New surgical technique allows doctors to add more organs to the donor pool

Two types of light-based therapies can sterilize donor organs prior to transplantation

New surgical technique allows doctors to add more organs to the donor pool

A new technique co-developed by U of T researchers uses light-based therapy to kill viruses in organs meant for transplantation. The method lets physicians treat human donor lungs infected with Hepatitis C, preventing viral transmission to the organ recipient.

The co-authors of the procedure, published in Nature, are hopeful that it could vastly increase the number of organs eligible for transplantation in North America.

The new surgical technique is based on existing methods

This technique uses an existing procedure known as ex-vivo lung perfusion. Here, after retrieval by practitioners, the lungs are placed in a chamber with a circuit and specific liquids flow through the organs’ vasculature.

During this circuit the solution passes through the lungs, washing out a lot of viruses. The newly developed technique uses a machine with two light-based therapies — namely, ultraviolet C irradiation and photodynamic therapy — to eventually sterilize the organs before the transplantation.

The research team developed a customized illumination device which is attached to the machine where perfused liquid passes through, irradiating the virus and therefore inactivating it with light.

The researchers aim to further develop the technique by treating the lungs themselves with light, not just the liquid that passes through them. To achieve this, more research is needed on the optical properties of the lungs to engineer new technology to illuminate them.

Adding organs to the donor pool

Co-author Dr. Marcos Galasso, a U of T thoracic surgeon and ex-vivo lung perfusion specialist, stressed the importance of this new technique in an interview with The Varsity.

“There is a great need for donor organs,” he said, “[which has led] to some people dying on the waiting list for transplantation.”

Galasso added that treating Hepatitis C-infected donor lungs alone could make a huge impact on the donor pool due to the opioid crisis gripping North America. He noted that most patients who die from drug overdoses test positive for the virus.

According to Galasso, if health care practitioners could add volunteers infected with Hepatitis C to the donor pool, there could between 1000 to 2000 new lung donors eligible per year in North America.

“We could actually have a massive impact in the organ donation environment in North America [with this surgical technique].”

The promise of ketamine in overcoming treatment-resistant depression

Therapeutic potential of ketamine discussed in review by U of T medical researchers

The promise of ketamine in overcoming treatment-resistant depression

Content warning: Discussions of suicide in the context of treating major depressive disorder.

Ketamine is a promising medication that brings hope to patients struggling with severe depression, offering potential therapeutic effects for those who are non-responsive to standard antidepressants.

The dissociative anesthetic is currently used by physicians and veterinarians to cause fast-acting insensitivity to pain during medical procedures. It is also used illicitly as a recreational drug, causing feelings of disconnection and relaxation among users.

Yet in controlled settings, ketamine also shows potential as a medication to help patients who are suffering from major depressive disorder. In April, a research review by U of T researchers found that ketamine offers significant effects as an antidepressant.

The lead author of the paper, Dr. Joshua Rosenblat, discussed the review’s findings with The Varsity. As a clinician-scientist in the Department of Psychiatry, Rosenblat is currently studying the antidepressant effects of ketamine.

He explained three major effects that differentiate ketamine from standard antidepressants: a different mechanism of action, a rapid onset of effects, and a response in patients who are not positively affected by commonly prescribed antidepressants.

Ketamine affects depression via a novel mechanism of action

For the past several decades, standard antidepressants have worked by affecting levels of serotonin, norepinephrine, and dopamine, explained Rosenblat.

In generalized terms, serotonin is a chemical messenger thought to regulate mood, while norepinephrine controls alertness and arousal. Dopamine affects attention and emotion.

But ketamine affects the brain differently. Rather than targeting these neurotransmitters, it instead changes levels of glutamate – the main excitatory messenger in the brain.

Ketamine’s unique mechanism of action could therefore explain why it may positively affect patients suffering from treatment-resistant depression, who do not respond to standard antidepressants.

Ketamine could provide a more rapid onset of affects, versus standard antidepressants

Ketamine also provides a rapid onset of effects. Standard antidepressants, said Rosenblat, usually take two months of prescribed usage to take effect.

