St. Mike’s research platform to expand across Canada

TORONTO – The federal government’s artificial intelligence strategy will include up to $100 million in funding to expand an Ontario-based health data initiative to the rest of Canada.

The program, called Vital, is a health data platform run out of Toronto’s St. Michael’s Hospital that gathers anonymized records from hospitals for use by researchers. Its predecessor program, Gemini, also based at St. Michael’s, has already been used by researchers to glean insights from the Ontario healthcare system to improve patient outcomes, while saving money and freeing up hospital beds in the province.

Vital plans to expand that program nationally, the Globe and Mail reported.

The rollout across eight more provinces, starting in Quebec and Alberta, is meant to address long-standing concerns that Canada has fallen behind in mining healthcare data for system improvements and economic benefit. The project uses an approach called federated AI, meaning the underlying data remains within each province or territory’s borders.

“Better healthcare depends on better use of data,” AI Minister Evan Solomon said in a statement to The Globe and Mail on Sunday. Vital, he added, can turn clinical data that is fragmented across institutions, provinces and territories “into modern, secure health infrastructure that can support better research, stronger innovation and improved care.”

Vital offers an example of how AI can be used to benefit society, its proponents say.

Its predecessor, Gemini, has gathered anonymized patient information such as vital signs, bloodwork and medication orders from 45 Ontario hospitals over the past decade. That data has been made available to researchers using AI to search for patterns to improve patient care.

Gemini and Vital are co-led by Fahad Razak (pictured left) and Amol Verma (pictured right), two internal medicine doctors at St. Michael’s who met when they were medical students at the University of Toronto. In 2015, soon after they started practicing medicine, they realized hospitals were making decisions on how to prioritize care “without a lot of data to support those decisions,” Dr. Verma said.

They convinced seven Ontario hospitals to share data on 240,000 patient admissions. Their initial work, published in 2017, won favour with the Ontario government after it identified opportunities to improve care in general medicine wards by providing quality measurement reports back to doctors and hospitals.

Building Gemini has been no small feat. Canada has long struggled to effectively share patient data. Healthcare is a provincial responsibility, which leaves most information in silos.

Electronic health record systems owned by private companies can’t always communicate with one another, while standards for patient privacy in data-sharing agreements are so high that researchers sometimes give up making use of the practice.

An expert advisory group informing the Pan-Canadian Health Data Strategy in 2022 found that fragmented health data, ineffective governance and outdated policies prevented timely data-sharing and resulted in health inequities during the COVID-19 pandemic. “Had a stronger health data foundation been in place,” the report stated, “lives would have been saved.”

A study in the Canadian Medical Association Journal, published in May, noted that data exchange still heavily depends on faxes or mailed letters, and that system-level analytics using electronic records “were underdeveloped nationally.”

Harnessing all that Canadian data would create one of the world’s best health datasets, Vital’s co-leads argue, as it would draw from 41 million people across diverse backgrounds in single-payer systems. That in turn could spur Canadian-based ventures to build solutions to improve the health system.

The first recommendation by the expert group advising the pan-Canadian strategy was to launch a “fully integrated and continuously optimized learning health system” benefitting all people in Canada by 2030.

Vital is a direct response to that, building on Gemini’s success, Dr. Razak said. Gemini has captured more than 30 billion data points from three million hospitalizations over the past decade. Its data has fueled more than 150 research projects funded by more than $210-million worth of grants.

Programs based on Gemini research have powered early warning systems to prevent death, amputations or the onset of delirium in patients. One study determined that mass patient transfers between Toronto hospitals during the pandemic could have resulted in 30 percent more system capacity if they’d been planned by an optimization algorithm.

Another Gemini study estimated that insights gleaned and programs developed from its research saved 50,000 bed days and avoided $51 million in costs at 21 Ontario hospitals, over 18 months from 2022 through 2024.

Buoyed by success and a $30-million grant from the federal government in 2024, Dr. Verma reached out to others in the health data research field across Canada to see if they could take Gemini’s approach national.

Key was the promise that Vital would use “federated analytics,” in which a separate software layer runs analysis and algorithms on provincial datasets one at a time. It keeps the data within its own jurisdiction, which resides within sovereign computing infrastructure.

“Everyone agreed this was the way to go,” said Laval University professor Philippe Després, who co-leads Quebec’s participation in Vital. In Quebec, the data will reside at McGill University, while University of Calgary will be home to data used for Alberta’s participation in Vital.

Neesh Pannu, an Alberta lead on Vital and professor of medicine at the University of Alberta, said that the project was built “through networks of personal relationships” in Canada’s small health data community. “It was just people talking to each other and saying “‘Hey, that sounds like a really great idea.’”

Quebec and Alberta signed on in the past year, bringing 160 hospitals into the fold in total. In March, Vital received $68-million from governments and healthcare institutions, anchored by $24.6-million from the Canada Foundation for Innovation. With funding from the AI strategy, Vital will expand to B.C., Manitoba and the four Atlantic provinces, and should be fully national by year’s end, Dr. Razak said.