Stay up to date about the most recent developments from Health Everywhere and the wider innovation community by accessing the latest news. News Filters Publication Year All Years 2023 2022 Theme 4 2024 Articles All Articles Theme 1 Theme 2 Theme 3 Theme 4 General Articles UCalgary-based program expands province-wide GENERAL SPARK program receives grant from Alberta Innovates, supporting post-secondary innovators across Alberta. September 11, 2023 3 UCalgary projects receive $20.3M in provincial innovation grants GENERAL UCalgary's innovation ecosystem just received a $20.3-million boost, thanks to Alberta's Major Innovation Fund. September 6, 2023 Theme 1 - Bridging Community and Acute Care Uniting researchers, decision-makers, and digital health innovators to ensure seamless, inclusive, and scalable healthcare implementation in acute and community-based care settings. Advancing eHealth innovation to enable intelligent patient monitoring THEME 1 Partnerships with Xsensor and Baxter to evaluate the impact of eHealth tools on patient outcomes and detect early... January 2024 Health innovation for infection prevention and control THEME 1 This bundle of projects focuses on industry partnerships and the application of eHealth tools to... Date TBD Theme 2 - Remote Monitoring and Virtual Care By leveraging academic research, industry collaboration, and community engagement, Health Everywhere creates a foundation for scaling virtual and mobile health innovations for virtual care. Enhancing recovery after surgery THEME 2 An international program with Alberta leadership that aims to use rehabilitation both prior and following... January 2024 Improving specialist access programs THEME 2 Leveraging new technologies and workflows to provide rural and remote patients access to specialized... Date TBD Theme 3 - Connectivity and Data Access We face significant challenges with the lack of health data integration, leading to interoperability issues among patients and care providers. This theme seeks to establish secure and seamless data access and interoperability for improved healthcare. Building the basic infrastructure to allow data to flow securely THEME 3 Evaluate distributed data vending (DDV) with blockchain to transform electronic health records (EHRs) by encouraging... Date TBD Developing a pipeline for exceptional analytics and research THEME 3 Develop a synthetic data sandbox that drives innovation by allowing innovators to develop products using synthetic... Date TBD Theme 4 - Integrated Innovation Ecosystem Support By addressing gaps and opportunities in the current ecosystem, our aim is to create a dynamic eHealth and mHealth ecosystem, by identifying resources, matching them with innovators, and improving overall integration. Evaluating the current eHealth and mHealth ecosystem THEME 4 A series of projects to better understand the factors, processes, and tools needed to support a vibrant ecosystem. This... Date TBD Bespoke ecosystem support services THEME 4 While innovators experience challenges navigating the support available to them, there are also unique services... Date TBD

Data Access and Connectivity Healthcare Data Sharing and Management: Implementation of Distributive Machine Learning Technology and Blockchain Technology What If Your Health Data Worked For You? Lead Steve Drew Share this project LinkedIn X (Twitter) Copy link Share this project LinkedIn X (Twitter) Copy link Data Access and Connectivity Healthcare Data Sharing and Management: Implementation of Distributive Machine Learning Technology and Blockchain Technology What If Your Health Data Worked For You? Lead Steve Drew Share this project LinkedIn X (Twitter) Copy link Share this project LinkedIn X (Twitter) Copy link THE CHALLENGE Patients currently have limited control over their own health data, relying on Alberta Health Services to manage and protect it. Centralized storage of sensitive information heightens the risk of breaches and cyberattacks, while siloed systems restrict access and hinder collaborative research that could advance population health. Many patients are also concerned about how their data is used or shared without explicit consent, reinforcing the need for more secure, transparent, and patient-centered data management solutions. THE CHALLENGE Patients currently have limited control over their own health data, relying on Alberta Health Services to manage and protect it. Centralized storage of sensitive information heightens the risk of breaches and cyberattacks, while siloed systems restrict access and hinder collaborative research that could advance population health. Many patients are also concerned about how their data is used or shared without explicit consent, reinforcing the need for more secure, transparent, and patient-centered data management solutions. THE CHALLENGE Patients currently have limited control over their own health data, relying on Alberta Health Services to manage and protect it. Centralized storage of sensitive information heightens the risk of breaches and cyberattacks, while siloed systems restrict access and hinder collaborative research that could advance population health. Many patients are also concerned about how their