He explained that with ketamine, alleviation of depressive symptoms can appear within two hours of consumption. This is especially promising as an option for patients suffering from suicidal thoughts.

A decrease in suicidal thoughts can plausibly reduce the number of suicidal attempts; however, Rosenblat noted that the evidence is currently too limited to make a conclusion. He explained that studies are lacking, as only a small percentage of patients affected by such thoughts attempt to commit suicide.

Ketamine could also be used for special applications. Depression is very common among patients facing terminal cancer, explained Rosenblat.

“If you were to start them on an antidepressant and they only have one month left to live, for example, [the patients may] only experience the side effects, and never get the benefits.”

Rosenblat is currently leading a clinical trial at Princess Margaret Hospital to research the use of ketamine for improving the final months of life for patients affected by terminal cancer.

The risks and drawbacks of ketamine as an antidepressant

While the prospect of applying ketamine for treating depression is promising, there are several discouraging factors to its application.

To start, ketamine carries the risk of substance abuse. While ketamine is not strongly addictive, said Rosenblat, recreational users of the drug can develop a dependence.

Ketamine may also be prohibitively expensive for potential patients, as it is not covered by OHIP. Furthermore, as a medicine that is only available for research study or private use, it cannot currently be prescribed by most physicians.

There are also limited studies on the rare side effects of ketamine. In the short-term, the main known side effects are disassociation, a daydream-like state, and nausea which may occur during the administration of ketamine.

“We don’t know what we don’t know,” said Rosenblat. It is unclear whether ketamine may cause rare, adverse reactions in some patients. Long-term side effects of ketamine are also unclear.

Rosenblat therefore does not encourage self-medication for U of T students suffering from mental health challenges, as ketamine is not sufficiently studied.

Only a “very small percentage” would likely positively benefit from ketamine, explained Rosenblat, compared to standard treatment options supported by a much wider body of research.

The future of ketamine research

Although ketamine is not fully studied and is currently only used in special situations, it still brings “a message of hope,” said Rosenblat.

While ketamine is still not approved as an antidepressant, the U.S. Food and Drug Administration has approved esketamine, a structurally similar compound, as a nasal spray antidepressant. This became the first antidepressant of its kind to be used in the United States.

While Rosenblat notes that much more future research needs to be done with ketamine, he agrees that preliminary results are “very promising.” With a new avenue of research in treating severe depression, the future of research in the field seems optimistic.

Greater risk of heart attacks the day after Super Bowl, cardiologists find

Psychological stress, increased consumption of alcohol and salty foods are possible causes

Greater risk of heart attacks the day after Super Bowl, cardiologists find

The broadcast of the Super Bowl has been linked to a heightened risk of cardiac events in Ontario, including heart attacks and heart failures, according to a recent U of T-affiliated study.

The NFL’s annual championship game, the Super Bowl, is frequently the most viewed television spectacle in Canada each year.

Using data drawn from health care records in Ontario, the researchers analyzed the number of emergency department visits and hospitalizations for heart attacks, heart failures, and atrial fibrillation — rapid, irregular heartbeat rhythm — over 10 years of Super Bowl weeks from 2008 to 2017.

The analysis showed that on the Monday following each Super Bowl, there is a marked increased risk of heart attacks in Ontario. For patients younger than 65, the risk of heart failure also spiked on the following Monday.

Interestingly, the researchers did not find a statistically significant increase in the relative risk of heart attacks, heart failures, and irregular heart rhythms on the day of the Super Bowl.

Possible explanations for the spike in cardiac events

Dr. Sheldon Singh, a cardiologist and cardiac electrophysiologist at Sunnybrook Health Sciences Centre, wrote to The Varsity that this finding may arise from the complex relationship between stress and cardiac events.

“Prior work has shown that stress can have residual effects with [heart attacks] occurring hours after a clearly identified stressor,” wrote Singh.

“In addition… there may also be issues with patients delaying when they seek medical care — such as ignoring symptoms when they occur hoping they will pass, misinterpreting symptoms, or not wanting to disrupt any social gathering they are at.”

“It’s also important to remember that Super Bowls occur late on Sunday evenings,” noted Singh, “so it would not be unexpected to see an increase in events on [the] following Monday.”

