A Message from the Guest Editor

I am grateful to be the Guest Editor for this special edition on “smart healthcare” that addresses digital health at a system level. Among other themes, authors discuss capital investments to promote new service delivery, the extended use of analytics, and the need to develop and plan for workforce sustainability. As you read this eclectic compilation of articles, notice the different ways in which these initiatives have been implemented. These experts share their lessons learned and provide recommendations which offer plenty of food for thought.

The first article by Arnaout and co-authors discusses how the Canadian Partnership Against Cancer has integrated synoptic reporting and quality improvements to drive a national learning system in cancer surgery. The electronic synoptic reporting tools provide data that is crucial for information retrieval and sharing which, in turn, supports healthcare providers. The article describes how to maximize the use of synoptic reporting to drive cancer system improvements nationwide.

Arnaout and a different collection of co-authors write about the future of healthcare in British Columbia and how Artificial Intelligence (AI) will help to reduce duplication of efforts across that province. This article emphasizes the importance of sound clinical governance structures to ensure the effective deployment of AI tools.

The article by Silano outlines the transformative potential of AI for Indigenous communities and describes some of the complex ethical, political, and practical considerations associated with developing and introducing new technologies. The author describes the importance of equity and inclusion which are central to the Two-Eyed AI framework.

Atanackovic and co-authors stress the importance of learning when implementing new initiatives. She and her co-authors created a bilingual toolkit of psychological health and safety resources, designed to empower primary care teams to promote psychologically safe organizations. The article describes the toolkit development process and emphasizes the importance of interprofessional collaboration.

The article by Manns and co-authors examines a variety of provincial health system structures and notes the significant variations across Canada. Conclusions suggest that a single provincial model can reduce costs of non-clinical support functions like analytics. This model may improve electronic information integration enabling better reporting and more fluid provincial innovation.

Aftab and co-authors are concerned about the well-being of the hospital workforce. This article describes the collaborative approach used by the Toronto Academic Health Science Network to enhance existing occupational health and safety service delivery through collective excellence and community building across 14 academic healthcare organizations. One of the goals was to develop a technology strategy to enhance workflow through automation which helps to reduce the administrative burden of care.

Anderson’s article chronicles her technological journey over the last four decades, from the early days of minimal data processing to global networking. It touches on AI and robotics and suggests that technology evolution and implementation challenges are the same universally across industries.

Significant challenges are emerging surrounding privacy, confidentiality, and cybersecurity. Lo’s article highlights how these digital vulnerabilities can be addressed by proactively safeguarding data and mitigating security risks. Recommendations for health leaders include offering more staff training, assessing the data handling practices of vendors, and developing a data breach management plan.

Sheikh and co-authors want to reduce the burden of preventable deaths from sepsis in Canada and advocate for a national sepsis policy. One of the problems in diagnosing this condition is the lack of centralized information. Recommendations include learning from the efforts of other countries.

Barber’s article addresses equity, diversity, inclusivity, and accessibility in primary care and outlines the development of an integrated educational experience model. This includes a self-assessment tool, digital learning space, and a national mentorship network. The importance of interconnected working groups and advisory committees is obvious throughout, and the need for technology to keep these groups connected will endure.

Ladak and co-authors share their study about workforce planning which addresses the role of partner engagement and how it can be integrated into planning. Among other lessons, this study offers opportunities to better use data for planning and develop electronic resources that support integrated planning work.

The article by Lavoie and co-authors, although not on theme, emphasizes the importance of the supply chain in addressing healthcare-related greenhouse gas emissions. It provides an overview of the types of tools that are available to calculate carbon footprints and help companies rate their performance. This is important for health leaders because we are in a position to shift supplier practices.

Healthcare workers often lack access to healthy and sustainable food overnight and on weekends. Lalande and co-authors share their findings from a general surgery residency pilot in which staff had access to plant-forward, low-carbon foods. This article will help health leaders align their practices with planetary health principles.

In another article with a “green theme,” Barber and co-authors discuss climate change and how it poses a significant impact on health services as a result of vector-borne diseases, heat-related illnesses, and injury from severe weather. The work of these researchers provides an important starting point for understanding how to adapt health systems to improve low-carbon healthcare.

The final article on bioplastics by Yu and co-authors focuses on the regulatory landscape in Canada and offers insights gained from other sectors and countries. Recommendations include those around vetting environmentally sustainable bioplastic alternatives for single-use plastics, and drastically reducing the consumption of plastics, regardless of their feedstock.

I trust that you will enjoy this special edition and it will assist in your transformation journey as technologies and tools become further embedded in day-to-day activities. The journey and the future of smart healthcare will be transformative not only for healthcare but also for all spheres of our lives.