the problem.

That's why Patricia Trbovich and her team at the University of Toronto, in partnership with the Institute for Safe Medication Practices Canada, have developed a free, online tool that helps hospitals identify the risk of drugs being lost or stolen within their organization, and offers guidance on how to address those risks.

In developing the tool, the team pinpointed areas that make a hospital vulnerable to diversion as opposed to targeting individuals who lose or steal drugs.

“We saw this as an opportunity to look at it from a system perspective, seeing what is it in terms of the way we’ve configured our technologies, workflow processes and environments that is allowing for diversion to occur?” says Trbovich, an associate professor at the Institute of Health Policy, Management and Evaluation in the Dalla Lana School of Public Health.

The diversion risk assessment tool addresses a huge and complex problem. Nationally, reports of the loss of opioids and other controlled drugs have doubled annually since 2015. When drugs are lost or stolen within hospitals, everyone suffers. Drug diversion compromises the safety of patients and staff, increases health-care costs and contributes to substance abuse in the population.

The most commonly diverted drugs are opioids, which are prescribed to relieve pain. Trbovich and Mark Fan, manager of Trbovich’s research group HumanEra, published a study in CMAJ Open that looked at opioid losses from Canadian health-care facilities from 2012 through 2017. Using Health Canada data, they found there were about 65,000 reports of loss during this period, equating to about 112 kilograms of opioids with a street value of about $136 million.

“What makes this topic challenging is that we think losses and thefts are underdetected, and then potentially underreported. We don’t know the relative contributions of those two things,” says Fan, noting that any medication is at risk of going missing.

Moreover, hospitals don’t seem to know when or how medications are being lost or stolen.

“When we started talking to hospitals about it, they were saying, ‘We know it happens, but we don’t have a good way to track how often it happens,’” says Trbovich, who holds the Badeau Family Research Chair in Patient Safety and Quality Improvement at North York General Hospital. “Opioids might go missing for example, but they don’t necessarily know what led to it going missing. They are mandated to report to Health Canada when opioids go missing; often they report it back as ‘unexplained loss.’”

Organizations can use the tool at no cost, but they must first register. The risk assessment examines how controlled drugs are managed throughout a hospital. Users are asked, for example, how discrepancies in inventory records are detected, how staff access controlled areas and how processes around ordering, storage, transfer and disposal of medications are conducted.

The tool produces a risk score based on the information provided. Users can compare their score against other hospitals. There is also a reference guide that has recommendations to address areas of weakness, which was developed in collaboration with the Institute for Safe Medication Practices Canada and the Ontario Branch of the Canadian Society of Hospital Pharmacists.

Hospitals can re-do the assessment after implementing recommended safeguards, notes Trbovich. “Once they’ve addressed [vulnerabilities], they could then on a regular basis benchmark themselves against others or themselves if they want to see how they’re improving,” she says.

To date, dozens of hospitals have signed up to do the risk assessment. The research team will analyze the aggregated results to provide an overview of the diversion risks in Canadian hospitals. The analysis will highlight differences in risk based on region, hospital size and technologies used, so that organizations can learn from each other, says Fan.

“Having this national ‘snapshot’ is going to help policymakers assess where we need to raise the floor on our safety practices across Canada, and to transfer the learnings,” he says. “If we see some people are doing really well, it’s something to celebrate and bring to other hospitals.”

The project received support from the Canadian Institutes of Health Research.

President’s Impact Awards recognize far-reaching contributions of U of T researchers

Christopher.Sorensen — Fri, 10 Mar 2023 16:30:23 +0000

President’s Impact Awards recognize far-reaching contributions of U of T researchers

Christopher.Sorensen Fri, 03/10/2023 - 11:30

Cutline

(photo by Nick Iwanyshyn)

Topic

Temerty Faculty of Medicine

Unity Health

Institute of Health Policy Management and Evaluation

Munk School of Global Affairs & Public Policy

President's Impact Award

Creative Destruction Lab

Dalla Lana School of Public Health

Faculty of Applied Science & Engineering

Faculty of Arts & Science

Hospital for Sick Children

Mathematics

Ontario Institute for Studies in Education

Research & Innovation

Rotman School of Management

University Health Network

Women's College Hospital

From informing Ontario’s pandemic response to shaping the fields of education, social policy, robotics and entrepreneurship, the University of Toronto is recognizing researchers for the impact of their work across Canada and beyond.

Among the winners of this year’s President’s Impact Awards – which honour individual U of T faculty members and teams for research that has led to significant impacts beyond academia – are 13 leaders of the Ontario COVID-19 Science Advisory Table.

The group was recognized as a team for “outstanding contributions and dedication to supporting evidence-informed decision making and response to the COVID-19 pandemic in Ontario and nationally.”

