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WIHV

Women’s College Hospital Institute for Health System Solutions and Virtual Care

Improving health through evidence-based innovation in clinical care and policy.


Since its launch in June of 2013, The Women’s College Hospital Institute for Health System Solutions and Virtual Care (WIHV) continues to deliver on its mandate to develop, implement and evaluate evidence-based solutions for the greatest challenges in health care. Our institute develops and tests new ideas, new programs and new policy approaches in the world of ambulatory care – and then helps to scale them up across Ontario and beyond.

Our philosophy is to engage and collaborate with all players in healthcare – patients, providers, researchers, government and industry – to deliver tangible solutions that improve the health system as a whole.

Our goal is to inspire innovation and enable Ontario’s most promising leaders to transform their creative ideas into practical solutions that can be scaled up across Canada and beyond.

Our focus is on programs and projects that use resources in creative ways. We will generate new ideas, new knowledge, new models of care and new approaches to policy that improve outcomes and the patient care experience in an era of limited resources.

WIHV’s research and innovation streams tackle the greatest challenges in healthcare in a rapidly changing landscape. We now support 22 ongoing projects, ranging from large multi-centred randomized control trials to student-led retrospective chart reviews. Projects are rigorously evaluated according to the Triple Aim of improved population health, improved patient experience of care, and steady or reduced per capita cost of care.

All of our programs and innovation projects fall within our twin foci of Quality and Value.

QUALITY: Improving ambulatory care for people living with complex chronic conditions 

As the population ages and people live increasingly with chronic conditions, the healthcare system must respond. We are moving from a paradigm of emergency rooms, hospital beds and multiple specialists in silos, to one in which patients receive integrated care in the community and transition seamlessly through different parts of the system. Building on the strength of Women’s College Hospital, a hospital without inpatient beds, in the area of “virtual care,” WIHV focuses on improving quality at transitions of care. Using technology and outreach, in a model that is economically sustainable, we work to improve transitions from hospital to home and reduce emergency room usage for people living with chronic disease.


VALUE FOR MONEY: Ensuring the sustainability of the healthcare system through a focus on effective, appropriate and efficient care delivery

Healthcare costs are rising across the Organization for Economic Cooperation and Development (OECD), and will continue to rise as technology advances and the population ages. Yet much of our increased spending is either because care is inefficient, tests are duplicated, or unnecessary care is provided. WIHV’s multidisciplinary teams develop and evaluate ways to reduce both underutilization and overutilization using the best available evidence so that both quality of care and value for money are improved.

These twin areas of QUALITY and VALUE are informed at every stage by an abiding commitment to HEALTH EQUITY. The Institute views all of our work through the lens of improving care for marginalized and under-served populations as well as advancing the health of women. In partnership with patients, providers, government and industry, our projects examine the interactions of the traditional health-care system with social service systems, the justice system and other public and private services to improve outcomes and the patient experience.


VIRTUAL CARE: A Framework for a Patient-Centric System

Advances in social media and telecommunications place us on the precipice of true "virtual care" through which patients and providers will have seamless and ubiquitous access to the data that can vastly improve some of the most costly and troublesome aspects of our system: handoffs and transitions.  Virtual Care is about bringing together people and information; it is the healthcare equivalent of what people have been doing in other facets of their lives for years, including banking, shopping or fundraising. The disruptive power of virtual care comes with the realization that it is the patient who should be the most direct beneficiary of all things health. Acknowledging that reaching this goal is a complex endeavor, WIHV is hosting a series of symposia to facilitate interactions between the core players in our system and to provide actionable recommendations to stakeholders from across the health sector.  Learn more by reading our first Virtual Health Symposium White Paper.

Please click on a name for more information

Our People

  • Dr. Danielle Martin

    Dr. Danielle Martin

    Vice-President Medical Affairs & Health System Solutions

    Danielle Martin is Vice-President, Medical Affairs and Health System Solutions at Women's College Hospital (WCH). She is a family physician in the Family Practice Health Centre at WCH and an Assistant Professor in the Departments of Family and Community Medicine and Health Policy, Management and Evaluation at the University of Toronto. Danielle's focus is on improving health at the system level as well as the individual level. Her clinical work has involved remote northern medicine as well as a current focus on maternity care, and she is an active medical educator.

    Danielle's policy expertise and passion for equity have made her an emerging leader in the debate over the future of Canada's health-care system. She holds a Masters of Public Policy from the School of Public Policy and Governance at the University of Toronto. In 2006, her first year in practice, she helped launch Canadian Doctors for Medicare, the voice for Canadian physicians who believe in "a high quality, equitable, sustainable health system built on the best available evidence as the highest expression of Canadians caring for one another". She chaired the board of CDM until May 2013.

    A recipient of the Canadian Medical Association Award for Young Leaders, Danielle sat two terms on the Health Council of Canada from 2005-2011. In 2006 the Ontario College of Family Physicians recognized her as one of three New Family Doctors of the Year. She was recently named by the Toronto Star in its list of the "13 People to Watch in 2013."

  • Dr. R. Sacha Bhatia

    Dr. R. Sacha Bhatia

    Director of Institute for Health System Solutions & Virtual Care

    Dr. R. Sacha Bhatia is the Director of the Institute for Health System Solutions and Virtual Care (WIHV) at Women’s College Hospital. When not managing WIHV’s diverse portfolio of projects, Dr. Bhatia is a staff cardiologist at Women’s College Hospital and at University Health Network.

    He also serves as Assistant Professor in Department of Medicine at the University of Toronto and at the Institute for Health Policy Management and Evaluation. He is also an adjunct scientist at the Institute for Clinical Evaluative Sciences. Previously he has worked as a clinical and research fellow in cardiology at Massachusetts General Hospital, and as a research fellow at Harvard University.

