Perspectives on Health and Tech

In this episode of Perspectives on Health and Tech, Oracle Health welcomes Shelagh Maloney, CEO of Digital Health Canada, for a forward-looking conversation about how Canada can build a more connected, equitable, and digitally empowered healthcare system. From advancing interoperability and clinician mobility to exploring the role of artificial intelligence in care delivery, Shelagh shares insights from Digital Health Canada's AI in Action initiative — including the "winning conditions" needed to deploy AI responsibly and inclusively. Together, we explore how technology, policy, and collaboration can unite care across provinces, empower citizens with access to their data, and help clinicians deliver smarter, more human-centered care from coast to coast to coast.   -------------------------------------------------   Episode Transcript: 00:00:00:00 - 00:00:44:03 Welcome to Perspectives on Health and Tech podcast, brought to you by Oracle Health. In this series, we have conversations on creating a seamless and connected health care world where everyone thrives. Let's get started. Welcome to the Perspectives on Health and Tech Podcast, brought to you by Oracle Health. I'm Larry Sylvestre and today we're exploring one of the most defining challenges and opportunities in Canadian health care: interoperability.   00:00:44:04 - 00:01:13:04 From enabling clinicians to practice across provincial lines to giving Canadians direct access to their health records, interoperability is key to building a truly connected health system. Joining us today is Shelagh Maloney, the CEO of Digital Health Canada, an organization at the heart of advancing digital health, professional development, and policy collaboration across the country. Shelagh, thank you for being here.   00:01:13:05 - 00:01:38:05 Before we dive in, could you tell us a bit about your vision since taking on the CEO role earlier this year? Well thanks, Larry. First, let me start by saying how thrilled I am to be on your podcast. I'm looking forward to the conversation. And yes, I did join Digital Health Canada. It's been almost a year. I joined at the end of January 2025 and it's been a whirlwind.   00:01:38:05 - 00:02:04:08 And Digital Health Canada, like other, you know, national associations that we really want to provide value to our members. We have networking events and we have influence health policy. We look at advocating for the profession. And, you know, one of the things that I'm excited about is that we've just launched a strategic plan to 2030.   00:02:04:11 - 00:02:22:06   And so a big component of that is going out and asking our members what Digital Health Canada means to them and what they're looking for. We're doing some work in the governance space. I think education is trauma, endless possibilities now, and particularly as AI is getting so big. And I know we're going to talk about that later.   00:02:22:08 - 00:02:47:10 And of course, advocacy for both professionals and the profession at large. That's a perfect set up for our discussion, Shelagh. How can Canada move forward from our fragmented systems to a pan-Canadian model of care that's equitable, citizen centric, and digitally connected? One of the biggest conversations right now in health care is around nation building, breaking down barriers between provinces and territories.   00:02:47:12 - 00:03:14:01 What are you seeing from your standpoint at the leadership role at Digital Health Canada? You know, this is such a timely question and I'll tell you why. Yesterday we had a conversation with, Doctor Anderson Chuck, the CEO of CIHI and Doctor Fahad Razak, who is the among other things, does a role at Unity Health, in Toronto, but also is the Canada research chair and data informed health care improvement.   00:03:14:03 - 00:03:34:00 And it was really interesting. And one of the things we talked about was, and, you know, you and I know this, it's not a technology issue that we're dealing with in terms of interoperability and connected care, but it's a cultural issue. And it's really interesting that, that's a different sort of change in our thinking a little bit.   00:03:34:02 - 00:03:58:22 But certainly, one of the big challenges in a federated system, having a national perspective and doing things at that large national scale is more of a challenge than we would hope that it would be. Yeah. Certainly the landscape is full of different perspectives on how to proceed. And sometimes some of these conversations do get politicized.   00:03:59:00 - 00:04:27:16 But certainly it's great to see, I think some of the federal government perspectives and agencies coming together to try and be facilitators in this discussion. And I think, Canadians in general are ready for us to meet that challenge head on. So it's really inspiring to hear how we're aligning policy and technology and how those things could potentially unlock the possibilities for clinicians and ultimately, better continuity of care for patients.   