Fahad Razak

Fahad Razak, who served as the Science Table’s scientific director, says he is grateful to be celebrated alongside his colleagues, noting that it was only through their collective expertise and efforts that the Science Table was able to provide transparent scientific analysis and evidence-based, equity-minded guidance in response to an ever-shifting crisis.

“I'm really happy that University of Toronto has recognized that much of the consequential work that is done is not done by individuals – it's done by teams,” says Razak, an internist and epidemiologist at St. Michael’s Hospital, Unity Health Toronto and an assistant professor in the department of medicine in U of T’s Temerty Faculty of Medicine and at the Dalla Lana School of Public Health’s Institute of Health Policy, Management and Evaluation (IHPME).

“That multidisciplinary composition of our table was one of the critical drivers of success of putting out modelling scientific briefs or other recommendations that were thoughtful and comprehensive about the effects that could happen across society.”

The other Science Table members sharing the honour with Razak are:

Peter Jüni, an affiliate scientist at Li Ka Shing Knowledge Institute, Unity Health, who was the table’s scientific director and a professor of medicine and epidemiology in the Temerty Faculty of Medicine and IHPME before leaving for University of Oxford in 2022.
Co-chairs Adalsteinn Brown, dean of the Dalla Lana School of Public Health, Brian Schwartz, a professor in the department of family and community medicine in the Temerty Faculty of Medicine, and Upton Allen, the head of infectious diseases at the Hospital for Sick Children and a professor of pediatrics in the Temerty Faculty of Medicine and at IHPME.
Assistant scientific directors Nathan Stall, a physician at Sinai Health and an assistant professor in the Temerty Faculty of Medicine, and Karen Born, assistant professor of health administration at IHPME.
Director of communications Robert Steiner, assistant professor and director of the Dalla Lana Fellowship in Global Journalism at the Dalla Lana School of Public Health.
Modelling consensus table co-chairs Beate Sander, a senior scientist at the Toronto General Hospital Research Institute, University Health Network, and a professor at IHPME, and Kumar Murty, a professor of mathematics in the Faculty of Arts & Science.
Chair of the congregate care setting working group Paula Rochon, senior scientist at the Women’s College Hospital Research Institute and professor in the Temerty Faculty of Medicine
Co-chair of the drugs and biologics clinical practice guideline working group Andrew Morris, medical director of the antimicrobial stewardship program at Sinai Health/University Health Network and professor of medicine in the Temerty Faculty of Medicine.
Mental health working group chair Linda Mah, a senior clinician scientist at the Rotman Research Institute, Baycrest Health Sciences Centre and an associate professor of psychiatry in the Temerty Faculty of Medicine.

The team joins four other U of T researchers recognized this year. They are:

Ajay Agrawal, professor of strategic management and Geoffrey Taber Chair in Entrepreneurship at the Rotman School of Management. He is recognized for his “application of economic theory to the problem of market failures associated with transforming scientific inventions into scalable companies that benefit society,” which inspired the founding of the Creative Destruction Lab – a model that has been adopted by business schools around the world.

George Dei, professor in the department of social justice education at the Ontario Institute for Studies in Education. Dei was recognized for his “influential work advancing anti-racism, equity, anti-colonial thought and African Indigeneity in education and sustained impact on policies, practices and advocacy for inclusive schooling and Black youth’s educational success.”

Yu Sun, a professor in the department of mechanical and industrial engineering in the Faculty of Applied Science & Engineering and founding director of U of T’s Robotics Institute. He is honoured for “outstanding contributions to robotics at micro-nano scales, whose far-reaching impacts include transformative infertility treatments for patients and materials characterization techniques for industry.”

Ito Peng, a professor of sociology in the Faculty of Arts & Science and the Munk School for Global Affairs & Public Policy. She is credited for global “social policy leadership informing national and international policy bodies on issues of gender, the work of care and care migration.” Peng, whose expertise has been sought out by policymakers across the globe, was also named the recipient of the Carolyn Tuohy Impact on Public Policy Award, presented annually to a faculty member whose scholarship has had a significant impact on public policy as part of the Awards of Excellence Program.

Winners of the President’s Impact Award are designated as members of the President’s Impact Academy, which advocates for sustained excellence in research and innovation impact within and outside of the university.

“These awards represent how U of T’s research community is coming together tackle some of today’s toughest problems and making breakthroughs that result in real-world change,” says Leah Cowen, U of T’s vice-president, research and innovation, and strategic initiatives.

“From global issues to micro-scale innovations, this year’s laureates have shown themselves to be visionaries in their respective fields and consummate collaborators – working with scholars across disciplines and partnering with community members, public stakeholders, industry leaders and policymakers to address our current challenges and drive progress toward a brighter future.”