    As Director of WIHV, Dr. Bhatia sits on the steering committee for Choosing Wisely Canada, a national initiative managed through the University of Toronto in collaboration with the Canadian Medical Association. He has significant experience in health policy, and from January 2008 to December 2009 was the Premier of Ontario's health and research and innovation policy advisor. He is a health policy researcher who has published in peer reviewed journals, such as New England Journal of Medicine and the CMAJ. He has also presented at national and international meetings, such as the American College of Cardiology and American Heart Association Scientific Sessions. He was recently awarded the 2013 American College of Cardiology’s Young Investigator Award, and the American Society of Echocardiography’s Arthur E. Weyman Young Investigator Award. He sits on the Mission Committee of the Heart and Stroke Foundation, the cardiovascular working group of the Ontario Health Study, and advises the Ministry of Health and Long-Term Care, Health Quality Ontario, hospitals and other healthcare organizations on various health systems issues, including strategic planning and quality improvement.

    He has been invited to speak at conferences held by the Ministry of Health and Long-Term Care, the Ontario Hospital Association, ICES, various Local Health Integration Networks, law firms, hospitals and research institutes on various issues of health policy.

    Dr. Bhatia received his medical degree and MBA at McGill University and received his internal medicine and cardiology training in Toronto.

  • Kyla Pollack Behar

    Kyla Pollack Behar

    Health System Solutions Coordinator

    Kyla Pollack Behar is Coordinator of the Women’s College Hospital Institute for Health System Solutions and Virtual Care (WIHV), where she oversees all internal operations of the Institute. She was the first full-time WIHV staff to be hired when the Institute launched in July 2013 and has since then managed its growth into a core team of experts, innovators and researchers. Prior to her work at Women’s College Hospital, she served for several years as an aide to Hillary Clinton in both her U.S. Senate office and as a national scheduler on the 2008 Presidential campaign. She has also worked in the executive office of Planned Parenthood Federation of America and at the National Partnership for Women and Families. Kyla holds a Masters in Public Health from Columbia University where her research focus was around health policy, comparative health systems and women’s health. Her B.A. in Political Science is also from Columbia University, from which she graduated Magna Cum Laude.

  • Ivy Wong

    Ivy Wong

    Ivy Wong, Senior Research Lead, is Project Director for the Better Access and Care for Complex Needs (BeACCON) Project, hosted at WIHV. BeACCON is Ontario’s contribution to a pioneering new initiative connecting research and evaluation to policy and practice to improve outcomes, quality and efficiency of care for patients with the most complex needs.

    Ivy has just returned to Canada after several years as a civil servant in the Department of Health, and most recently was Head of Commissioning Policy and Incentives for the National Health Service (NHS) in London, England. Her focus was on funding reform, integrated care and financial incentives. Before working in health policy, Ivy was an IT consultant, specialising in financial services, and also worked as an Account Director in digital marketing and advertising.

    Ivy holds a Master of Public Administration from the London School of Economics, a Master of Public Affairs from L’Institut d'études politiques de Paris (Sciences Po) and a BA cum Laude from the University of Pennsylvania.

  • Bailey Griffin

    Bailey Griffin

    As a Research Assistant at WIHV, Bailey Griffin oversees a number of key long-term initiatives, including the AP-QIP, a novel quality improvement ethics approval process, as well as the coordination of health policy symposia. Bailey also serves as Project Coordinator for the province-wide Better Access and Care for Complex Needs (BeACCON) Network. BeACCON is a pioneering new initiative which connects research and evaluation to policy and practice in order to improve outcomes, quality and efficiency of care for patients with the most complex needs. Bailey’s programmatic interests are in health equity and appropriateness of care, two areas of particular focus for WIHV projects. She comes to WIHV with an MSc in International Health from Queen Margaret University, Edinburgh, where her academic research focused on health policy and equity in health systems and reproductive and sexual health. She holds a BHSc (Hons) from the University of Western Ontario Health Science and Psychology.

  • Ross Wallace

    Ross Wallace

    In his role as Senior Health Sector Engagement Lead at WIHV, Ross Wallace helps the team align its programs and partnerships with key public policy priorities, liaises with key public sector experts and advisers and helps the organization with its strategic planning. Beyond his work at WCH, Ross is a Principal with Santis Health, a public affairs and public policy consulting firm focused on healthcare innovation. Prior to joining Santis in 2014, Ross worked as the national Director of Government Affairs and Corporate Responsibility at AstraZeneca Canada. Before AZ, he spent almost four years as the Director of Strategic Partnerships at the MaRS Discovery District, a technology commercialization centre in downtown Toronto. Ross also lived in Washington DC for five years, working at the Embassy of Canada and for a political consulting company. He has an MBA from the University of Toronto and an MPA from Queen's University.

  • Jay Shaw

    Jay Shaw

    Dr. Jay Shaw is Health Systems Policy Analyst at the Institute for Health System Solutions and Virtual Care at Women’s College Hospital (WIHV), where he oversees WIHV’s knowledge translation and health policy consultative activities. He is also a Postdoctoral Fellow at the Institute for Health Policy, Management and Evaluation at the University of Toronto and a Visiting Fellow at Brunel University’s College of Health and Life Sciences in London, United Kingdom. Jay also currently leads the evaluation of a national, multi-year policy change initiative to support de-prescribing among older people in Canada. His ongoing research program is focused on comparative studies of integrated health care across the continuum, emphasizing the need to support more coordinated care for underserved populations.

    Prior to joining WIHV, Jay worked as a physiotherapist in the home and community care sector while completing his PhD in Health and Rehabilitation Sciences with a focus on health services research at Western University. He then completed a Canadian Institutes of Health Research-funded Postdoctoral Fellowship in comparative health systems research, spending a year studying the National Health Service in London, United Kingdom. Jay is also a Senior Research Consultant with VHA Home Health Care, an Academic Fellow at the Centre for Critical Qualitative Health Research, and teaches in the Essentials of Qualitative Research course series at the University of Toronto.