data is used or shared without explicit consent, reinforcing the need for more secure, transparent, and patient-centered data management solutions. THE INNOVATION This concept explores alternate ways to store healthcare data, aimed at improving both data security and accessibility for collaborative research while addressing patient privacy and control over their information. THE INNOVATION This concept explores alternate ways to store healthcare data, aimed at improving both data security and accessibility for collaborative research while addressing patient privacy and control over their information. HOW IT WORKS This concept is in an exploratory phase, investigating ways to decentralize health data storage and improve secure access. It explores methods for sharing data that prioritize patient privacy and consent, giving patients greater control while enabling safer, more collaborative use of health information. HOW IT WORKS This concept is in an exploratory phase, investigating ways to decentralize health data storage and improve secure access. It explores methods for sharing data that prioritize patient privacy and consent, giving patients greater control while enabling safer, more collaborative use of health information. THE BENEFITS For Users For Patients: Increased control and autonomy over personal health data, fostering trust in healthcare practices. For Researchers: Improved access to healthcare data, enabling collaborative research and new insights into population health trends. For The System Enhanced Security: Decentralized data storage may reduce risks associated with centralized systems and lower vulnerability to cyber threats. Collaboration and Insights: Accessible, ethically-managed health data supports cross-institutional collaboration, leading to broader insights and advancements in healthcare. Increased Trust: Addressing patient privacy concerns and data transparency could help rebuild trust in healthcare data management practices. THE BENEFITS For Users For Patients: Increased control and autonomy over personal health data, fostering trust in healthcare practices. For Researchers: Improved access to healthcare data, enabling collaborative research and new insights into population health trends. For The System Enhanced Security: Decentralized data storage may reduce risks associated with centralized systems and lower vulnerability to cyber threats. Collaboration and Insights: Accessible, ethically-managed health data supports cross-institutional collaboration, leading to broader insights and advancements in healthcare. Increased Trust: Addressing patient privacy concerns and data transparency could help rebuild trust in healthcare data management practices. Explore Further If you’d like to learn more or connect about Healthcare Data Sharing and Management , reach out to Steve Drew, Project Lead , at: steve.drew@ucalgary.ca Get Involved Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent sit amet metus sed lorem tincidunt pretium. Learn More View other projects and explore the Health Everywhere Portfolio to see how local innovations are transforming care across the province. View Portfolio Explore the Health Everywhere Portfolio to see how local innovations are solving real-world challenges and shaping the future of care across the province. ABOUT The Health Everywhere Hub portfolio map showcases academic-led projects tackling real healthcare challenges across Alberta. By highlighting shared goals and commonalities, we hope to spark collaboration and amplify impact across the system. It’s more than a list of projects - this evolving collection shows what’s possible when partnerships, bold ideas, and real-world testing come together.

Bridging Community and Acute Care MyHeartandCKD What if Chronic Kidney Disease Patients had a Decision Tool that Made Risks and Benefits Clear? Lead Matthew James Co-Lead Stephen Wilton Additional Contributors Todd Wilson, Pantea Javaheri, Julie Babione Share this project LinkedIn X (Twitter) Copy link Share this project LinkedIn X (Twitter) Copy link Bridging Community and Acute Care MyHeartandCKD What if Chronic Kidney Disease Patients had a Decision Tool that Made Risks and Benefits Clear? Lead Matthew James Co-Lead Stephen Wilton Additional Contributors Todd Wilson, Pantea Javaheri, Julie Babione Share this project LinkedIn X (Twitter) Copy link Share this project LinkedIn X (Twitter) Copy link THE CHALLENGE Patients with chronic kidney disease (CKD) face complex challenges when undergoing heart disease tests and treatments, which carry unique risks for this population. Many CKD patients lack the information needed to make informed, personalized choices about these procedures, potentially resulting in hospitalizations, reduced quality of life, and decreased survival. Effective communication of individualized risks and benefits is crucial to support decision-making based on each patient’s values and needs. THE CHALLENGE Patients with chronic kidney disease (CKD) face complex challenges when undergoing heart disease tests and treatments, which carry unique risks for this population. Many CKD patients lack the information needed to make informed, personalized choices about these