Psychological stress experienced by spectators, as well as an increased consumption of alcohol and salty foods are further factors that may contribute to the amplified risk of cardiac events during the Super Bowl.

However, Singh added that there may be other contributing factors that the study failed to identify due to its design.

“Our work is at a population level, not individual level, which makes it challenging to tease out the exact mechanism of the observed association,” wrote Singh.

Previous studies have shown that heart rates of Montreal Canadiens’ fans increase during hockey games. A spike in cardiac events have also been reported during FIFA World Cup soccer matches by other studies.

Singh wrote that it’s possible to generalize the findings for Super Bowl viewers to those of other sporting events, but it’s important to remember the distinction between a single critical match versus a series when making such assumptions.

Stress levels are more concentrated when the outcomes of a championship, such as the Super Bowl, depend on a single game.

However, the stress experienced during other types of sporting events, such as with hockey or baseball, is generally more distributed because the final outcome often depends on the best of a series.

“We have to appreciate that [increased] cardiac events also have been reported with single catastrophic or stressful events, such as severe snowstorms… earthquakes, and other natural disasters,” wrote Singh.

Health care providers may be able to better plan for a spike in admissions for cardiac-related events around the Super Bowl each year using the study’s findings.

Moreover, Singh believes that educating individuals on the association between emotional stress and dietary indiscretion on one’s overall health will have important implications for public health.

“Given the popularity of the Super Bowl, there is an opportunity for health care practitioners to reach a broad segment of the population, which may have impacts not only during the Super Bowl, but with other events as well,” wrote Singh.

“I am hopeful the general public will access information from our study and public health agencies use this to launch health care campaigns promoting healthy lifestyles.”

Where computers and clinics intersect

Raw Talk Podcast hosts expert panel discussions about AI’s role in healthcare

Where computers and clinics intersect

Experts in medicine, academia, and industry explored the promises and perils of the applications of artificial intelligence (AI) in health care during panel discussions with the Raw Talk Podcast on May 7. The event was organized by graduate students of U of T’s Institute of Medical Science.

The two panels, collectively named “Medicine Meets Machine: The Emerging Role of AI in Healthcare,” aimed to demystify sensationalism and clarify misconceptions about the growing field of study.

“On one hand, it seems like everyone has heard about [AI],” said Co-executive Producer Grace Jacobs. “But on the other hand, it seems like there’s a lot of misunderstanding and misconceptions that are quite common.”

How AI is used in health care

While discussing the reality of AI, several panelists emphasized that it should be viewed and treated as a tool. “It is statistics where you don’t have to predefine your model exactly,” said Dr. Jason Lerch of the University of Oxford.

Other speakers agreed that AI is an expansion of — or a replacement for — traditional statistics, image processing, and risk scores, as it can provide doctors with more robust and accurate information. However, final health care recommendations and decisions remain in the hands of doctors and patients.

“You always need a pilot,” said Dr. Marzyeh Ghassemi, a U of T assistant professor of computer science and medicine.

But what advantages can this tool provide? Ghassemi thinks it can assimilate clues from a wider range of patients’ conditions to predict treatment outcomes, replacing the experience-based intuition that doctors currently rely on.

Speaking on her time in the Intensive Care Unit as an MIT PhD student, Ghassemi said, “A patient would come in, and I swear they would look to me exactly the same as prior patients, and the… senior doctors would call it. They would say, ‘oh, this one’s not going to make it. They’re going to die.’ And I would say, ‘Okay… why?’ And they said, ‘I’m not sure. I have a sense.’”

“They used different words — gestalt, sense — but they all essentially said the same thing. ‘I just — I have a sense.'”

Doctors develop this sense by seeing many cases during their training, but they can intuit only the cases that they had personally experienced; AI algorithms can potentially understand many more cases using a wider dataset.

Accessing those cases requires access to patient data, and access to data requires conversations about consent and privacy. Ghassemi and Dr. Sunit Das, a neurosurgeon at St. Michael’s Hospital and Scientist at the Keenan Research Centre for Biomedical Science, said that “de-identification” — the removal of information that can be traced back to individual identities — protects privacy.