  • Hayley Baranek

    Hayley Baranek

    Hayley Baranek is a Research Assistant at WIHV and is currently working on a number of quality improvement and health system solutions projects. Her primary research focus at WIHV centers on developing and implementing an integrated management strategy to improve the care of heart failure patients who suffer from multiple co-morbidities. The strategy looks at patients across three Toronto hospitals: Toronto General Hospital (TGH), Toronto Western Hospital (TWH), and Women’s College Hospital (WCH). Hayley also works on projects to address care in various areas of medicine such as sickle cell anemia, diabetes, and breast cancer. Hayley first came to WIHV as a graduate practicum student in the summer of 2014 and began full-time following her graduation from the Master’s in Public Health Program at Queen’s University. Hayley also holds a BA from McGill University where she majored in Psychology and minored in Behavioral Science and World Religion.

  • Cindy Xinjie Yin

    Cindy Xinjie Yin

    Cindy Xinjie Yin is the Research Assistant for the Echo WISELY study, an international investigator blinded randomized controlled trial to determine if an education and feedback intervention will help reduce inappropriate transthoracic echocardiograph ordering. She comes to WIHV with a B.A.Sc. from McMaster University in Hamilton where she focused her academic research on immunology and chronic pain. She has three years of experience working as part of Dr. Zhou Xing’s Phase I Clinical Trial team in the development and testing of a novel Tuberculosis vaccine at the Centre for Infectious Disease at McMaster University. Her results on this vaccine trial have been published in Nature: Immunology and Science Translational Medicine. Cindy is dedicated to creating health system solutions to maximize efficiency and distribution of resources, with special interest in infectious disease spread and response to emerging healthcare needs.

  • Ciara Pendrith

    Ciara Pendrith

    As a Biostatistician at WIHV, Ciara helps to plan research methodology and conduct statistical analysis for a number of affiliated research projects. Ciara also assists in the evaluation effort for Choosing Wisely Canada, a national campaign to encourage physicians and patients to engage in conversations around unnecessary tests, treatments and procedures, and to help physicians and patients make smart and effective choices to ensure high-quality care. She holds an MSc in Epidemiology and Biostatistics from the University of Western Ontario and a BSc (Hons) in Life Sciences from Queen's University. Prior to her work at WIHV, Ciara assisted with research initiatives at both the Women's College Research Institute and Women's College Family Practice Health Team.

  • Minnie Rai

    Minnie Rai

    Minnie Rai serves as a Research Assistant at WIHV working on a range of quality improvement interventions across Women’s College Hospital. She comes with an extensive clinical, qualitative and quantitative research background working on an array of projects across the continuum of care at various locations. Her research experience includes work for the Division of Respiratory Medicine at the Hospital for Sick Children, Bioethics at Humber River Regional Hospital, the Department of Anesthesia at St. Joseph’s Hospital in London, Ontario and The Department of Neurological Sciences at the London Health Sciences Centre. Her degree from the University of Western Ontario is in English Language and Literature with extensive coursework in the sciences and health sciences. She is excited to be part of the WIHV team and to contribute to quality improvement research that will positively impact the patient care experience.


Affiliate Innovators

WIHV engages with a number of clinical and academic experts and entrepreneurs both internally at Women’s College Hospital and beyond. Our team of affiliated innovators are dynamic individuals within the clinical/academic healthcare community who are working to find and scale up game-changing health system solutions.

  • Dr. Geetha Mukerji

    Dr. Geetha Mukerji

    Dr. Geetha Mukerji is a full-time staff Endocrinologist and General Internist at Women's College Hospital with cross-appointment at Mount Sinai Hospital/University Health Network. She is the Clinical Lead in Quality for the Institute for Health Systems Solutions and Virtual Care where she provides expert quality improvement advice to project leads to develop and initiate their quality improvement projects. She is also a Clinician in Quality and Innovation and an Assistant Professor in the Department of Medicine and holds a Master’s degree in Quality Improvement and Patient Safety from the Institute of Health Policy and Management Evaluation at the University of Toronto. Her academic interests include: 1) system improvement efforts for those with complex chronic diseases, 2) quality improvement in transitional care populations, and 3) safety and quality care processes in the ambulatory setting. She is also actively involved in teaching quality improvement and patient safety to undergraduate and post-graduate trainees.

  • Dr. Noah Ivers

    Dr. Noah Ivers

    Dr. Noah Ivers (MD, PhD) is a family physician practicing at the Women's College Hospital Family Practice, a scientist at Women's College Research Institute, an adjunct scientist at the Institute for Clinical Evaluative Sciences and an assistant professor with the Department of a Family and Community Medicine at the University of Toronto. He holds a New Investigator Award in Community Based Primary Health Care from the Canadian Institutes of Health Research.

    His research focuses on optimizing the design and delivery of complex interventions to improve quality and patient outcomes in primary care, with a methodological focus on pragmatic, cluster-randomized trials and systematic reviews. Currently, he is leading or co-leading four randomized trials including acting as the evaluation lead for the SCOPE 2 project, advising on trial design, measurement, and analysis. In general, he believes that the way we manage and organize clinics and health systems should be informed by evidence as robust as the kinds we use to determine if drugs are effective and is working with WIHV to accomplish that vision.

