WHRI Digital Health Survey

2023 Digital Health Survey

To understand the current scope of digital health research at both BCCHR and WHRI being led by institutional investigators and trainees, the barriers and facilitators to their success, the joint Steering Committee for Digital Health Research launched another Digital Health Survey in December 2023. Some initial key results that we would like to share are below. Stay tuned for our full summary report next month, where we will dive deeper into the survey findings and provide valuable recommendations.

Quantitative Findings:

1. Categories of survey respondents: Most of our survey respondents are affiliated with BCCHR.

2. Specific roles at BCCHR/WHRI: For those who selected BCCHR/WHRI, most of them are administrative/professional staff, followed by PI and graduate students.

3. Technology Readiness Levels (total count 19): 4/19 indicated that their projects are at the highest TRL 9, while most other participants’ projects are within TRL 1-5.

4. Types of Technology: Website and mobile applications are the most two common types of technology that are used/developed at C&W.

5. Levels of importance that participants like to receive support: In general, all 11 areas have been identified as needing support based on the total number of responses received. When grouping ‘critically important,’ ‘very important,’ and ‘important’ together, ‘Ease of navigating regulatory requirements around privacy/ethics/security’ (98%), ‘In-house digital health development, data management, and IT support’ (91%) and ‘Promoting clinical implementation of digital health interventions developed at C&W’ (86%) emerge as the three areas of greatest importance among all responses. Despite ‘Commercialization or scale-up’ (28%) and ‘Ease of access to province-wide population data and large cohort data’ (22%) receiving slightly more votes for ‘Not important’ and ‘Slightly important,’ over 70% of respondents still consider them as important areas to receive support.

Qualitative Findings:

Among participants who provided contacts, 10 one-on-one semi-structured interviews with the principal investigators and their teams were conducted to better understand their goals, clinical impact, outcome, barriers, enablers, and self-censoring. Five areas of themes were identified as below: 

1. External partner and decision-maker support: Researchers reported that external partners and decision-makers often lack the awareness and deep understanding necessary to fully grasp the technical challenges or the technologies being developed. This lack of understanding also extends to the value of the data being used. Additionally, researchers expressed the need for support from the highest levels of hospital leadership to facilitate implementation. On the other hand, researchers highlighted strong interest from patients, care providers, and healthcare administrators in advancing and implementing their work, which serves as a significant enabler for progress.
2. Strong multidisciplinary internal team: Researchers reported challenges with staff turnover and retention, often due to funding limitations. Additionally, they faced difficulties in accessing expertise in data sciences or relevant technology fields. Many researchers expressed a desire to join a community of like-minded professionals but were unsure how to connect with them. On the other hand, in cases where a strong interdisciplinary team was established, researchers did find their projects advanced more efficiently and effectively.
3. Lack of funding to support technology development and testing: Many teams struggled to secure funding across all Technology Readiness Levels (TRLs). This was sometimes attributed to working with rare
   diseases, but more frequently to the fact that their research fell between the mandates of CIHR and NSERC, leading to a gap in multidisciplinary or collaborative funding mechanisms. Researchers did not report any enablers in this area.
4. Data access and integration: Investigators reported difficulties in accessing electronic medical record (EMR) data. Another significant challenge was the lack of integration across various data sources, which could be valuable for research but are housed in various jurisdictions or different platforms. For example, the lack of integration between CST-CERNER and REDCap systems creates delays in acquiring the full dataset needed to answer research questions. Researchers did not report any enablers in this area.
5. Unclear and slow regulatory and governance processes: Many investigators indicated that navigating ethics review and gaining approval at C&W, and in some cases across multiple jurisdictions when proposing innovative research is very time consuming. Furthermore, process related to PHSA IT, privacy and security and governance are often changing or unclear, making it difficult to test new technologies in C&W clinics. Researchers also expressed concern with IP management and copyright when collaborating with industry partners and response from UILO is often inconsistent and slow. Similarly, limited support for commercialization, particularly in securing regulatory approvals from Health Canada, was noted at UBC. No enablers were reported by researchers in this area.

In conclusion, the actions we need to take to respond to the community for research in Digital Health are: 

1. Seek clear value from wayfinding, partnership development, and ongoing team support 
2. Support the recruitment process and the capacity to gather additional diverse expertise
3. Continuously advocate for research integration and needs to PHSA/C&W/PDHIS, etc.
4. Find a sustainable way to continue the C&W DHR Accelerator Grant Program 
5. Leverage the new opportunity at UILO and REB to further address barriers 
6. Build relationships and seek support from the new Digital Health & Data Super Hub at BCCHR through further improving and clarifying data access processes