Good Tech, Compassionate Healthcare – Details, episodes & analysis

Thank you for joining us for this special episode of Good Tech Compassionate Healthcare. In May of 2024, AMS Healthcare was thrilled to convene 170 healthcare stakeholders from across Ontario to delve into the timely and ethical scaling of AI in our healthcare sector. The insights we gained were invaluable. The conference revealed a consensus that there is an urgent need to deploy AI solutions in the most capacity-challenged areas of our healthcare system, particularly in primary care. This move is crucial to reducing workforce burnout and improving workflows. Many of the leaders that we spoke to at our conference were asked a series of questions about AI in healthcare, and we will be sharing their insightful responses in these special episodes.

The leaders featured in Part Two are:

Jennifer Gibson - Director of the University of Toronto Joint Centre for Bioethics

Suresh Balu - Director for Duke Institute for Health Innovations

Nicole Woods - Director of The Institute of Education Research at the University Health Network

Carla Velastegui - Caregiver Advocate in the Digital Healthcare Sector

Dr Amol Verma - Physician and Scientist at St. Michael's Hospital Unity Health

Anna Foat - Patient Partner and Advocate

Laura Desveaux - Science Lead and Learning Health System Program Lead at Trillium Health Partners

amshealthcare.ca

Thank you for joining us for this special episode of Good Tech Compassionate Healthcare. In May of 2024, AMS Healthcare was thrilled to convene 170 healthcare stakeholders from across Ontario to delve into the timely and ethical scaling of AI in our healthcare sector. The insights we gained were invaluable. The conference revealed a consensus that there is an urgent need to deploy AI solutions in the most capacity-challenged areas of our healthcare system, particularly in primary care. This move is crucial to reducing workforce burnout and improving workflows. Many of the leaders that we spoke to at our conference were asked a series of questions about AI in healthcare, and we will be sharing their insightful responses in these special episodes.

The leaders featured in Part One are:

Dr. Keith Thompson - Family Physician and Adjunct Faculty Professor at Western University

Dr. Jaron Chong - Assistant Professor of Diagnostic Radiology at the Department of Medical Imaging at Western University

Colleen Flood - Dean of the Faculty of Law Queen’s University

Phyllis Berck - Patient Partner with UHN

Dr. Brian Hodges - Executive-Vice President of Education and Chief Medical Officer at University Health Network

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

NORC Innovation Centre at UHN

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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”

https://norcinnovationcentre.ca/wp-content/uploads/NORC-Report-FINAL.pdf

Toronto Star article

Women’s College Hospital

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.

 Women’s Age lab website

Definition: ‘Elder orphans,’ without kids or spouses, face old age alone. An overlooked segment of the population.

In this conversation, Benjamin Chin-Yee, an AMS Healthcare Fellow in Compassion and AI Clinical Fellow in Hematology at Western University
and Post Doctoral Associate at the Rotman Institute of Philosophy at Western engages with Jay Shaw, an AMS Healthcare Phoenix Fellow
Assistant Professor in the Department of Physical Therapy at the University of Toronto and Research Director of AI Ethics and Health at the University of Toronto Joint Center for Bioethics discuss digital technologies for healthcare and health equity and the impact these technologies are going to have on how we care for patients

AMS Website

https://www.ams-inc.on.ca/

Benjamin Chin-Yee

https://www.benchinyee.com/

Jay Shaw

https://ihpme.utoronto.ca/faculty/james-jay-andrew-shaw/

Challenges and Strategies in Engaging Structurally Marginalized

Communities in Virtual Care:

https://academic.oup.com/jamia/article-abstract/29/5/990/6532728?login=false

The Definition of Inclusive Design: https://tinyurl.com/2p8drzjh

COVID-19, digital health technology and the politics of the unprecedented by Dillon Wamsley and Benjamin Chin-Yee:

https://journals.sagepub.com/doi/full/10.1177/20539517211019441

In this episode, Sarah Munce, Scientist at the KITE Research Institute at the University Health Network, and Assistant Professor in the department of Occupational Science and Occupational Therapy at the University of Toronto, and Jennifer Stinson, Nurse and Clinician Scientist in the Child Health Evaluative Science Programs within the Research Institute at the Hospital for Sick Children, discuss virtual peer navigation as an avenue for the delivery of compassionate care for youth, and a smartphone based app that has been developed to help young people cope with pain. 

Pediatric Patient Engagement Online Training Material

https://porcch.ca/

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 podcast.
- Ms. Donna Hart had a heart transplant and contributed her lived experience in an at heart Her Stories video.
- Ms. Vincenza Spiteri DeBonis has non-obstructive coronary artery disease and contributed her lived experience in an at heart Her Stories video.
- Ms. Lise Owens has Takotsubo cardiomyopathy and contributed her lived experience in an at heart Her Stories podcast.

Proposed Compassion Technologies and Attributes for Chatbot ‘Holly’
Chit-Chat. Relationship optimization – bidirectional, phased, actionable conversation (Authentic, Aware, Respectful).
Text Summarization. Voice tone and/or responsive data points in the text of women used to assess mood/emotion (Aware, Empathic, Empowering).
Personalized Learning. 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.