  • Dr. Kevin Levitt

    Dr. Kevin Levitt

    Dr. Kevin Levitt is a full-time staff Cardiologist at Toronto East General Hospital with a cross appointment at Women's College Hospital. As an Innovation Fellow, Dr. Levitt is responsible for supervising, developing and evaluating research projects at WIHV related to appropriate use. He has completed a 2 year advanced training fellowship in echocardiography and has a Master's Degree in Quality Improvement and Patient Safety from the Institute of Health Policy and Management Evaluation (IHPME) at the University of Toronto. His research interests include Quality Improvement Initiatives within cardiology specifically addressing Appropriate Use Initiatives. He is actively developing methods to improve the quality and delivery of echocardiography in Ontario. His research has been recognized internationally and is a Finalist for the Young Investigator Award at the American College of Cardiology. He is involved in teaching residents and fellows as well as supervising their Quality Improvement projects. He is cross appointed at IHPME mentoring and evaluating students who are completing their Master's Degree in Quality Improvement and Patient Safety.

  • Dr. Trevor Jamieson

    Dr. Trevor Jamieson

    Dr. Trevor Jamieson is a General Internist and Clinician in Quality and Innovation at St Michael's Hospital/University of Toronto. He has a background in Software Engineering from Waterloo and is in the final year of a Masters in Biomedical Informatics from Oregon Health and Sciences University in Portland. His interests are in getting people access to the right data and the right people at the right times, and he is furthering that goal through his work at the Women's College Hospital Institute for Health Systems Solutions and Virtual Care as an Innovation Fellow. As an Innovation Fellow Trevor actively promotes the creation and implementation of tools for use in clinical situations, the use of those tools to promote higher quality care and process, and their evaluation in regards to outcomes that matter for Ontario's patients. He is also interested in how information technologies get integrated in complex systems, and, in particular, how they impact behaviour.

  • Dr. Onil Bhattacharyya

    Dr. Onil Bhattacharyya

    Dr. Onil Bhattacharyya is a family physician and the Frigon-Blau Chair in Family Medicine Research at Women’s College Hospital. He is also an associate professor in the Department of Family and Community Medicine and an assistant professor at the Institute of Health Policy, Management and Evaluation, University of Toronto. He received his medical degree at McGill University. He has a PhD in health services research from the University of Toronto and was a Takemi Fellow at the Harvard School of Public Health.

    Dr. Bhattacharyya studies innovative health service delivery models in both high and low income settings. He is committed to using health services research to make a more effective, responsive, and integrated health care system.

    Dr. Bhattacharyya is co-leading BRIDGES: Building Bridges to Integrate Care, an Ontario Ministry funded initiative to incubate and evaluate new models of care for complex chronic disease. He is co-lead of the Toronto Health Organization Performance Evaluation group (T-HOPE), which brings together medical students and MBAs to study social enterprises in health in low- and middle-income countries. He has attracted funding from the Ontario Ministry of Health and Long-term Care, CIHR, and other non-profits. Dr. Bhattacharyya has published more 30 peer-reviewed papers and numerous book chapters, and been invited to present two TEDx talks.

  • Dr. Ilan Shahin

    Dr. Ilan Shahin

    Dr. Ilan Shahin is a family physician practicing in downtown Toronto. He completed his medical degree and MBA at McGill University and has a background in biology, mathematics and philosophy. His academic interests include health psychology and models of care, and he believes that improving care for patients can be achieved through making better use of the knowledge and resources we have through good design. By joining WIHV as a Health Innovation Fellow, he helps adapt proven design methodologies to the health services context for more empathic and effective patient care. He also studies the scale-up of health organizations in the developing world as a research fellow with the Toronto Health Organization Performance and Evaluation group.

  • Dr. Payal Agarwal

    Dr. Payal Agarwal

    Dr. Payal Agarwal is a practicing family physician in Toronto. She holds an undergraduate degree in Systems Design Engineering from the University of Waterloo, where she refined her software design and development skills while working at several leading technology companies. During her medical studies at the University of Toronto, Payal’s research efforts focused on the development of novel technologies to improve healthcare delivery and education. As an Innovation Fellow at WIHV, Payal is currently focused on the creation of new models of care by adapting proven methodologies from the design, technology, and entrepreneurship fields. In addition, Dr. Agarwal is the Head of Product at Input Health, a mobile based patient engagement platform.

  • Dr. Steve Pomedli

    Dr. Steve Pomedli

    Steve Pomedli is a practicing family physician in Toronto and recently completed a Global Health Fellowship at the University of Toronto, looking at different approaches to primary care in Canada, the United States and Brazil. He previously studied medicine at Harvard Medical School and International Health Policy at the London School of Economics. As an Innovation Fellow, he is particularly excited to be engaging patients, clinicians, entrepreneurs, designers and policy-makers to make healthcare better, and is motivated by the potential to improve communication and the linkages between the many parts that deliver healthcare services.

  • Dr. Sam Vaillancourt

    Dr. Sam Vaillancourt

    Dr. Sam Vaillancourt is a specialist emergency physician and trauma team leader practicing at St. Michael's Hospital. He completed his specialty training in 2013 at the University of Toronto and previously received his medical degree from McGill University. In 2012, he completed a master of public health in health policy and management at Harvard University and an internship at the Institute for Healthcare Improvement. As an Innovation Fellow, he is interested in the potential of policy, entrepreneurship, and the social sector to design solutions for patients with the most complex care needs. He is currently an associate scientist at the Li Ka Shing Knowledge Institute of St. Michael's where his research centres around patient participation in quality of care assessment and integrating emergency care. Sam teaches point-of-care ultrasound in Toronto and Rwanda.

  • Leigh Hayden

    Leigh Hayden

    Leigh Hayden is a Research Manager at Women’s College Hospital and serves a key role coordinating the Innovation Incubator. She is a medical anthropologist, with expertise in qualitative methods and an interest in user-centred design of health services. She has a range of health-related research experience, including: the experience of diabetes self-management, primary care in low and middle income countries, health metrics, and user-centred guideline development. She is lucky have the opportunity to support several WIHV projects through patient journey mapping and other forms of ethnographic inquiry.