Large de-identified datasets from the United States and the United Kingdom are available for AI research, but generally, Canada lags behind these countries in making health data available for this purpose.

Dr. Alison Paprica, Vice-President of Health Strategy and Partnerships at the Vector Institute, agreed that data should be used for research, but argued that de-identification alone does not eliminate risk.

“You’re not just giving a dataset to anybody,” she said. “You’re giving a dataset to people who are extremely skilled at finding relationships and patterns and maybe piecing together information in ways that most people couldn’t. So I think there’s going to be heightened sensitivity around re-identification risk.”

Society must manage this risk and balance it against the benefits. “How do we balance that?” Paprica asked. She suggested that consulting all involved stakeholders could help strike that equilibrium.

Advice for scientists aiming to use AI in their research

So what advice did the panelists have for scientists hoping to harness the power of AI in their own research?

Ghassemi stressed the importance of knowing what you’re doing: researchers have created many tools that make AI research easy to implement, but conscientious scientists need to know the statistical and training principles behind the methods.

“If you’re not aware of how these things are trained,” she said, “it’s really easy to misuse them. Like, shockingly easy to misuse them.”

Other panelists advised users to take care when choosing data to train the algorithms. “A learning algorithm can’t overcome bad data that goes in, or can’t completely overcome it,” said Lerch.

Moderator Dr. Shreejoy Tripathy summed up a key takeaway on applying AI to health care: “Understand your data… And understand your algorithms.”

Former U of T professor pleads guilty to second-degree murder of wife

Mohammed Shamji, Elena Fric-Shamji were both U of T faculty

Former U of T professor pleads guilty to second-degree murder of wife

Former University of Toronto professor and neurosurgeon Mohammed Shamji pleaded guilty at his pre-trial on April 8 to the second-degree murder of his wife, Dr. Elena Fric-Shamji, who was also a U of T professor and physician.

The murder occurred on November 30, 2016, two days after Fric-Shamji had filed for divorce after 12 years of marriage, which the court heard had been marked by verbal, emotional, and physical abuse. Testimony from the preliminary inquiry included descriptions of repeated sexual assaults and one instance of Shamji choking Fric-Shamji until she lost consciousness.

In May 2016, Fric-Shamji had initiated divorce proceedings “after years of unhappiness,” but Shamji pleaded for more time to work through their problems, according to an agreed statement of facts read to the court.

The couple reconciled but the marriage continued to deteriorate until Fric-Shamji served divorce papers, which was met by resistance from Shamji. In an argument shortly after, he struck Fric-Shamji “multiple times, causing her significant blunt force injuries all over her body, including a broken neck and broken ribs. He then choked her to death,” according to the statement of facts.

Fric-Shamji’s body was found on December 1, 2016. Shamji was arrested the following day and charged with murder by Toronto Police a few days after.

The charge of second-degree murder carries an automatic life sentence, with no possibility of parole for 10 years.

According to the statement of facts, Shamji went about his day-to-day business, including performing surgeries, the day after the murder.

Shamji has been held in a GTA detention centre since the murder. He pleaded guilty two days before jury selection was to take place.

The couple met at the University of Ottawa where Fric-Shamji was attending medical school and Shamji was completing his residency. Two of their three children, now 11 and 14, were present at the pre-trial, along with numerous family and friends who all wore purple ribbons to bring attention to the issue of domestic violence. 

Jean DeMarco, the lawyer for the victim’s family, told reporters that his clients were “satisfied” and “pleased” with the result.

Shamji will return to court to face a sentencing hearing on May 8 in downtown Toronto.


If you or someone you know needs help, you can call the Assaulted Women’s Helpline’s 24-hour crisis line:

1-866-863-0511 (Toll Free)

1-866-863-7868 (TTY)

416-863-0511 (Toronto)

BoneTape: gluing the broken pieces back together

U of T scientists create revolutionary device for fixing facial bone fractures

BoneTape: gluing the broken pieces back together

Researchers affiliated with the University of Toronto and Sunnybrook Health Sciences Centre have invented a flexible bone stabilization device that promises to help improve the treatment of craniomaxillofacial (CMF) fractures — or fractures around the head and face. Referred to as BoneTape, the device is currently undergoing pre-clinical testing in hopes of improving CMF reconstruction.