00:04:27:18 - 00:04:51:01 Let's turn a little bit to the citizen side of the discussion. How does a citizen first approach align with work happening in Canada now? Well, you know, it's kind of interesting in like 2012. So a while ago and this was all the rage when, when patient engagement and patient partners were just sort of, I think coming into mainstream.   00:04:51:07 - 00:05:09:00 Some may argue they're not quite mainstream yet, but that was where the hype really started. And it was Leonard Kish who was an IT strategist in the US. And I remember and you might remember this, Larry, there was a famous quote that he said if patient engagement was a drug, it would be the blockbuster drug of the century.   00:05:09:02 - 00:05:43:05 And so that has been frequently, you know, bantered around. But the rest of the sentence that I really love is and it would be medical malpractice not to use it. And I know and you know, my former roles at Canada Health Info way and CIHI, we did a lot of research in this area. And we know that patients, when they are engaged, when they are part of their, has access to their health records and can see their information and know where they are in the queues, they are more informed about their health care, they are more confident in the care that they receive, and they have better relationships with their care   00:05:43:05 - 00:06:09:13 providers. And all those things together mean that their outcomes are better. So we know it is. There's evidence to demonstrate that engaging patients in the process and including them, as we're developing systems, etc., will make a difference to health care. Agreed. Certainly, when we look across the country and reflecting back on, you know, just the previous question to answer that we corresponded on.   00:06:09:15 - 00:06:32:04 As you look across every province and they have their own health legislation and different policies, procedures, approaches to health care delivery, etc. It really is a bit of a thicket and even the best facilitators in that have failed historically to move the needle and hopefully we're in a much better position now to understand what the challenge is, how we can move it forward.   00:06:32:05 - 00:06:54:23 What was fascinating to me is, as you and I were both at the Infoway Partnership Conference recently was a stakeholder from Portugal who was on stage talking about how they put the patient at the center of interoperability around consent and that they adjudicate which clinicians in the care team are going to have access to their records, and that they have the opportunity to even rescind that.   00:06:55:01 - 00:07:23:09 Do you see that having any potential in Canada? Maybe not in whole, but perhaps in part? My desired answer would be to say, absolutely yes. I think we are getting there, and I think we would love to have that. And I think, frankly, patients and their family, we're getting a little bit impatient, and asking the questions if they don't think that it's already there, it's like, what do you mean   00:07:23:09 - 00:07:55:15 my specialist and my GP are not exchanging information? What do you mean the emergency department and the clinic don't have the same information? And so, I think we're recognizing that we need to get there. And frankly, one of the things that we're seeing is patients increasingly are using ChatGPT and other models, and they're collecting their own information and creating their own health records, because nobody else is doing it and the system is failing them in that regard.   00:07:55:17 - 00:08:18:21 So, you know, if we don't do it for patients with patients, I'm afraid, and rightfully so, they'll find a web mechanism to do it on their own. And that, from a health system perspective, won't be helpful because, you know, the care providers, etc. may not have the information that they need to provide the best care that's available to a patient.   00:08:18:23 - 00:08:57:23 It's excellent point. And that draws me in to sort of another sort of another train of thought about the data is the data. And, you know, there are a lot of constituents across the care continuum who feel like they're living on little islands of data and perhaps not connected with others. And as we talk about building a pan-Canadian infrastructure to enable the mobilization of that data, you start to think about artificial intelligence in that conversation, not only for the sake of the institutions and clinicians who need to deliver care, but for the individuals themselves.   00:08:58:01 - 00:09:32:13 And that becomes particularly material in Canada, where we have one of the lowest population densities on the planet, and we have a very challenging time providing equitable care to this broad and diverse population and massive geography. And so moving the data to the clinicians becomes, you know, paramount to bein