  • Dr. Katie Armstrong

    Dr. Katie Armstrong

    Dr. Katie Armstrong is a Plastic & Reconstructive Surgery resident at the University of Toronto. She is currently completing a MSc in Health Services Research specializing in Health Economics at the Institute of Health Policy, Management and Evaluation. Katie is interested in creating and evaluating cost-effective solutions within health care. She has helped develop SMS-based clinical tools to be used by the local health care team in Gaborone, Botswana; and evaluated perioperative protocols that allow autologous breast reconstruction patients to be safely sent home the next day at Women's College Hospital. As an Innovation Fellow at WIHV, Katie is currently running a CIHR-funded randomized controlled trial that aims to replace early, in-person follow-up care with mobile app home monitoring after ambulatory surgery.

WIHV benefits from the expertise of its Advisory Board, chaired by Dr. Chaviva Hosek and made up of top health system leaders and thinkers from across Ontario. The Advisory Board convenes quarterly to provide advice to WIHV on emerging health sector issues and to assist in linking with critical partners to ensure that the work is as broadly applicable as possible. Scientific and research experts on the Board help WIHV to recruit world-class researchers who will address the most relevant and pressing policy-relevant ambulatory care issues.

  • Dr. Chaviva Hosek, Advisory Board Chair
  • Dr. Gillian Hawker
  • Alexandra Johnson
  • Anthony Dale
  • Cathy Fooks
  • Dr. Christopher S. Simpson
  • David Henry
  • Don Tapscott
  • Dr. Lynn Wilson
  • Michael Decter
  • Dr. Moira Stewart
  • Dr. Paul Dorian
  • Dr. Paula Rochon
  • Tom Closson
  • William Falk

WIHV currently supports over 22 ongoing projects, ranging from large multi-centred RCTs to student-led retrospective chart reviews. All our projects are rigorously evaluated in line with the Triple Aim of improved population health, improved patient experience of care, and reduced cost of care. WIHV Projects fall within our two foci of: (1) improving quality of ambulatory care and (2) improving value for money.

Examples of initiatives currently underway at Women’s College Hospital that exemplify WIHV’s approach of incubating promising ideas and partnering to implement and evaluate them include:

Choosing Wisely Canada

WIHV is excited to join the steering committee of Choosing Wisely Canada (CWC), a national initiative led through Dr. Wendy Levinson at the University of Toronto, in collaboration with the Canadian Medical Association (CMA). CWC aims to help physicians and patients engage in conversations about unnecessary tests, treatments and procedures. WIHV is designing the Ontario Implementation Strategy for Choosing Wisely Canada and will play a key role in the evaluation and research of the initiative.

Learn more about the Choosing Wisely Canada campaign.

Virtual Ward

The Virtual Ward is a new model of care that is designed to support patients in conjunction with their family doctors for several weeks after hospital discharge. This is a collaborative in partnership with Toronto Central Community Care Access Centre, St. Michael's Hospital, and the University Health Network. Learn more about the Virtual Ward.

Our Innovation Incubator is currently advising on the design phase of Virtual Ward 2.0, a step-up rather than step-down in which patients at risk for hospitalization are given an increased level of care at home.

P-Step

The Psychiatric Structured Treatment Extension Program (P-STEP) supports patients during the transition from hospital to community and provides a resource for primary care providers (family doctors or nurse practitioners). The ultimate goals of the program are to improve quality of care and to decrease ER visits and hospital readmissions.

Innovate A-Fib

Innovate A-Fib is a project to improve care in the community for patients with Atrial Fibrillation (“a-fib”), a condition involving an irregular heart rhythm, known as arrhythmia. A-fib is the most common type of arrhythmia, affecting approximately 350,000 Canadians. The project is conducted in partnership with the University Health Network (UHN), Mount Sinai Hospital, Taddle Creek Family Health Team).

SCOPE and SCOPE 2

S.C.O.P.E. (Seamless Care Optimizing the Patient Experience) provides doctors who are treating high-needs patients access to more community resources and specialist care. SCOPE improves the coordination of care for high-end users, reducing total utilization while improving the patient’s experience and the quality of care that they receive. SCOPE is being implemented in partnership with University Health Network and the Toronto Community Care Access Centre (CCAC).

Seamless Care Optimizing the Patient Experience (S.C.O.P.E.) 2 builds off of the highly successful S.C.O.P.E project and will offer a greater number of primary care providers with high needs patients access to community resources and specialist care.

1-800-Imaging

1-800-Imaging is a Joint Division of Medical Imaging (JDMI) projectoffering a central access point to primary care providers and medically complex patients who require radiology services. Access to a radiologist enables primary care providers immediate bi-directional feedback as to the most appropriate exam for their patient based on the clinical indication, avoiding an unnecessary Emergency Department visit and getting patients the care they need faster.

P.A.T.H.

PATH (Promoting Access to Team-Based Healthcare) brings high-needs patients most at risk of avoidable ED visits into a team-based primary care practice. The program creates a structured way to bring unattached, high needs, medically complex patients into primary care practice while addressing common issues that can often overwhelm providers.

Echo WISELY

Over the last ten years, the number of transthoracic echocardiographs ordered per year has more than doubled, far exceeding the recommended use criteria and putting patients at risk due to unnecessary tests. Echo WISELY aims to reduce inappropriate ordering in ambulatory settings through an education and feedback-based intervention. It is an international, multicentre, randomized control trial with eight sites in Canada and the United States: University Health Network, Mt Sinai Hospital, Saint Michaels Hospital, Women’s College Hospital, Sunnybrook Health Sciences Centre, Kingston General Hospital, Scarborough Hospital, and Massachusetts General Hospital.

Island A.C.S.