Traumatic CMF fractures commonly occur due to road accidents, sports incidents, and war-related injuries. The thin and geometrically complex bones and soft tissues of the head and face, as well as the difficult cosmetic approaches of current treatment options, makes these injuries difficult to treat.

Jeffrey Fialkov, a CMF surgeon and one of the researchers credited for the invention, points out that current solutions for fractures — whether to the face or the femur — are similar. Metal plates are placed to align bone fragments and screws are used to hold the bones together while they heal.

However, plates and screws are not ideal for treating some shattered CMF bones that are very thin and complex in shape. For screws to provide solid fixation, a certain bone thickness is needed, thus limiting their applicability for some CMF injuries.

Reports suggest that up to half of the patients who undergo reconstructions experience complications, often requiring follow-up surgeries to remove the hardware.

In an interview with The Varsity, Fialkov said that it was the “need to get facial fractures and facial reconstruction to heal without loading them up with metal” that led to a search for alternative options. Fialkov and Cari Whyne, a senior scientist and professor of surgery at U of T, studied the structural integrity of the skull and facial skeleton to determine solutions for CMF.

In a major realization during their biomechanical research, Fialkov said that the pair found that “the forces that act on the facial skeleton are nowhere near as strong we originally thought and we don’t need to use so much hardware to fix it.”

Working with the idea of a flexible “tape-based” support system, research led by Paul Santerre, professor at the Institute of Biomaterials and Biomedical Engineering (IBBME) and University Health Network Baxter Chair in Health Technology & Commercialization, and Robert Pilliar, another IBBME professor, helped to identify the best materials to create BoneTape.

Applied to the fracture site once the fragments are properly realigned, a biocompatible adhesive attaches the tape to the bone. The material is translucent, allowing the fracture site to be seen and the tape to be properly aligned.

An advantage of the tape is its pliability. According to Michael Floros, a postdoctoral fellow working on the project, “using an initially flexible material is one of the major innovations.”

Unlike plates, which have to be moulded to closely match the shape of each bone fragment, the tape’s flexibility allows it to assume the natural shape of the patient’s CMF structure.

Made from a bioresorbable material, the BoneTape does not have to be removed from the patient once the fracture has healed either. Over an 18-month period, the material “resorbs in a process similar to dissolvable sutures,” Floros wrote to The Varsity.

The application of a flexible tape promises to be an easier technique for surgeons to master.

Miniplates must be bent to match a patient’s bone anatomy, and screws, often less than a couple millimetres in size, are very challenging to place. Misplacements can lead to an improper alignment of the bone that may cause discomfort and pain.

Use of BoneTape can also reduce tissue damage experienced by the bone during drilling for screw placement.

Fialkov said that once the bones are aligned, “it does not require a lot of skill to be able to just lay the bone tape across the fractured site.”  This means that procedures in the operating room will be more efficient and accessible to users.

Following preclinical trials, Whyne, Fialkov, Santerre, Pilliar, Floros, and Eli Sone — a bioadhesive specialist and a recent addition to the team — plan to bring BoneTape to the market for clinical use through Cohesys, a company that Floros founded to oversee the project as it develops.

The genetic basis of oxygen-deprived tumours

PhD candidate Vinayak Bhandari studies genetic drivers of cancer

The genetic basis of oxygen-deprived tumours

A recent study published in Nature Genetics sought to determine the effects of hypoxia — low levels of molecular oxygen — on the development of cancer, including how it may speed up cancer growth. Lead author Vinayak Bhandari, a PhD candidate in U of T’s Faculty of Medicine and the Ontario Institute for Cancer Research, examined hypoxia in over 8,000 tumors across 19 tumour types.

Hypoxia can have detrimental health effects, one of which is that it can cause cancer cells to proliferate. 

According to Bhandari, normally, blood vessels in our bodies are well-organized and able to transport nutrients, including oxygen, to all cells. This changes in tumours.

