TRANSFORM HF’s 2023 Collaboration Starter Grant recipient Dr. Ibukun Abejirinde wants to transform our approach to remote patient monitoring. With her team of collaborators – Dr. Payal Agarwal, Jeanette Smith, Dr. Myrtede Alfred, Michele Strom, and Dr. Quynh Pham – Dr. Abejirinde’s research involves exploring novel models of care that are person-centred and equity promoting.
We sat down with Dr. Abejirinde to discuss her TRANSFORM HF-funded project, its impact so far, and what’s coming next from this collaboration.
How did you get involved in this work?
Joining Women’s College Hospital as a scientist, my portfolio within the Centre for Digital Health and Evalution involved leading evaluation of provincial programs – and one of the programs was remote patient monitoring (RPM). In that work, there were two things that really struck us.
First, there was a lot of anticipation and excitement about what RPM could do from an equity perspective – connecting people to continuous care and making them feel safe and supported at home.
Second, we observed that all the programs we evaluated were very clinically oriented – for instance, a COVID-19 pathway or a diabetes pathway. However, health care needs to be human and patient-centred – people are not clinical pathways.
We saw a need to develop a framework, which we called a typology, by which we could compare different remote monitoring programs irrespective of their clinical pathway to bring us closer to having trusted evidence base around what works and what doesn’t. Those are the two things that we decided to take forward in the Collaboration Starter Grant.
Can you describe your project and what you were hoping to achieve?
There were three things that we wanted to do. One, we wanted to build partnerships with institutions, organizations, and patient partners who are involved with remote monitoring solutions as users or researchers – and do so on a national level. The second was that we wanted to better understand the extent to which equity was being prioritized and actioned on in different types of remote monitoring programs – with a specific focus on those who were dealing with chronic illnesses – by analyzing the gaps and opportunities in programs that had already been reported in literature. The third objective was to determine a shared, disease agnostic – or person-centred – approach to defining remote monitoring programs that puts the individual at the centre of the technological innovation, as opposed to the disease at the centre.
Why is a patient-centred and equity-promoting approach so important for the design and implementation of remote monitoring solutions?
When you look at health service delivery and what is prioritized, I think we tend to focus on mainstream populations and take an economies of scale approach with planning programs and designing innovations, using the mindset of “if it’s not going to sell, then we don’t want to do it”. But the challenge from a health systems perspective is that the more people we leave behind, the more minorities become the majority because we have not solved their issues.
From an innovation, moral, and health system perspective, there needs to be a focus on equity – and that doesn’t just mean making opportunities available for everybody, but rather ensuring that those opportunities are accessible and responsive. There’s an opportunity for technology to augment and support; however, not a lot of thought has been given to how we ensure that these technologies and innovative models are meeting people that need them in ways that are responsive to their needs, such as providing different language options or translation services.
Can you speak a bit about the relationships you formed with individuals and organizations through this Collaboration Starter Grant?
The grant gave us the opportunity to broaden our reach and build partnerships with institutions within Ontario, such as Brightshores Health System, the Ontario Brain Institute, and Northern Ontario School of Medicine University. We were also able to glean insights from digital health experts and representatives from outside of the province, including Saskatchewan and Prince Edward Island, who helped inform our typology, identify blind spots, and validate the work that we were doing.
The most impactful relationship for me was with one of our patient partners, Jeanette Smith, who was a collaborator on our TRANSFORM HF project. Jeanette co-hosted feedback and facilitation sessions with other patients and caregivers who had experience using remote monitoring. It was heartwarming to have her on the team, and she has continued with us as a collaborator for a CIHR Grant that we applied for to create an equitable service model that builds on this work.
Jeanette Smith, patient partner and collaborator.
What does the next phase of your project look like?
Now that we have initiated these conversations, collected data, and synthesized our findings, we’re working on a couple of things. Firstly, we are continuing to disseminate our research. We’ve presented at some conferences and are now working on two publications. Secondly, we’re thinking about how we can build upon the relationships that we’ve established and continue this cross-learning exchange. The CIHR grant – which we’ve applied for again since we didn’t get it the first time – is an opportunity to keep these conversations going and situate the work in a real-world implementation of RPM.
What do you hope its impact will be on people living with heart failure?
I think it’s relevant for them to know that researchers acknowledge that patients should be at the centre of innovation. Anyone who wants to be able to live their lives fully supported by technology should be able to do so – it shouldn’t be a question of ‘Is the technology too expensive?’ or ‘Do I live too far away to be monitored?’. Those are key things that would be game changing for access to health care and equitable solutions.
TRANSFORM HF’s Collaboration Starter Grants encourage, foster, and support members of our community working collaboratively on research and project proposals that advance our mission and expand our network.
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