Patients who have had a heart attack have high rates of repeat heart attacks and even death. Although medications and participation in rehabilitation can help to reduce this risk, only 30-40% of patients participate in rehabilitation and by one year only 50% of patients continue to properly take their medications. Interventions to Support Long-Term Adherence and Decrease Cardiovascular Events Post-Acute Coronary Syndrome (ISLAND-ACS) will implement and evaluate strategies to increase the proportion of heart patients who continue to take their medications and participate in rehabilitation.

STAR-IBD

STAR-IBD is a 12-month study to evaluate the implementation of an ambulatory corticosteroid care program. The program refers Mount Sinai Hospital patients who suffer from ulcerative colitis to a specialized clinic at Women’s College Hospital’s Acute Ambulatory Care Unit (AACU) so that they can be managed at home rather than in hospital. The project aims to see at least a 25% reduction in ulcerative colitis-related hospitalization days and associated health care costs.

Secure Messaging Platform

Many Ontarians report that they would like the ability to e-mail their physician, but privacy concerns, operability and functionality continue to be a challenge. The Women’s College Hospital CACE Clinic is evaluating the adoption of the WellX secure messaging platform so that patients can communicate more rapidly and effectively with their care providers. Through a pre-and post-evaluation that includes focus groups of both care providers and patients, the study also examines potential barriers to adoption of these technologies and in what health care context they would be most likely to improve the quality of care.

Summer Health Equity Fellowship

The work we do to improve health care quality and value is informed at every stage by a commitment to health equity. Women’s College Hospital and WIHV recognize that improving the health and well-being of marginalized and under-served populations is essential to the strength our health system and to our society. Each summer, we seek to advance scholarship in the field of health equity by sponsoring a Summer Health Equity Fellow to conduct a summer research project in his or her area of focus.

Please click on a name to learn more about our past Fellows and their health equity projects:

  • Glenn Cohen, 2013 Fellow

    Glenn Cohen, 2013 Fellow

    Project

    For his Health Equity Fellowship with WIHV, Glenn Cohen has written a publication focused on the Canadian provinces' role in medical tourism -- the travel of patients from one country (the home country) abroad (to the destination country) for the primary purpose of health care. During his Fellowship he examined the ways in which various Ontario stakeholders (the Ontario Medical Association, Ontario Hospital Association, and Ministry of Health and Long-Term Care in particular) facilitate or create obstacles to medical tourism, what information and advice they provide Ontario physicians, and what are the implications of medical tourism on equity in both the home and destination country.

    He also worked during his time in Canada on completion of his book, "Patients with Passports: Medical Tourism, Ethics, and Law" (under contract, Oxford University Press). The book tackles medical tourism for services legal in both the home and destination countries, including hip replacements, cardiac bypass, cosmetic surgery, etc; for services illegal or unapproved in the home country but legal and approved in the destination country, for example abortion, assisted suicide, reproductive technology, and stem cell therapies; and medical tourism for services illegal in both places, primarily the international black market for kidneys.


    Bio

    Glenn Cohen is one of the world's leading experts on the intersection of bioethics (sometimes also called "medical ethics") and the law, as well as health law. He also teaches civil procedure at Harvard University. From Seoul to Krakow to Vancouver, he has spoken at legal, medical, and industry conferences around the world and his work has been covered on PBS, NPR, ABC, Mother Jones, the New York Times, the Boston Globe, and several other media venues.

    His current projects relate to reproduction/reproductive technology, research ethics, rationing in law and medicine, health policy, and to medical tourism – the travel of patients who are residents of one country, the "home country," to another country, the "destination country," for medical treatment.

    He is the author of more than 50 articles and chapters and his award-winning work has appeared in leading legal (including the Stanford, Cornell, and Southern California Law Reviews), medical (including the New England Journal of Medicine, JAMA), bioethics (including the American Journal of Bioethics, the Hastings Center Report) and public health (the American Journal of Public Health) journals, as well as Op-Eds in the New York Times and Washington Post. Cohen is the editor of "The Globalization of Health Care: Legal and Ethical Issues" (Oxford University Press, 2013, the introduction of which is available at SSRN), and is currently writing “Patients with Passports: Medical Tourism, Law, and Ethics” (under contract Oxford University Press) as well as working on three other books. Prior to becoming a professor he served as a law clerk to Judge Michael Boudin of the U.S. Court of Appeals for the First Circuit and as a lawyer for U.S. Department of Justice, Civil Division, Appellate Staff, where he handled litigation in the Courts of Appeals and (in conjunction with the Solicitor General’s Office) in the U.S. Supreme Court.

  • Kathleen Kenny, 2013 Fellow

    Kathleen Kenny, 2013 Fellow

    Project

    Kathleen Kenny’s study ‘Women, Custody Loss and Shifting Ground: The Experts Speak’ examines different dimensions of women's lives in the aftermath of custody loss. These include women's construction of social identity and experiences with stigma, coping, mental health, social/health systems interactions, health risk negotiation, social support and resiliency. The project also investigates women's insights into ways they could be better supported pre and post custody loss to mitigate negative health impacts, instability and other barriers to family wellbeing and unification. In order to build on the limited research and visibility of marginalized women’s suffering in the aftermath of custody loss, it is hoped that study findings will inform policy change and program development by initiating dialogue around provisions of social care and systemic changes needed to improve health equity and outcomes for families affected by drug use.

    Women, Custody Loss and Shifting Ground: The Experts Speak’ qualitatively explores factors associated with the production of health and social vulnerability among drug-using women who have experienced child custody loss to Child Welfare Authorities. The research design encompassed face-to-face in-depth interviews conducted with 19 women in Toronto who self-identified as having lost custody of a child and having used illicit drugs in the past 6 months. Women were purposively recruited via recruitment flyers and in-person interactions with the researcher. Ongoing with data collection, was an iterative process of analysis, whereby analytic memos were created to document reflexive and analytic processes. Seeking to capture emerging patterns and themes/sub-themes in the data, a coding framework will be developed in the coming few months using qualitative analysis software.