“In tumours, the blood vessels are often very disorganized and have sluggish blood flow,” wrote Bhandari in an email to The Varsity. This leads to low-oxygen tumours. “Around half of all solid tumours end up with low levels of oxygen.”

Hypoxic conditions can accelerate the spread of aggressive cancer cells. In tumours, cancer cells exist with different sets of mutations. Some cancer cells will be susceptible to hypoxic environments due to their specific mutation, and these cells often do not survive. 

“But other cells that have a specific mutation may not be affected by low oxygen,” wrote Bhandari. “So you end up enriching the tumour for cells with that aggressive mutation that can survive an extreme environment and you get a more aggressive cancer.”

Despite the threat that hypoxia poses, it has previously been a challenge to study its effects due to the invasive and difficult process of measuring oxygen levels in tumours. 

To remedy this, Bhandari and his team created an innovative method for examining tumour hypoxia in more detail. 

“We used several mRNA signatures to computationally quantify tumour oxygen levels with existing patient data. We then used this hypoxia information and looked broadly at lots of different genomic features of tumours and found some really interesting links in several cancers,” wrote Bhandari. “We then dug deeper into prostate cancer where we have really good long term data for how patients respond to treatments and we looked further into interactions between hypoxia, changes in the DNA and also how tumours change over time.”

Dr. Paul Boutros — former Associate Professor at U of T’s Department of Medical Biophysics, now at the University of California, Los Angeles, and the supervisor for this study — added that hypoxia and its relevance to cancer growth is still not well understood, but that this research is a significant step. 

“I think other researchers are going to be able to take advantage of these data to explore a lot of new angles,” wrote Boutros. 

Boutros believes that other researchers will begin to look at genomics associated with hypoxic cancer cells, and begin to look more into genomic data in a new light. Boutros also adds that this research highlights how hypoxic environments arise due to different factors aside from genetic mutations, including cell morphology and evolutionary properties. 

Bhandari emphasized the multidisciplinary nature of the team involved in the research, and how it was an asset. 

“We were only able to do this because we had biologists, chemists, data scientists, statisticians, engineers, pathologists and radiation oncologists come together to work on this problem in asymmetric fashion. Everyone contributed in important ways over many years and I think this is the best way forward for answering difficult questions.”

Bridging the technological divide in Canadian health care

Electronic Medical Records and patient care

Bridging the technological divide in Canadian health care

In Canada, a battle rages in health care. On one side stands a relatively stagnant health care system, already expensive but comparatively effective, with a legacy of poor technology integration. On the other side, investment in technology has the potential to not only reduce costs but also produce better patient care.  

Initially, further tech-focused investment would make health care even more expensive for the government. In Ontario alone, health care spending equates to 43.2 per cent of all provincial expenditures. Across Canada, health care amounts to about 11 per cent of gross domestic product (GDP), or $4,919 per year per person, as of this year. As a percentage of our GDP, we have the fourth most expensive social health care system of 28 comparatively wealthy countries, falling short of only Switzerland, France, and Norway. However, our above-average spending nets above-average results.

Compared to other wealthy nations, Canadians experience an above-average quality and quantity of health care. Canada consistently ranks highly on the majority indices that measure efficacy, despite having fewer physicians, long wait-times, and less equipment. Canada is ranked first at preventing and reversing debilitating illness, and also boasts above average cancer survivorship rates, above average healthy-age expectancies at 73.2 years, and above-average life expectancies at 81.9 years. These accomplishments have been achieved with our existing low-tech system. For example, we are without a consistent system and centralized database for recording personal medical information or automatically communicating medical files, at times even at the same hospital.

The adoption of Electronic Medical Records

To learn more about Canada’s relationship to health care technology, I investigated Canada’s partial adoption of Electronic Medical Records (EMRs). I spoke with Dr. Muhammad Mamdani, Director of the Li Ka Shing Centre for Healthcare Analytics Research and Training at St. Michael’s Hospital in Toronto; corresponded with Christina Christodoulakis, a PhD candidate in computer science at the University of Toronto; and interviewed Davey Hamada, a registered nurse in British Columbia.