procedures, potentially resulting in hospitalizations, reduced quality of life, and decreased survival. Effective communication of individualized risks and benefits is crucial to support decision-making based on each patient’s values and needs. THE CHALLENGE Patients with chronic kidney disease (CKD) face complex challenges when undergoing heart disease tests and treatments, which carry unique risks for this population. Many CKD patients lack the information needed to make informed, personalized choices about these procedures, potentially resulting in hospitalizations, reduced quality of life, and decreased survival. Effective communication of individualized risks and benefits is crucial to support decision-making based on each patient’s values and needs. THE INNOVATION This tool is a shared decision-making (SDM) aid designed specifically for patients with CKD who are facing choices about heart disease tests and treatments. It delivers personalized information on the potential benefits and risks of each option, helping patients and healthcare providers engage in informed, collaborative conversations that prioritize patient values, preferences, and overall health goals, so decisions are both evidence-based and aligned with what matters most to the patient. THE INNOVATION This tool is a shared decision-making (SDM) aid designed specifically for patients with CKD who are facing choices about heart disease tests and treatments. It delivers personalized information on the potential benefits and risks of each option, helping patients and healthcare providers engage in informed, collaborative conversations that prioritize patient values, preferences, and overall health goals, so decisions are both evidence-based and aligned with what matters most to the patient. HOW IT WORKS The decision aid helps patients compare two treatment options, showing likely outcomes with simple visuals and explanations. Patients rank what matters most to them, so decisions reflect their values and support meaningful shared decision-making with their healthcare providers. HOW IT WORKS The decision aid helps patients compare two treatment options, showing likely outcomes with simple visuals and explanations. Patients rank what matters most to them, so decisions reflect their values and support meaningful shared decision-making with their healthcare providers. THE BENEFITS For Users Enhanced Understanding: The tool helps CKD patients comprehend complex risk-benefit information tailored to their health profile. Increased Confidence: Patients gain confidence in their treatment choices, thanks to clear visuals and data that support understanding and alignment with personal values. Improved Patient-Provider Communication: Facilitates open dialogue, fostering trust and shared goals in the decision-making process. For The System Reduced Hospitalizations and Costs: By avoiding unnecessary procedures, the tool supports better health outcomes and reduces healthcare costs. Enhanced Clinical Practice: Embedding the tool in clinical workflows promotes consistent, patient-centered care and shared decision-making across healthcare settings. Improved Health Outcomes: By aligning treatments with patient priorities, the tool contributes to improved quality of life and potentially extended survival for CKD patients. THE BENEFITS For Users Enhanced Understanding: The tool helps CKD patients comprehend complex risk-benefit information tailored to their health profile. Increased Confidence: Patients gain confidence in their treatment choices, thanks to clear visuals and data that support understanding and alignment with personal values. Improved Patient-Provider Communication: Facilitates open dialogue, fostering trust and shared goals in the decision-making process. For The System Reduced Hospitalizations and Costs: By avoiding unnecessary procedures, the tool supports better health outcomes and reduces healthcare costs. Enhanced Clinical Practice: Embedding the tool in clinical workflows promotes consistent, patient-centered care and shared decision-making across healthcare settings. Improved Health Outcomes: By aligning treatments with patient priorities, the tool contributes to improved quality of life and potentially extended survival for CKD patients. Explore Further If you’d like to learn more about MyHeartandCKD , explore their tools, or get involved, visit: cansolveckd.ca Get Involved Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent sit amet metus sed lorem tincidunt pretium. Learn More View other projects and explore the Health Everywhere Portfolio to see how local innovations are transforming care across the province. View Portfolio Explore the Health Everywhere Portfolio to see how local innovations are solving real-world challenges and shaping the future of care across the province. ABOUT The Health Everywhere Hub portfolio map showcases academic-led projects tackling real healthcare challenges across Alberta. By highlighting shared goals and commonalities, we hope to spark collaboration and amplify impact across the system. It’s more than a list of projects - this evolving collection shows what’s possible when partnerships, bold ideas, and real-world testing come together.