    Preliminary findings show the social-ecological context of women’s lives as non-custodial mothers as significantly shaped by the event of child loss. Loss of child custody was articulated as contributing to health vulnerability through women’s experiences of increased mental health distress, self-harm, post-traumatic stress disorder, drug use, and intimate partner violence. At a social/structural level, child loss was also seen by women as heightening vulnerability through its association with loss of housing, incarceration, loss of employment, loss of social support, mistrust of ‘professionals’ (health workers, lawyers, child welfare workers, etc.), and loss of social status.


    Bio

    Kathleen Kenny is a graduate of Brown University and the University of Toronto and is presently working toward her PhD in the Department of Maternal and Child Health at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. She has professional experience in qualitative research methods, most recently in conducting research with people who use drugs as facilitator of community-based participatory research projects at South Riverdale Community Health Centre, Regent Park Community Health Centre and Sherbourne Health Centre ( Living with Hep C: A Photovoice Project and The Methadone Project). Kathleen has significant work experience with women drug users who have lost custody of children, gained over 4 years of front-line work co-developing the Grief and Loss Education and Action Project with women in Toronto, a project profiled in a recently published book, Children of the Drug War (2011). Kathleen has also been involved in the formation of Community Action for Families, a new Toronto collective by mothers, drug users, sex workers, survivors and allies that was a 2013 recipient of funds from the Groundswell Community Justice Trust Fund for its work to build nurturing and supportive networks/services for families and children.

  • Daniela Graziano, 2014 Fellow

    Daniela Graziano, 2014 Fellow

    Project

    Daniela Graziano focused her summer research on improving health care services for refugees in Toronto. The 2014 Health Equity Fellowship was developed in conjunction with the Crossroads Clinic, Toronto’s first hospital-based refugee health clinic, under the leadership and supervision of clinic director Dr. Meb Rashid.

    In collaboration with Vanessa Redditt, a Fellow in Global Health and Vulnerable Populations through the Department of Family and Community Medicine at the University of Toronto, Daniela conducted a literature review and a retrospective chart review of over 1,000 patients at the Crossroads Clinic. Many refugees and refugee claimants are seen by community clinicians who do not deal exclusively with immigrant and refugee patients. Since there is a paucity of data on the health needs of refugee population in Canada, health care workers often struggle with deciphering what should be the best practices in addressing the unique needs of refugees. Thus the quality of care given to refugees is often compromised. Daniela’s research addressed this gap by documenting the needs of newly arrived refugees and the variance in such needs between different refugee populations. Establishing the foundational work for an ongoing database analyzing the needs of different refugee populations in Canada will contribute to evidence-based clinical guidelines. The Crossroads clinic strives to serve as a leader in refugee health care, education and training with a rigorous focus on healthy equity and patient-centred health system improvement. Resources provided by WIHV for the Fellowship allowed a longstanding clinic goal to become a quick reality over the course of the summer. A published manuscript is forthcoming in Fall 2014.


    Bio

    Daniela Graziano is an incoming Global Health Masters student at McMaster University. She holds a Bachelor of Science from York University and had previously worked as a Research Assistant at the Li Ka Shing Knolwedge Institute at St. Michael’s Hospital in Toronto, during which she documented the performance of international health programs designed to improve healthcare for low- and middle-income countries (LMIC). Her commitment to refugee health extends to advocacy where she has assisted with organizing a National Day of Action and coordinating an effort to document Refugee Health Narratives through film and photography

Innovation Incubator

The Innovation Incubator at WIHV works to foster and support new ideas that will address the multi-faceted needs of complex patients. It does this by connecting patients, researchers, policymakers, and clinicians and other support workers to rapidly test and improve new ideas, using user-centred design approaches and lean methods.

WIHV’s Innovation Incubator, led by Dr. Onil Bhattacharyya, WCH’s Frigon Blau Chair in Family Medicine Research and a Women’s College Research Institute (WCRI) Scientist, draws from existing technology sector incubator models to adopt and implement innovative health systems research. By applying the methods of technology incubators to the health field, along with validated Triple Aim planning and evaluation methodology, the innovation incubator at WIHV provides the critical support services needed for good health ideas to develop at every stage of the innovation life cycle. Ultimately this model will enable WIHV to become a provincial resource that supports bottom-up clinical innovation to improve patient outcomes and reduce system costs. The Incubator is already currently supporting numerous local clinical projects in design, implementation and evaluation, such as the Virtual Ward and SCOPE projects.


BeACCoN Network

The work of the Innovation Incubator is integrated into the Canadian Institutes of Healthcare Research (CIHR) provincial research and innovation network, “ Better Access and Care for Complex Needs” or BeACCoN network. BeACCoN is Ontario’s contribution to a pioneering new initiative connecting research and evaluation to policy and practice to improve outcomes, quality and efficiency of care for patients with the most complex needs. The BeACCoN network will allow successful ideas tested at WIHV to be scaled through our network of researchers and community based sites across Ontario and beyond.

 

Enabling the Work - The F.M. Hill Chair in Health System Solutions

Based on a very generous private gift from Dr. F.M. Hill, the former physician-in-chief at Women's College Hospital, the F.M Hill Chair in Health System Solutions has been established to endow an internationally recognized health services researcher to develop an innovative research program that has the potential to revolutionize health system solutions, specifically for patients with complex needs.

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Resources

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Health Systems Capacity Planning: Strengthening Health Care for Ontario’s Future

Success in long-term capacity planning outlines critical roles for MOHLTC and their partners. Read about the building blocks for health care excellence and sustainability.

White paper » | Letter of support »


Women’s College Hospital Assessment Process for Quality Improvement Projects (WCH APQIP)

The WCH APQIP process allows researchers concerned with quality improvement and project design and evaluation (PDE), to receive ethics review in the timeliest manner possible.

