Digital health technologies and inequalities: A scoping review of potential impacts and policy recommendations.

Digital health technologies hold promises for reducing health care costs, enhancing access to care, and addressing labor shortages. However, they risk exacerbating inequalities by disproportionately benefitting a subset of the population. Use of digital technologies accelerated during the Covid-19 pandemic.

Improving the interoperability of drugs terminologies: Infusing local standardization with an international perspective.

Objectives: The objective of this study is to describe how OCRx (Canadian Drug Ontology) has been built to address the dual need for local drug information integration in Canada and alignment with international standards requirements.

Methods: This paper delves into (i) the implementation efforts to meet the Identification of Medicinal Product (IDMP) requirements in OCRx, alongside the ontology update strategy, (ii) the structure of the ontology itself, (iii) the alignment approach with several reference Knowledge Organization Systems, including SNOMED CT, RxNorm, and the list of "Code Identifiant de Spécialité" (CIS-Code), and (iv) the look-up services developed to facilitate its access and utilization.

Results: Each OCRx release contains two distinct versions: the full and the up-to-date version.

Cross-Sector Collaboration to Improve Access to Community Services for People Living With Diabetes: Contributions From Actor-Network Theory.

Diabetes is a global public health issue. The Public Health Agency of Canada published a Diabetes Framework 2022 which recommends collaborative work across sectors to mitigate the impact of diabetes on health and quality of life. Since 2020, the INMED-COMMUNITY pathway has been implemented in Laval, Québec developing collaboration between healthcare and community sectors through a participatory action research approach.

AI maturity in health care: An overview of 10 OECD countries.

Background: Artificial Intelligence (AI) and its applications in health care are on the agenda of policymakers around the world, but a major challenge remains, namely, to set policies that will ensure wide acceptance and capture the value of AI while mitigating associated risks.

Objective: This study aims to provide an overview of how OECD countries strategize about how to integrate AI into health care and to determine their actual level of AI maturity.

Methods: A scan of government-based AI strategies and initiatives adopted in 10 proactive OECD countries was conducted.

Trajectories of opioid consumption as predictors of patient-reported outcomes among individuals attending multidisciplinary pain treatment clinics.

Purpose: This study aimed to identify opioid consumption trajectories among persons living with chronic pain (CP) and put them in relation to patient-reported outcomes 6 months after initiating multidisciplinary pain treatment.

Methods: This study used data from the Quebec Pain Registry (2008-2014) linked to longitudinal Quebec health insurance databases. We included adults diagnosed with CP and covered by the Quebec public prescription drug insurance plan.

Building a Logic Model to Foster Engagement and Learning Using the Case of a Province-Wide Multispecies Antimicrobial Use Monitoring System.

Successfully designing and implementing a program is complex; it requires a reflexive balance between the available resources and the priorities of various stakeholders, both of which change over time. Logic models are theory-based evaluation approaches used to identify and address key challenges of a program. This article describes the process of building a logic model on advanced theories in complexity studies.

Evaluation of the implementation of single points of access for unattached patients in primary care and their effects: a study protocol.

Introduction: Attachment to a primary care provider is an important component of primary care as it facilitates access. In Québec, Canada, attachment to a family physician is a concern. To address unattached patients' barriers to accessing primary care, the Ministry of Health and Social Services mandated Québec's 18 administrative regions to implement single points of access for unattached patients ( (GAPs)) that aim to better orient patients towards the most appropriate services to meet their needs.

Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system.

Objectives: Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.

Evaluating the implementation of a referral system for virtual pharmacy counselling in a province-wide nurse phone line.

Digital technology offers several opportunities to improve access to professional expertise in primary care, and the offer of various "virtual" services has exploded in the past few years. The aim of this study was to evaluate the implementation of a direct-to-consumer on-line pharmacy consultation service (Ask Your Pharmacist - AYP) to a universal phone consultation service led by the universal public health system in Quebec (811 Info-Santé), through a direct bridge. Semi-structured interviews were conducted with clinician users of the service, and stakeholders involved in this pilot project funded by the Ministry of Economy (n = 22); documents were also analyzed, and content of the question was asked through the AYP service.

Nature and perceived benefits of patient-initiated consultations in community pharmacies: A population survey.

Background: The role of community pharmacists in enhancing patient care has received increased attention. However, there is a paucity of literature on the nature, frequency, and perceived impacts of patient-initiated consultations in community pharmacies.

Objectives: We aim to describe the profile of patients seeking advice from community pharmacists as well as the nature and impact of those consultations.

Assessing the Quality of Direct-to-Consumer Teleconsultation Services in Canada.

The objective of this study was to describe and assess the quality of the direct-to-consumer medical teleconsultation landscape in three Canadian provinces. An environmental scan of primary care teleconsultation platforms was conducted in January 2022 to identify medical teleconsultation platforms in Quebec (Qc), Ontario, and British Columbia (BC). The quality of each teleconsultation platform was assessed using a modified version of the HONcode principles.

