Three ideas out of 23 for building an even better Toronto
Use hospital patient data to improve diagnoses and treatments and to lower health-care costs.
Trevor Young, the dean of U of T’s Faculty of Medicine, is a big Star Trek fan. And although he doesn’t expect the arrival of tricorders – a device the show’s doctor used to scan a patient’s body and make a diagnosis – he does see huge potential to use computers and the patient data collected by the university’s nine fully affiliated hospitals to improve the health-care system. He foresees a new centre for medical computation at U of T that would bring together physicians and computer scientists to solve major health problems, while also lowering medical costs.
How? Powerful machine-learning algorithms could routinely scour the data for patterns that could be used to find new ways to diagnose and predict patient outcomes based on a range of factors. “For instance, the system may be able to figure out if heart attacks could be predicted, based on genes or very finely-honed lifestyle factors that go way beyond just alcohol or red meat consumption,” he says.
Another example: A web-based portal could give patients constant access to their health record, help them interpret their lab results and provide recommendations about healthy living. A follow-up appointment with their physician could be made automatically, or the physician could discuss the result with the patient through a video conference. “There are so many opportunities to use technology to improve health care in Toronto, and throughout Canada,” says Young. “So far, we’ve just scratched the surface.”
Help aboriginal patients through a program to build doctors’ understanding and empathy.
Chandrakant Shah, a professor emeritus in the Dalla Lana School of Public Health, works as the staff physician at Anishnwabe Health Toronto, a clinic serving the city’s aboriginal community, including many homeless people. He has witnessed firsthand how the system can fail aboriginal patients.
Shah tells the story of a woman who arrived at his clinic: she had few physical complaints but seemed unhappy. It was only after seeing Shah for two years and developing trust in him that she confided that she had been taken from her home when she was six and placed in a residential school. She had been physically and sexually abused, and had never told anyone – not even her family. “She was going through post-traumatic stress,” says Shah. Afterward, through talking about it, she was able to begin healing.
When doctors can feel as if they’ve “walked in a patient’s shoes,” they develop greater empathy, says Shah, and this leads to improved health outcomes. For doctors who see aboriginal patients, that means understanding the crushing impact of post-colonial policies, such as the residential school system, as well as the impact of systemic discrimination.
Shah has trained a team of 35 aboriginal volunteer instructors to deliver free talks about indigenous people’s health issues – including aboriginal concepts of health and healing – to the 57,000 students enrolled in health-sciences programs at Ontario’s colleges and universities. The program launched in 2010 and last year, 19 of 47 institutions participated. Shah hopes the program will eventually lead to better – and fairer – health care for the tens of thousands of aboriginal people who call the Toronto area home. “I want students to have empathy for their patients, no matter who they are,” he says.
Offer free financial advice to low-income hospital patients.
Everyone knows that a balanced diet and regular exercise contribute to good health, and that smoking and excessive use of alcohol or drugs can lead to disease. But there’s another crucial – and often overlooked – factor that affects a person’s health: income. Dr. Andrew Pinto, a professor of medicine, says studies show that income is one of the most important social determinants of health, along with education.
Last year, Pinto, who is also a physician and scientist at St. Michael’s Hospital in downtown Toronto, became involved in a pilot project, possibly the first of its kind in North America, to help low-income patients improve their financial situation. Patients selected for the program are referred to a specialist within the hospital’s family health team who provides tailored advice designed to boost patients’ incomes and reduce their expenses. The assistance can be as simple as showing the person how to do their taxes or formulating a monthly budget. Or it can be more complex, such as identifying skills-training or grant programs the patient could apply to. “Addressing this key factor – income – could lead to better health through improved diet, more stable housing and a reduction in stress,” says Pinto.
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