News Health Everywhere Launch Event Date We envision a vibrant eHealth and mHealth ecosystem, accelerating innovation, growth, and transforming healthcare through collaboration and partnerships. March 6, 2024 | Alex Baron On January 23, 2024, over 100 guests joined us as we held the Dr. Mamoru ‘Mo’ Watanabe Lectureship on Digital Health Today and Tomorrow. Hosted by the W21C Research and Innovation Centre, this event formally introduced and showcased "Health Everywhere", a new eHealth and mHealth hub created from a $6.3M Major Innovation Fund award from the Government of Alberta. This lectureship series honours the contributions of Dr. Mamoru ‘Mo’ Watanabe. Joining the University of Calgary’s Faculty of Medicine (now named Cumming School of Medicine) to serve as professor and head of internal medicine in 1974, Dr. Watanabe served as dean of the Faculty of Medicine from July 1982 until June 1992, and is believed to be the first Japanese Canadian dean of a Canadian medical school. He passed away July 5, 2023, at the age of 90. Opening remarks were provided by Dr. Mary Brindle, W21C Academic Director, and Dr. William Ghali, Vice-President (Research) at the University of Calgary. Dr. Ghali shared with the audience his memories of working with Dr. Watanabe and his legacy in digital health. The event was then led in a keynote address by Dr. James A. Makokis, speaking on the negative role colonialism continues to play in healthcare for Indigenous Canadians. This was followed by a lecture from Dr. Christy Cauley on the integration of mobile health to optimize recovery in patients. After a quick intermission the audience was introduced to Health Everywhere by five of its lead researchers. This included presentations from Dr. Chad Saunders, Dr. Martin Ferguson-Pell, Dr. Mary Brindle, Dr. Matt James, and Dr. Tyler Williamson. These presentations were followed by a Q&A with all the leads participating at once. Overall, the three-hour event proved to be a wonderful opportunity for the Health Everywhere team to introduce this initiative to the public while also making great connections between industry and academic leaders. Image Source: Brittany DeAngelis, O’Brien Institute for Public Health Project Contact- Alex Baron

Theme 2: Remote Monitoring and Virtual Care Robin's Nest as a White Label Platform — Lead: Linda Duffett-Leger . INNOVATION STAGE Proof of Concept Health Innovation Focus Acute Illness; Chronic Disease;Mental Health & Addiction Population and Setting — Technology and Intervention Data Modelling, Platform and Dashboard Visualization; Wearable Technology, Imaging & Biosensors BENEFITS For Users Foster stronger therapeutic relationships through secure video-based interactions. Personalize care and interventions with real-time wearable data and AI-driven insights. Simplify remote monitoring and virtual consultations for improved workflow efficiency. Increase participant engagement and retention in clinical trials with a user-friendly platform. Streamline data collection and analysis in a single, integrated system for better decision-making. For The System Data Consistency: Centralized platform reduces errors and manual data reconciliation, improving trial fidelity and reporting accuracy. Seamless Integration: Interfaces with existing EHR systems (e.g., Epic) for real-time data sharing and better care coordination. Efficiency Gains: Automates routine tasks like scheduling, billing, and consent management, reducing administrative burden. Improved Patient Outcomes: Combines real-time monitoring with education and peer support, fostering long-term engagement and health behavior changes. Project Theme Information Current State Healthcare systems are under growing strain from limited resources and rising patient demand, especially in post-acute and chronic care settings. While remote patient monitoring has the potential to ease these pressures, current solutions often lack scalability, seamless integration of wearable device data, and user-friendly designs. This limits their adoption and effectiveness in real-time health monitoring. Clinical trial managers and clinicians face significant hurdles with fragmented tools for telehealth, wearables, and data analytics, leading to inconsistent data collection and low participant engagement. These challenges create inefficiencies, increasing administrative burdens, and contributing to higher dropout rates, missed interventions, and compromised trial outcomes. Other Known Use Cases Partnerships with Xsensor and Baxter are undergoing to evaluate the impact of eHealth tools on patient outcomes. The specific focus will be on two products: 1) Xsensor’s ForeSite® Intelligent Surface, an artificial intelligence-powered continuous skin monitoring... What is the Innovation Robin’s Nest is a comprehensive, all-in-one telehealth platform that integrates secure video communication, wearable technology for real-time physiological monitoring, AI-driven predictive analytics, and a robust learning management system (LMS). Designed to support