Structuring and organizing interprofessional healthcare in partnership with patients with diabetes: the INterprofessional Management and Education in Diabetes care (INMED) pathway.

Type 2 diabetes is a complex chronic disease that requires ongoing monitoring by an interprofessional team to prevent complications. The INMED (INterprofessional Management and Education in Diabetes) care pathway was developed by our team to optimize primary care services for these patients and their families. The objective of this study is to describe the preliminary results of its adoption and implementation.

Association of Antidepressant Prescription Filling With Treatment Indication and Prior Prescription Filling Behaviors and Medication Experiences.

Background: Given the wide range of uses for antidepressants, understanding indication-specific patterns of prescription filling for antidepressants provide valuable insights into how patients use these medications in real-world settings.

Objective: The objective of this study was to determine the association of antidepressant prescription filling with treatment indication, as well as prior prescription filling behaviors and medication experiences.

Design: This retrospective cohort study took place in Quebec, Canada.

Telehealth in Primary Healthcare: A Portrait of its Rapid Implementation during the COVID-19 Pandemic.

Objective: This study documents the adoption of telehealth by various types of primary healthcare (PHC) providers working in teaching PHC clinics in Quebec during the COVID-19 pandemic. It also identifies the perceived advantages and disadvantages of telehealth.

Method: A cross-sectional study was conducted between May and August 2020.

OCRx: Canadian Drug Ontology.

This paper describes the development and evaluation of a Canadian drug ontology (OCRx), built to provide a normalized and standardized description of drugs that are authorized to be marketed in Canada. OCRx aims to improve the usability and interoperability of drugs terminologies for a non-ambiguous access to drugs information that is available in electronic health record systems. We present the first release of OCRx that is described in Web Ontology Language and aligned to the Identification of Medicinal Product (IDMP) standards.

Usage of Digital Tools to Access Primary Care in Quebec: An Environmental Scan.

Timely access to care is a persistent challenge for health care systems. Providing the right care to the right patient at the right time is important to reduce inappropriate use and improve the performance of healthcare services. The complexity of accessing primary care contributes to the high usage of emergency rooms for not-urgent conditions.

Implementation of a Computerized Provider Order Entry System in a Pediatric Hospital in Canada.

The Centre Hospitalier Universitaire Sainte-Justine (Montreal, Canada) is a pediatric academic tertiary hospital that has begun the implementation of a commercial computerized provider order entry system (CPOE) in October 2019. The objectives of this paper are 1) to estimate the impact of the CPOE system on medication errors, and 2) to identify vulnerability issues related to the configuration of the CPOE system's design. Using a pre-post implementation methodology measuring medication errors captured by clinical pharmacists revealed that the implementation of a CPOE has eliminated all prescription conformity (e.

Organizational readiness for artificial intelligence in health care: insights for decision-making and practice.

Purpose: Artificial intelligence (AI) raises many expectations regarding its ability to profoundly transform health care delivery. There is an abundant literature on the technical performance of AI applications in many clinical fields (e.g.

User-Centered Design for Promoting Patient Engagement in Chronic Diseases Management: The Development of CONCERTO.

Multimorbidity increases care needs among people with chronic diseases. In order to support communication between patients, their informal caregivers and their healthcare teams, we developed CONCERTO+, a patient portal for chronic disease management in primary care. A user-centered design comprising 3 iterations with patients and informal caregivers was performed.

Investigating the Barriers to Physician Adoption of an Artificial Intelligence- Based Decision Support System in Emergency Care: An Interpretative Qualitative Study.

The development of artificial intelligence (AI) systems to support diagnostic decision-making is rapidly expanding in health care. However, important challenges remain in executing algorithmic systems at the frontlines of clinical practice. Hence, most often, these systems have not been trained with local data nor do they fit with context-specific patterns of care.

Failure to follow medication changes made at hospital discharge is associated with adverse events in 30 days.

Objective: To evaluate the hypothesis that nonadherence to medication changes made at hospital discharge is associated with an increased risk of adverse events in the 30 days postdischarge.

Study Setting: Patients admitted to hospitals in Montreal, Quebec, between 2014 and 2016.

Study Design: Prospective cohort study.

Both New and Chronic Potentially Inappropriate Medications Continued at Hospital Discharge Are Associated With Increased Risk of Adverse Events.

Background: Admission to hospital provides the opportunity to review patient medications; however, the extent to which the safety of drug regimens changes after hospitalization is unclear.

Objective: To estimate the number of potentially inappropriate medications (PIMs) prescribed to patients at hospital discharge and their association with the risk of adverse events 30 days after discharge.

Design: Prospective cohort study.

Patient-initiated consultations in community pharmacies.

Background: Mobilizing pharmacists practicing in community pharmacies as a new player in primary care has recently emerged as a cost-effective strategy for clinical consultations related to minor ailments. However, little is known about these consultations initiated by patients. The objectives of this study were to describe patient initiated consultations in community pharmacies, and to estimate the impact of these consultations on care-seeking behaviors of patients.