According to Mamdani, “there seems to be a general consensus that the adoption of tech [into health care] is a good thing.” Christodoulakis’ U of T-based research reflects this: she found that in Canada, about seven per cent of tests are ordered because practitioners are unaware of already relevant results. A central database of EMRs that is used and updated consistently would solve this problem. The benefits of EMRs include improved speed of finding records, prevention of handwriting illegibility, aid in the early identification of diseases, assistance in targeting services based on risk, help with long-term monitoring of patients, and improved immunization consistency.

Hospitals and smaller family practices have been slowly and irregularly integrating EMRs for the past 30 years. Most of these earlier databases were designed by software engineers with little input from medical professionals. This meant that their software was not functional for practitioners — sometimes queries were too rigid or irrelevant information was readily displayed while critical information was hard to find. According to Christodoulakis, “some physicians reported that they sometimes stop using EMRs because hunting for menus and buttons disrupts the clinical encounter and hinders doctor-patient interaction.”

At present, software packages from different manufacturers seldom work together. Mamdani explained that “often patient records have to be printed out and delivered by mail.” This slows down the treatment process and further clogs the system. This lack of electronic communication also exists within institutions, where medical professionals print records for hand delivery. The poor integration of software and communication often opens the door for third-party organizations to perform patchwork to mend discontinuous records together, as is the case with Alberta Netcare and ConnectingOntario. But it is important to note that privatizing health care record management can carry serious consequences for patients and the health care system as a whole.

Though records are currently scattered among hard copies and various software, it is possible to unite the system. As Christodoulakis’ research notes, adopting or changing EMR systems requires “training, maintenance, IT support, system upgrade and data storage, governance and migration costs,” often too expensive a barrier for small and medium-sized institutions. Based on an estimate from 2010, the financial cost equates to $10 billion. But integration of an efficient database of medical records is just the tip of the iceberg.

Addressing the divide

According to Hamada, “health care providers have been in many ways slow to adapt to the technological boom.” He explained, “This is in part due to our education, which is lacking in any content regarding technological innovation and also the lack of foresight in the institutions that we work for.” Hamada’s workplace has not adopted EMRs, seldom uses software beyond email, and the state-of-the-art equipment he uses runs on an operating system that has not been supported since 2014.

For Hamada, adapting to changing tech is easy. But at his workplace, a recent change in the process of ordering porter services, or facility managers, continues to confuse many despite having support hotlines available throughout their upgrade. Mamdani and Christodoulakis both confirmed that some health care professionals are resistant to the technology making its debut in the health care system.

This is in part because people dislike change and re-learning concepts, but also due to a lack of transparency in data use. Hamada reports that at his workplace, data is collected but its use is a mystery. “In order for nurses to see data as a positive thing, there needs to be greater transparency and involvement around changes made based on evidence,” he said.

Mamdani, a renowned leader in health care, has emphasized facilitating communication between disciplines throughout his career. He integrates tech, economics, and data science into his team, and advocates for strong leaders to continue to bridge the technological gap. He believes that this systemic divide will continue to exist until teams learn to find a common language and talk to each other.

Mamdani’s team includes a few data scientists who work closely with health care professionals to build a data-friendly culture. Their research has been able to predict, with 80 per cent accuracy, the length of patient stays. Data science facilitates communication with the whole team and allows a more unified progression for the patient’s care. His team has also been able to predict trends in staffing, which saves approximately $200 million for St. Michael’s Hospital and could save up to $800 million for others.

Technological change, along with all of its benefits, comes with a very real cost. In Hamada’s workplace, the technology remains in the shadows because qualified health care professionals excel at what they are best at — taking care of people. The numbers show that Canadian health care is effective, even without consistent EMRs or databases that communicate. The cost of tech disturbs that status quo. But a centralized database would likely reduce redundancies in health care and improve efficiency. Advanced analytics has the strong potential to push our health care system to better look after us, especially as our population ages.

Improving outcomes and better integrating the health care system into the digital world is an important pursuit — but it must be checked with an emphasis on people and care over all else. In an ideal application, technology would and should improve our ability to take care of one another.

The Varsity has reached out to Campus Health Services, which declined the interview request, as well as the Gerstein Crisis Centre.