remote patient monitoring, clinical trial management, and chronic care, Robin’s Nest provides a unified solution that streamlines workflows, enhances participant engagement, and improves data consistency. By combining advanced features into a single platform, it enables healthcare providers to deliver evidence-based programs and maintain strong therapeutic relationships, while offering actionable insights for better decision-making. How it Works Robin’s Nest integrates multiple advanced features into a single platform to streamline remote patient monitoring and clinical trial management. Wearable technology collects real-time physiological data, such as heart rate and sleep patterns, which is securely transmitted to healthcare providers or trial managers. AI-driven analytics assess stress levels and provide predictive insights, enabling clinicians to take timely, data-informed actions. The platform supports individual and group video-based telehealth sessions, facilitating virtual consultations, follow-ups, and peer support. Its robust learning management system (LMS) offers patients access to educational content and self-guided learning modules, while real-time monitoring and alerts notify clinicians of critical changes. All data is aggregated into a centralized health dashboard, combining biometric data, self-reports, and engagement metrics to deliver actionable insights for improving care and trial outcomes. Other Known Cases: SENSE Program for delivery of frontline staff mental health Get Involved Explore Partnerships Email Linda Duffet-Leger to explore partnership opportunities Get in touch linda.duffetleger@ucalgary.ca . View other projects and explore the Health Everywhere Portfolio to see how local innovations are transforming care across the province. Explore the Health Everywhere Portfolio to see how local innovations are solving real-world challenges and shaping the future of care across the province. View The Portfolio ABOUT The Health Everywhere Hub portfolio map showcases academic-led projects tackling real healthcare challenges across Alberta. By highlighting shared goals and commonalities, we hope to spark collaboration and amplify impact across the system. It’s more than a list of projects - this evolving collection shows what’s possible when partnerships, bold ideas, and real-world testing come together. Previous Item Next Item

3 UCalgary projects receive $20.3M in provincial innovation grants 3 UCalgary projects receive $20.3M in provincial innovation grants Sep 6, 2023 UCalgary’s innovation ecosystem just received a $20.3-million boost, thanks to Alberta’s Major Innovation Fund (MIF) UCalgary’s innovation ecosystem just received a $20.3-million boost, thanks to Alberta’s Major Innovation Fund (MIF). On Sept. 5, Nate Glubish, minister of technology and innovation, announced that three UCalgary projects have received four years of funding to lead province-wide strategic initiatives to accelerate research and commercialization in the areas of medical devices, electronic and mobile health, and space and defence technologies. “Provincial support for high-tech research and innovation will help our post-secondary scholars move from groundbreaking technological ideas to entrepreneurial realities, fuelling a more diverse economy and making a positive impact in the wider community,” says Dr. Ed McCauley, president and vice-chancellor of the University of Calgary. Major Innovation Fund projects are highly collaborative, requiring the engagement of scholars from institutions across Alberta, industry partners, and the communities that the projects intend to serve. It is an outcomes-focused program, funding projects that will attract and retain top talent, diversify Alberta’s economy, support industries and local businesses, and leverage additional investments. “UCalgary’s innovation ecosystem is growing thanks to the drive of our research community and investments like the Major Innovation Fund,” says Dr. William Ghali, vice-president (research). “These three projects will streamline the research-to-commercialization pipeline for their sector and create opportunities for both innovative research and widespread of adoption of novel, made-in-Alberta solutions.” UCalgary’s projects are the Alberta Medical Device Innovation Consortium, Health Everywhere, and Space and Defence Technologies Alberta. Previous Next

