Dr. Amol Verma, left, and Dr. Fahad Razak co-lead Vital, a health data platform run out of Toronto’s St. Michael’s Hospital.Sammy Kogan/The Globe and Mail
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 health care system to improve patient outcomes, while saving money and freeing up hospital beds in the province. Vital plans to expand that program nationally.
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 health care 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 health care 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.”
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The government is expected to unveil its AI strategy this week, more than five months later than it was originally promised.
The AI strategy will include more funding for startups and companies seeking access to AI computing power, along with initiatives aimed at broadly boosting adoption among businesses, while promoting Canada’s sovereign computing capabilities, according to a source familiar with a draft of the strategy. The Globe is not naming the source as they were not authorized to speak publicly.
While AI has led to new multibillion-dollar companies, opinion polls show Canadians have major concerns about the technology and its impact on society, including the potential for job losses and the spread of misinformation.
Much has changed with AI since last fall, too, such as the development of powerful models that can exploit software vulnerabilities and potentially compromise critical infrastructure. Revelations that OpenAI did not notify law enforcement that the Tumbler Ridge, B.C., shooter discussed scenarios involving gun violence with ChatGPT have sparked calls for stricter oversight of AI companies.
AI Minister Evan Solomon, shown at a news conference in Vancouver on May 11, announced details of health data project Vital on Monday.Rich Lam/The Canadian Press
“It’s kind of like Team Pitchforks and Team Pom-Poms,” Mr. Solomon said about the divided public sentiment at an event in Toronto last Monday. “We are going to be Team Pragmatic.”
Against that backdrop, 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 and Amol Verma, 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. Health care 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.”
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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.”
Those systemic issues “have been barriers to Canada’s global competitiveness in clinical trial investment,” Gaby Bourbara, president of drug giant AstraZeneca PLC’s Canadian arm, said in an e-mail.
Dr. Razak said Canada’s share of the global market for clinical trials fell from 6 per cent in 2010 to 3 per cent in 2022, representing $2-billion a year in lost investment.
At the same time, places such as Britain and Denmark invested heavily to harness their health care data and increased engagement with the private sector.
“That means we lose billions in annual investment and have slower access to new therapies for patients,” said Jaxson Khan, senior fellow at the Munk School of Global Affairs and Public Policy at University of Toronto.
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.
Dr. Verma pulls up a document outlining the Vital program. The plan is to expand the program nationally.Sammy Kogan/The Globe and Mail
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 per cent 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 health care 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.
With a report from Kelly Grant