A Message from the Guest Editor

Health informatics as a health professional discipline and a scientific field has come of age in Canada, encompassing all aspects of digital health today. The profession of health informatics is a complex discipline that is evolving, contributing to and leading Canada’s 3.7 billon dollar digital health sector. Today, the term digital health has become synonymous with every aspect of citizen health that touches technology from electronic health records to mobile health applications. The systems and technologies that form digital health are designed, developed, implemented, maintained, and managed by health informatics professionals across Canada.

The number of health informatics professionals is large and it is growing. There are over 43,000 health informatics professionals who work in digital health. Health informatics has become the fourth largest health professional group by number. Academic educational programs have also grown in this field of study. There are 34 Canadian academic programs that teach health informatics competencies. Health informatics academic programs rank third in terms of number of programs—only nursing and medicine have more academic programs. As health leaders, you may already recognize some of the roles that health informatics professionals typically hold in government, regional health authorities as well as in vendor organizations and health technology start-ups across Canada. In this special edition of Healthcare Management Forum, we begin to explore several differing facets of health informatics research and management in Canada.

Given that health technologies are supporting all aspects of citizen health and wellness, whether it be in the hospital, home, or in the community, there is a need for more health informatics research that develops an evidence base for how we design, develop, implement, manage, and maintain our technologies so that we, as a society, can create innovations that provide the greatest benefit to health, wellness, and the quality and safety of our healthcare system. Health informatics faculty who teach our future health informatics professionals have undertaken some amazing research across our country. They have led in many areas.

We have several articles that span a wide cross-section of health informatics research that characterizes the discipline. The articles address key research questions and issues important for health leaders by experts in the field. The articles cover existing and emerging areas of health informatics research and are described below.

Human factors is an important area of research in health informatics. In this edition, Kushniruk and his co-author outline the need to address human factors issues as they may affect health technology adoption, safety, and patient outcomes. They describe a range of methods that can be used in information management and information technology departments in healthcare organizations or digital health technology companies to improve the usability of systems and technologies. This article also describes the ways in which human factors considerations can be integrated into the selection and procurement of health technologies in healthcare organizations.

My article examines health technology safety in the context of a learning health system. The safety of care processes and the safety of the technology are improved over time. Each time a new digital health innovation is integrated into the system of care, safety needs to be considered. Organizations need to employ tools and processes that enable the fulsome use of health technologies to improve their safety while, at the same time, learning from safety events pre- and post-implementation of technology to improve the overall safety of the healthcare system where the technology has been deployed.

Hudson took an implementation science perspective in his article on physician engagement strategies in the context of large-scale health information system implementations. The author provides an in-depth review of the literature on physician engagement, an essential aspect of technology implementation in healthcare settings. Strategies that were described include the following: engaging physicians to understand their needs, employing user-centred design principles, promoting physician leadership, and attention to physician-specific training approaches and needs.

Donelle and colleagues focus on personal technology use and policy. In this research, the authors examine personal digital technology use among two important groups of nurses, Registered Nurses and Registered Practical Nurses. The researchers found that 73% of the study participants used their own devices in the workplace. Nurses used their own devices to tell time, to support information needed associated with patient care, and to support communication with members of the healthcare team. The results of the research identify a need to develop guidelines and policy for using personal devices in health settings.

Bryce and colleagues examine the principles and practices of urgent care centres and conducted a rapid review in this area. The authors found that available services, healthcare services collaboration, expected impact, preferred location, staffing priorities, and community partnerships were key to supporting urgent care centres. Health technologies have an important role in supporting communications and service collaboration in urgent care centres.

The journal also addressed new and emerging areas of study such as virtual care, artificial intelligence, and specification of eHealth technologies. Virtual care has seen an exponential growth in its design, implementation, and use since the COVID-19 pandemic. Motulsky and co-authors study the implementation and integration of a direct-to-consumer on-line pharmacy consultation service into a universal phone service (811 Infosante) in Quebec. The findings of the research reveal that adoption of the service was low and identify a need for greater alignment between the needs of consumers and implemented digital services. In keeping with the research focus on virtual care, Adams and Leslie examine the current state of medical profession regulatory policy, practice standards, and guidelines in the area of virtual care.

Artificial intelligence in the context of healthcare has also emerged as an important area of research in health informatics. Gurevich and co-authors outline the benefits and challenges associated with artificial intelligence for health. The authors provide an in-depth review and discussion of the opportunities and challenges associated with the technology as it relates to health equity. More specifically, their research provides a guide to administrators and policy-makers in the ways in which inequities arising from AI can be mitigated.

Lastly, Abidi and Rickards look at the specifications and feasibility of chronic obstructive pulmonary disease self-management systems and how leaders should consider the needs of individuals affected by the disease and the health professionals who treat patients in their procurements of technology. Such research is important as it draws on the health informatics evidence base, integrating it with procurements.

Health informatics professionals represent a large, important, and growing group of individuals that design, develop, implement, maintain, and manage the technologies that support health and wellness as well as our systems of healthcare. Canada has led the way in innovating health informatics education and practice. Health informatics faculty-led research has been an important aspect of advancing the field and the discipline. Health informatics faculty have advanced the research and integrated their findings into education and practice. Recognizing the essential role of health informatics is essential. In 2023, all the evidence points to health informatics coming of age in Canada!