Bridging Community and Acute Care IMPROVE CV Care What if Heart Care Went Beyond Symptoms to Include Stress, Support, and Daily Life? Lead Matthew James Co-Lead Stephen Wilton Additional Contributors Maria Dalton, Mitchell Pearson, Denise Kruger, Dr. Michelle Graham, Dr. Bryan Har, Dr. Tolulope Sajobi Share this project LinkedIn X (Twitter) Copy link Share this project LinkedIn X (Twitter) Copy link Bridging Community and Acute Care IMPROVE CV Care What if Heart Care Went Beyond Symptoms to Include Stress, Support, and Daily Life? Lead Matthew James Co-Lead Stephen Wilton Additional Contributors Maria Dalton, Mitchell Pearson, Denise Kruger, Dr. Michelle Graham, Dr. Bryan Har, Dr. Tolulope Sajobi Share this project LinkedIn X (Twitter) Copy link Share this project LinkedIn X (Twitter) Copy link THE CHALLENGE Patients and physicians often have limited time during appointments to explore non-physiological factors that strongly influence cardiovascular health, including mental health, social support, and medication affordability. Without space to address these drivers, conversations frequently focus only on urgent clinical symptoms, leaving important contributors to long-term cardiovascular outcomes unaddressed. THE CHALLENGE Patients and physicians often have limited time during appointments to explore non-physiological factors that strongly influence cardiovascular health, including mental health, social support, and medication affordability. Without space to address these drivers, conversations frequently focus only on urgent clinical symptoms, leaving important contributors to long-term cardiovascular outcomes unaddressed. THE CHALLENGE Patients and physicians often have limited time during appointments to explore non-physiological factors that strongly influence cardiovascular health, including mental health, social support, and medication affordability. Without space to address these drivers, conversations frequently focus only on urgent clinical symptoms, leaving important contributors to long-term cardiovascular outcomes unaddressed. THE INNOVATION The intervention is a streamlined survey and reporting tool designed to improve communication between cardiovascular patients and physicians. It collects and summarizes relevant health factors, promoting personalized, patient-centered care that considers a fuller picture of the patient’s well-being. THE INNOVATION The intervention is a streamlined survey and reporting tool designed to improve communication between cardiovascular patients and physicians. It collects and summarizes relevant health factors, promoting personalized, patient-centered care that considers a fuller picture of the patient’s well-being. HOW IT WORKS Before appointments, patients complete a brief survey capturing mental health, social support, and self-care using validated tools. The results generate a report that flags key changes and provides insights for clinicians, helping them quickly understand the patient’s overall health and support needs beyond immediate symptoms. HOW IT WORKS Before appointments, patients complete a brief survey capturing mental health, social support, and self-care using validated tools. The results generate a report that flags key changes and provides insights for clinicians, helping them quickly understand the patient’s overall health and support needs beyond immediate symptoms. THE BENEFITS For Users For Patients: This tool encourages open dialogue about mental health and other non-physiological factors without stigma, helping patients feel heard and understood. For Physicians: It optimizes appointment time by collecting data in advance, allowing appointments to focus on actionable insights and personalized care. For The System Enhanced Personalization of Care: Physicians can address red flags more effectively, improving patient outcomes by targeting what matters most to each patient. Increased Efficiency: The tool reduces the need for lengthy discussions on background factors, streamlining clinical timelines and enabling more focused, impactful care. THE BENEFITS For Users For Patients: This tool encourages open dialogue about mental health and other non-physiological factors without stigma, helping patients feel heard and understood. For Physicians: It optimizes appointment time by collecting data in advance, allowing appointments to focus on actionable insights and personalized care. For The System Enhanced Personalization of Care: Physicians can address red flags more effectively, improving patient outcomes by targeting what matters most to each patient. Increased Efficiency: The tool reduces the need for lengthy discussions on background factors, streamlining clinical timelines and enabling more focused, impactful care. Explore Further If you’d like to learn more about IMPROVE CV Care or connect with the project team, visit: Improve CV UCalgary Page Get Involved Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent sit amet metus sed lorem tincidunt pretium. Learn More View other projects and explore the Health Everywhere Portfolio to see how local innovations are transforming care across the province. View Portfolio Explore the Health Everywhere Portfolio to see how local innovations are solving real-world challenges and shaping the future of care across the province. ABOUT The Health Everywhere Hub portfolio map showcases academic-led projects tackling real healthcare challenges across Alberta. By highlighting shared goals and commonalities, we hope to spark collaboration and amplify impact across the system. It’s more than a list of projects - this evolving collection shows what’s possible when partnerships, bold ideas, and real-world testing come together.