In this episode we have two brilliant scientists, both AMS Fellows in AI and Compassion, discussing how important compassion is in the co-design of digital care allowing for buy- in, ownership and engagement for patient, provider and community alike.

Carolyn Steele-Gray, PhD

Scientist, Toronto’s Bridgepoint Laboratory for Research and Innovation, Sinai Health

Assistant Professor, Institute for Health Management Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto

Tier Two Canada Research C hair in Implementing Health Innovation

2020 AMS Healthcare Fellow in Compassion and Technology

Mike Lovas, BEng, MASc, BDes

Director of Design and Innovation at Cancer Digital Intelligence, Princess Margaret Cancer Centre at UHN.

2021 AMS Healthcare Fellow in Compassion and Technology

In this conversation Nelson Shen NHA, PhD, and Daniel Buchman PhD, RSW discuss patient data privacy and consent in mental health care.

Nelson and Daniel are both working on research that will improve the experience of mental health patients and their relationships with health care providers.

If you would like more information on Nelson and Daniel and the important work that they are doing
here are some links to get you started:

Nelson Shen, NHA, PhD: Scientist at the Center for Addiction and Mental Health (CAMH), Assistant Professor at the University of Toronto Institute of Health Policy Management Evaluation, and a 2021
AMS Healthcare Compassion and AI Fellow
Nelson Shen AMS Healthcare project: Imagining Compassionate Consent for Digital Mental Health Services.

Daniel Buchman, PhD, RSW: Bio Ethicist and Independent Scientist at the Centre for Addiction and Mental Health (CAMH), Assistant Professor at the Dalla Lana School of Public Health at the University of Toronto, Member of the University of Toronto Joint Center for Bioethics, and a 2020 AMS Healthcare Compassion and AI Fellow.

Daniel Buchman AMS Healthcare project: Understanding AI implications for stigma and compassion in mental health and addiction. 

BrainHealth Databank: A CAMH-wide initiative that will accelerate research and improve care by collecting and studying the full spectrum of data that individuals choose to share to advance mental
health. 

In this conversation Nicole Letourneau RN, BN, MN, PhD, Monica Oxford PhD, and Linda Duffet-Leger PhD, MN, BN discuss their study on mothers with depression and how they are developing a technology to improve the serve and return relationship between caregivers and their children. 

If you would like more information on Nicole, Monica, and Linda and the important work they are doing here are some links to get you started:

Nicole Letourneau RN, BN, MN, PhD: Professor and Research Chair in Parent and Child Mental Health at the University of Calgary

Monica Oxford PhD: Professor at the University of Washington school of Nursing and Executive Director for the Barnard center for Infant and Early Childhood Mental Health

Linda Duffet-Leger: PhD, MN, BN: Associate Professor in the Faculty of Nursing at the University of Calgary

Team members: 

- Cindy Lee Dennis: Professor at the Lawrence S. Bloomberg Faculty of Nursing and the Faculty of Medicine, Department of Psychiatry at the University of Toronto.

- Penny Tryphonopoulos: Assistant Professor at the Arthur Labatt Family School of Nursing, Western University

- Mohammad Moshirpour: Meng Software Program Director Schulich School of Engineering, Senior Instructor Department of Electrical and Software Engineering at the University of Calgary.

Parent child interaction teaching scale (PCI): used to be known as the nursing child assessment teaching scale

Serve and Return: parental sensitivity and responsiveness to infants and young children in relationships

EQIP: enabling quality interaction with parents

Links to resources on infant and child mental health:

https://www.sickkids.ca/en/learning/our-programs/infant-and-early-mental-health-promotion/

https://www.zerotothree.org/

https://www.youtube.com/watch?v=TzMxrMJBZdQ

https://developingchild.harvard.edu/science/key-concepts/serve-and-return/

https://developingchild.harvard.edu/resources/serve-return-interaction-shapes-brain-circuitry/

https://barnardcenter.nursing.uw.edu/

https://www.pcrprograms.org/

In this conversation Amy Hsu PhD, Scientist at Bruyère Research Institute, and Faculty Member of Family Medicine in Ottawa, and Peter Tanuseputro MHSc, MD, CCFP, FRCPC, Public Health Physician at the Bruyère Research Institute and the Ottawa Hospital Research Institute discuss AI enabled compassionate end of life care through their life expectancy calculator Project Big Life.

Dr. Amy Hsu, PhD: Scientist at Bruyère Research Institute in Ottawa and a Faculty Member in the Department of Family Medicine in Ottawa. Amy holds the University of Ottawa Brain and Mind- Bruyère Research Institute Chair in Primary Health Care in Dementia.

Dr. Peter Tanuseputro, MHSc, MD, CCFP, FRCPC: Public Health Physician and Family Physician at the Bruyère Research Institute and the Ottawa Hospital Research Institute. 

RESPECT: Risk evaluation for support predictions for elder life in the community tool

OSSU: Ontario Spor Support Unit 

CIHR: Canadian Institutes of Health Research 

RESPECT (Life expectancy calculator): https://www.projectbiglife.ca/
-  Project Big Life has developed 4 additional calculators; dementia, elder-life, heart attack and stroke, and sodium measurements.

CMAJ paper 

Additional resource about end-of-life care

Tool to plan a conversation about death with your loved ones over dinner: https://deathoverdinner.org/