We will both be speaking. I will start this off, and then I will pass it on to my colleague, Dr. Milne.
Thank you for this opportunity.
My name is Feng Chang. I'm an assistant professor with the School of Pharmacy at the University of Waterloo, as well as the chair of rural pharmacy with the Gateway Rural Health Research Institute.
I will start by talking briefly about what Gateway is all about and why we're here. I will give two quick examples of the types of research we have been involved in that demonstrate a link to technological applications. Then I will pass it on to Dr. Milne, and he will wrap it up.
Gateway Rural Health Research Institute is the first community-driven centre for rural health research based in Canada. It was established in 2008 in a farming community in southern Ontario, in Huron County.
Gateway's mission is to improve the health and quality of life of rural residents through research, education, and communication. In the last few years we have established collaborations with a number of academic institutions, working with the University of Waterloo, Western University, and Georgian College, specifically to bring some of their education programs to the rural communities via distance learning. We also have a diverse research team with seven research chairs in areas ranging from seniors wellness to mental health to healthy sustainable communities.
We are interested in chronic disease prevention and management because, as Mary mentioned earlier, the burden is significant, but the burden is disproportionately higher in rural communities. Depending on the definition you use, 19% to 30% of Canadians live in a rural area. Past studies have already shown that life expectancies and disability-free life expectancies are shorter in rural communities. There is also a higher incidence of chronic illnesses when it comes to smoking, heavy drinking, and obesity. As well, even in our very own area in Huron County, there are higher incidences of hypertension, obesity, and chronic lung diseases. These are as compared with the Canadian average.
We see technology as a method of support to implement better measures for prevention as well as management.
I'm also a practising pharmacist with a specialty in geriatrics or working with older people. I'll give two quick examples of the types of research that I've been involved in with Gateway as well as with the School of Pharmacy.
When we talk about apps, and there are so many of them, a lot of them are targeted toward seniors or older patients. For example, medication adherence is a huge problem. There are a lot of reminders or calendar systems out there on the market that promote having users more independently track their medications, to take them at the appropriate times, etc.
We did a project at the School of Pharmacy working with some seniors and using these senior-directed health apps. It was interesting, because there were things that just weren't taken into consideration when it came to development. For example, the volume might have been too low and people weren't able to decipher what the app was saying. Also, there could be a button that the user would touch that would bring the user to the next window. This was considered self-explanatory to the developers or to users who are more familiar with Word or laptops or desktops, but it wasn't to all the users from an older patient perspective. There are certainly some gaps that we can aim to fill in that area.
Another example was using point-of-care technology applications, especially when it comes to diagnostics. Geographical areas in rural communities are quite expansive and we have a shortage of specialists or even of community primary physician support. I'll use INR testing as an example.
Patients who are on warfarin, which is a lifelong anticoagulant used to prevent heart attacks and strokes, have to receive this on a weekly to monthly basis for as long as they are on this medication. They need to go to a physician for a lab rec, which they take to the lab and get the test done. They go home and the lab takes a day or so to get the results back to the physician. They either go back to the physician or get a phone call, and then they go to a pharmacy to get their medication.