Bridging Community and Acute Care Integrated Care Pathway (ICP) Evaluation Redesigning Pathways for More Centralized, Holistic Care Lead Michelle Grinman Co-Lead Karen Okrainec Additional Contributors Sunita Chacko, Ceara Cunningham Share this project LinkedIn X (Twitter) Copy link Share this project LinkedIn X (Twitter) Copy link Bridging Community and Acute Care Integrated Care Pathway (ICP) Evaluation Redesigning Pathways for More Centralized, Holistic Care Lead Michelle Grinman Co-Lead Karen Okrainec Additional Contributors Sunita Chacko, Ceara Cunningham Share this project LinkedIn X (Twitter) Copy link Share this project LinkedIn X (Twitter) Copy link THE CHALLENGE In Canada, adults with multiple chronic conditions rely heavily on hospital care, with admissions and readmissions accounting for nearly 30% of healthcare spending. These patients often face fragmented care, limited coordination among providers, and inadequate post-discharge support. As they move between specialists and care settings without consistent follow-up, they are at higher risk of repeated admissions, preventable complications, and poorer health outcomes. THE CHALLENGE In Canada, adults with multiple chronic conditions rely heavily on hospital care, with admissions and readmissions accounting for nearly 30% of healthcare spending. These patients often face fragmented care, limited coordination among providers, and inadequate post-discharge support. As they move between specialists and care settings without consistent follow-up, they are at higher risk of repeated admissions, preventable complications, and poorer health outcomes. THE CHALLENGE In Canada, adults with multiple chronic conditions rely heavily on hospital care, with admissions and readmissions accounting for nearly 30% of healthcare spending. These patients often face fragmented care, limited coordination among providers, and inadequate post-discharge support. As they move between specialists and care settings without consistent follow-up, they are at higher risk of repeated admissions, preventable complications, and poorer health outcomes. THE INNOVATION The Integrated Care Pathway (ICP) is a structured, team-based model designed to improve discharge planning, continuity of care, and post-discharge support for high-risk, medically complex patients in the Calgary Zone. Each patient is connected to an Integrated Care Lead (ICL) who coordinates complex discharge planning, streamlines communication between hospital and home, and links patients to community and primary-care supports. The ICL follows patients for up to 90 days after discharge, with frequent check-ins during the critical first 1–2 weeks when the risk of ED visits or readmission is highest. Patients also have access to a 24/7 phone line—delivered in partnership with HealthLink—for urgent guidance and clinical navigation. THE INNOVATION The Integrated Care Pathway (ICP) is a structured, team-based model designed to improve discharge planning, continuity of care, and post-discharge support for high-risk, medically complex patients in the Calgary Zone. Each patient is connected to an Integrated Care Lead (ICL) who coordinates complex discharge planning, streamlines communication between hospital and home, and links patients to community and primary-care supports. The ICL follows patients for up to 90 days after discharge, with frequent check-ins during the critical first 1–2 weeks when the risk of ED visits or readmission is highest. Patients also have access to a 24/7 phone line—delivered in partnership with HealthLink—for urgent guidance and clinical navigation. HOW IT WORKS The ICP assigns a dedicated Integrated Care Lead who supports patients from hospital admission through 90 days post-discharge. The model includes coordinated discharge planning, personalized care plans in the EMR, proactive phone follow-ups, a 24/7 support line via 811HealthLink, and connections to primary care, home care, and community services to ensure seamless transitions. HOW IT WORKS The ICP assigns a dedicated Integrated Care Lead who supports patients from hospital admission through 90 days post-discharge. The model includes coordinated discharge planning, personalized care plans in the EMR, proactive phone follow-ups, a 24/7 support line via 811HealthLink, and connections to primary care, home care, and community services to ensure seamless transitions. THE BENEFITS For Users Enhanced Support and Follow-Up: Patients receive ongoing guidance after discharge, improving their ability to manage chronic conditions at home. Improved Continuity of Care: Tailored follow-up and coordinated care plans reduce care fragmentation and prevent gaps that lead to readmissions. Greater Patient Autonomy: Patients are empowered with consistent, accessible support, strengthening their confidence and capacity to self-manage their health. For The System Reduced Hospitalization and Readmissions: Proactive discharge planning and post-discharge monitoring lower the likelihood of ED visits and preventable readmissions, easing pressure on acute care. Improved Resource Efficiency: Coordinated care and streamlined case management reduce strain on hospital teams and support more efficient care delivery. Long-Term Cost Savings: By preventing complications and avoidable hospital use, ICP supports sustainable healthcare utilization, better long-term outcomes, and health system costs THE BENEFITS For Users Enhanced Support and Follow-Up: Patients receive ongoing guidance after discharge, improving their ability to manage chronic conditions at home. Improved Continuity of Care: Tailored follow-up and coordinated care plans reduce care fragmentation and prevent gaps that lead to readmissions. Greater Patient Autonomy: Patients are empowered with consistent, accessible support, strengthening their confidence and capacity to self-manage their health. For The System Reduced Hospitalization and Readmissions: Proactive discharge planning and post-discharge monitoring lower the likelihood of ED visits and preventable readmissions, easing pressure on acute care. Improved Resource Efficiency: Coordinated care and streamlined case management reduce strain on hospital teams and support more efficient care delivery. Long-Term Cost Savings: By preventing complications and avoidable hospital use, ICP supports sustainable healthcare utilization, better long-term outcomes, and health system costs Explore Further If you’d like to learn more or connect about Integrated Care Pathway (ICP) Evaluation , reach out to Michelle Grinman, Project Lead , at: michelle.grinman@ucalgary.ca Get Involved Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent sit amet metus sed lorem tincidunt pretium. Learn More View other projects and explore the Health Everywhere Portfolio to see how local innovations are transforming care across the province. View Portfolio Explore the Health Everywhere Portfolio to see how local innovations are solving real-world challenges and shaping the future of care across the province. ABOUT The Health Everywhere Hub portfolio map showcases academic-led projects tackling real healthcare challenges across Alberta. By highlighting shared goals and commonalities, we hope to spark collaboration and amplify impact across the system. It’s more than a list of projects - this evolving collection shows what’s possible when partnerships, bold ideas, and real-world testing come together.