The WCH APQIP can provide you with:

  • Fast review times for QI/PDE projects
  • Research Ethics Board (REB) documentation useful for publication purposes
  • Advice on resources available to your project
  • A process by which to propose your QI/PDE project ideas at WCH


Is your project eligible?
Read our eligibility criteria »

Complete an application
Fill out our intake form »

For more information, please e-mail:
WIHV@wchospital.ca

NB: Applicants must read the informational pdf provided above before beginning the application process

Leadership

Dr. Danielle Martin
Vice-President Medical Affairs & Health System Solutions

Danielle Martin is Vice-President, Medical Affairs and Health System Solutions at Women's College Hospital (WCH). She is a family physician in the Family Practice Health Centre at WCH and an Assistant Professor in the Departments of Family and Community Medicine and Health Policy, Management and Evaluation at the University of Toronto. Read more...

Danielle's focus is on improving health at the system level as well as the individual level. Her clinical work has involved remote northern medicine as well as a current focus on maternity care, and she is an active medical educator.

Danielle's policy expertise and passion for equity have made her an emerging leader in the debate over the future of Canada's health-care system. She holds a Masters of Public Policy from the School of Public Policy and Governance at the University of Toronto. In 2006, her first year in practice, she helped launch Canadian Doctors for Medicare, the voice for Canadian physicians who believe in "a high quality, equitable, sustainable health system built on the best available evidence as the highest expression of Canadians caring for one another". She chaired the board of CDM until May 2013.

A recipient of the Canadian Medical Association Award for Young Leaders, Danielle sat two terms on the Health Council of Canada from 2005-2011. In 2006 the Ontario College of Family Physicians recognized her as one of three New Family Doctors of the Year. She was recently named by the Toronto Star in its list of the "13 People to Watch in 2013."


Dr. R. Sacha Bhatia
Director of Institute for Health System Solutions & Virtual Care

Dr. R. Sacha Bhatia is the Director of the Institute for Health System Solutions and Virtual Care (WIHV) at Women’s College Hospital. WIHV is a newly launched innovation laboratory that develops and tests new ideas, new programs and new policy approaches in the world of ambulatory care, and then helps to scale them up across Ontario and beyond.
Read more...

When not managing WIHV’s diverse portfolio of projects, Dr. Bhatia is a staff cardiologist at Women’s College Hospital and at University Health Network.

He also serves as Assistant Professor in Department of Medicine at the University of Toronto and at the Institute for Health Policy Management and Evaluation. He is also an adjunct scientist at the Institute for Clinical Evaluative Sciences. Previously he has worked as a clinical and research fellow in cardiology at Massachusetts General Hospital, and as a research fellow at Harvard University.

As Director of WIHV, Dr. Bhatia sits on the steering committee for Choosing Wisely Canada, a national initiative managed through the University of Toronto in collaboration with the Canadian Medical Association. He has significant experience in health policy, and from January 2008 to December 2009 was the Premier of Ontario's health and research and innovation policy advisor. He is a health policy researcher who has published in peer reviewed journals, such as New England Journal of Medicine and the CMAJ. He has also presented at national and international meetings, such as the American College of Cardiology and American Heart Association Scientific Sessions. He was recently awarded the 2013 American College of Cardiology’s Young Investigator Award, and the American Society of Echocardiography’s Arthur E. Weyman Young Investigator Award. He sits on the Mission Committee of the Heart and Stroke Foundation, the cardiovascular working group of the Ontario Health Study, and advises the Ministry of Health and Long-Term Care, Health Quality Ontario, hospitals and other healthcare organizations on various health systems issues, including strategic planning and quality improvement.

He has been invited to speak at conferences held by the Ministry of Health and Long-Term Care, the Ontario Hospital Association, ICES, various Local Health Integration Networks, law firms, hospitals and research institutes on various issues of health policy.

Dr. Bhatia received his medical degree and MBA at McGill University and received his internal medicine and cardiology training in Toronto.


Dr. Chaviva Hosek
Advisory Board Chair, Institute for Health System Solutions & Virtual Care

Dr. Chaviva Hosek is a professor at the School of Public Policy and Governance and past president and CEO of the Canadian Institute for Advanced Research (2001-2012).
Read more...

She previously served as the director of policy and research in the Prime Minister's Office of the Rt. Hon. Jean Chretien (1993-2000). Between 1990 and 1993, she ran the Liberal Caucus Research Bureau and was senior policy advisor to Mr. Chretien as Leader of the Opposition. During that period, together with the Rt. Hon. Paul Martin, she was responsible for the Liberal Party's 1993 election platform, "Creating Opportunity,” popularly known as the first "Red Book." Between 1987 and 1990 she was an elected member of the Ontario legislature and served as minister of housing between 1987-1989.

A lifelong feminist, Dr. Hosek was an active member of the Ontario Committee on the Status of Women, chaired the Women's Studies Program Committee at the University of Toronto, and was a member of the elected executive of the National Action Committee on the Status of Women from 1979 to 1987. She served as its president from 1984 to 1986.

Dr. Hosek completed an honours bachelor of arts degree in English from McGill University, and a doctorate in English language and literature at Harvard University. She taught in the English department of Victoria College at the University of Toronto between 1972 and 1985. She has served as a member of the interview committee for the Rhodes Scholarships from Ontario, and currently serves as board member of the Pierre Elliot Trudeau Foundation. In the last 10 years she has served on the boards of Inco and Maple Leaf Foods and is currently on the board of Great West Life Co. Among numerous awards, she has received four honorary degrees, the Outstanding Performance Award of the Public Policy Forum and is an Officer of the Order of Canada.

  • Fully affiliated with:
  • University of Toronto
  • A member of:
  • Council of Academic Hospitals of Ontario (CAHO)