Theme 2: Remote Monitoring and Virtual Care Enhancing Recovery After Surgery Date We envision a vibrant eHealth and mHealth ecosystem, accelerating innovation, growth, and transforming healthcare through collaboration and partnerships. January 9, 2024 | Alex Baron As we age it can take longer for our bodies to heal from trauma. As many as 40% of patients that undergo surgery will have major complications that lead to long-term health problems, such as heart disease or stroke. This is especially true for adults over the age of 65 following a major surgery, with many experiencing difficulties in returning to their pre-operation levels of function. Led by Dr. Duminda Wijeysundera, MD, at the University of Toronto, the Functional Improvement Trajectories After Surgery (FIT After Surgery) study aims to gain a better understanding of how often and why some patients experience significant disability after surgery. As one of 14 study sites across Canada, W21C is currently working with the Calgary site lead, Dr. Melinda Davis, MD, director of Master Teaching Program, clinical associate professor, Cumming School of Medicine, on recruitment efforts at the Foothills Medical Centre, actively engaging with patients prior to their surgery. Patient recruitment for the Calgary site began in July 2021 and is ongoing. Researchers are excited about the possibilities this work could reveal, especially as Canada’s population continues to age and the likelihood of more seniors needing major surgery every year is increasing. Having a better understanding of when and why patients experience disability after surgery will enable patients to make better-informed decisions about having surgery and allow physicians to identify patients that may need additional support following surgery. Overall recruitment and follow up for the study is expected to finish in 2023, with preliminary results anticipated in early 2024. By capitalizing on W21C's capabilities in eHealth and mHealth technologies, fostering collaboration, and actively engaging communities, the Health Everywhere Hub is poised to play a pivotal role in improving seniors' recovery experiences post-major surgeries. Image Sources: Adobe Stock Project Contact- Alex Baron

We envision a vibrant eHealth and mHealth ecosystem, accelerating innovation, growth, and transforming healthcare through collaboration and partnerships. Enhancing Recovery After Surgery THEME 2: REMOTE MONITORING AND VIRTUAL CARE Date Alex Baron | January 2024 As we age it can take longer for our bodies to heal from trauma. As many as 40% of patients that undergo surgery will have major complications that lead to long-term health problems, such as heart disease or stroke. This is especially true for adults over the age of 65 following a major surgery, with many experiencing difficulties in returning to their pre-operation levels of function. Led by Dr. Duminda Wijeysundera, MD, at the University of Toronto, the Functional Improvement Trajectories After Surgery (FIT After Surgery) study aims to gain a better understanding of how often and why some patients experience significant disability after surgery. As one of 14 study sites across Canada, W21C is currently working with the Calgary site lead, Dr. Melinda Davis, MD, director of Master Teaching Program, clinical associate professor, Cumming School of Medicine, on recruitment efforts at the Foothills Medical Centre, actively engaging with patients prior to their surgery. Patient recruitment for the Calgary site began in July 2021 and is ongoing. Researchers are excited about the possibilities this work could reveal, especially as Canada’s population continues to age and the likelihood of more seniors needing major surgery every year is increasing. Having a better understanding of when and why patients experience disability after surgery will enable patients to make better-informed decisions about having surgery and allow physicians to identify patients that may need additional support following surgery. Overall recruitment and follow up for the study is expected to finish in 2023, with preliminary results anticipated in early 2024. By capitalizing on W21C's capabilities in eHealth and mHealth technologies, fostering collaboration, and actively engaging communities, the Health Everywhere Hub is poised to play a pivotal role in improving seniors' recovery experiences post-major surgeries. Project Contact: Dr. Mary Brindle Image Sources: Adobe Stock