Two pilot projects based on space technology hold the promise of reducing emergency department (ED) visits and improving patient outcomes in Canada.
The first project, which was launched on November 25 by the Integrated University Health Center for Social Services (CIUSSS), brings a telemedicine hub to Pierrefonds Local Community Service Center, a community healthcare center in the Montreal area.
The second project, which will be launched soon and run in parallel, will test the feasibility of using similar technology in an assisted living community, Villa Ste-Rose in Laval, Quebec, Canada, with residents with different levels of need.
Both initiatives use an autonomous care unit developed by Edmonton-based Baüne, a company focused on space medicine and technology that seeks to address preventable diseases and health disparities “from space to Earth and from Earth to space,” CEO Andrea Galindo told Medscape Medical News.
Originally designed to monitor the health of astronauts in space, the unit is an artificial intelligence–driven system with various devices that patients can use to check vital signs such as blood pressure, pulse, and blood oxygen level. It includes an interactive screen that provides patients with a comprehensive overview of their health, integrating information from a wearable device, medical devices, and an active emotion recognition vision sensor. The emotion recognition system operates in real time to enhance the decision support system.
The system has been adapted for clinical settings and can accommodate patients with disabilities and those in wheelchairs. Importantly, no footage is stored or saved, thus ensuring strict privacy compliance.
“We were developing this for our own needs for space, and they [CIUSSS] were looking for a way to cut into their waiting lists,” said David Saint-Jacques, an astronaut with the Canadian Space Agency, in The Globe and Mail. “What we want is what they want.”
“My dad passed away at a young age (51) and was generally a healthy man,” Galindo added. “His passing was probably due to a combination of stress factors, as well as some preventable health factors, that could have been taken into consideration earlier. Then perhaps this wouldn’t have happened.”
Many of the people working on the technology at Baüne have similar stories about people close to them who might have benefited from preventive health interventions, she said. “Our healthcare system is currently very reactive. Implementing preventive measures with technology won’t solve the whole problem, but it’s a start.”
Canada continues to face a shortage of family physicians, which is one reason that preventive healthcare often falls by the wayside. The CIUSSS initiative aims to address that shortage “by providing patients without a primary care physician the opportunity to undergo assessments and regular follow-ups,” said Stephen Rosenthal, MD, chief information officer, digital health officer, and chief technology officer for the Montréal West Island CIUSSS.
The tools developed in collaboration with the Canadian Space Agency “will be particularly useful in remote areas where access to care is limited,” he said. “Patients, selected from a list of those without a family doctor, are seen at the community healthcare centers offering standardized primary care services.”
“Based on an assessment by a nurse, they may be referred to a nurse practitioner, a family doctor, or, if necessary, to the ED,” he explained. “Care pathways have been established to ensure that patients receive timely attention, especially if their condition requires urgent intervention.” For the first phase of the project, the CIUSSS is targeting patients with specific illnesses who are waiting to be assigned a family physician.
The yearlong pilot is starting small, said Galindo, “but we’re looking to have a thousand patients before 12 months, and then scale drastically.” Baüne will refine the pilot as needed during that time and then expand it to other locations.
Although the project stakeholders are optimistic, some healthcare experts are concerned that patients who have waited years for a family doctor might be forced to settle for vital sign checks by the new technology, according to The Globe and Mail article.
The article quotes Lauren Lapointe-Shaw, MD, an internal medicine physician and researcher at the University of Toronto, Toronto, Ontario, Canada, who said, “We already have blood pressure cuffs in pharmacies. What worries me is that this is being sold as some kind of alternative to a family physician. It’s a very dramatic misunderstanding, I think, of what physicians can do for you, which is far beyond what a vital signs check can do for you.”
But Galindo is adamant that the technology “is designed to be a decision support system to alleviate some of the problems with the healthcare system, not to take over doctors’ jobs.”
The pilot at Villa Ste-Rose aims to evaluate whether and how the technology might improve the services already in place in the community, said general manager Jonathan Bélanger. “It could help us know our residents better, and by having more frequent data points for their vital signs, we might become aware early on that there’s a trend we don’t like. Then maybe we can be proactive instead of reactive. Instead of waiting for a clinical condition to emerge to the point where we would notice it, the technology might help us do some early assessments.”
Residents at Villa Ste-Rose have various degrees of autonomy, so findings from the pilot could provide value to patients across the spectrum, said Bélanger. “This technology will help us achieve much more than simply doing something like FaceTiming a patient because sometimes a clinician might be talking to individuals who can’t take vital signs by themselves or don’t know how to use the instruments. The autonomous care unit guides them step by step to ensure that the clinician gets standardized data.”
Furthermore, he said, “Some residents would be able to use the station independently and measure their vital signs more frequently, empowering them to provide our clinical team with almost real-time data, which would enable us to track health trends more quickly.”
Villa Ste-Rose has its own internal innovation hub, permitting start-ups and university teams to come into the community to test their technologies in a real-life care environment. New projects are assessed by an internal technology committee of caregivers, auxiliary nurses, care coordinators, and Bélanger, who is an engineer. “We make sure that everyone is aligned and that the technology is a good fit for our residents,” he said. Participation in a project is voluntary, and participants are enrolled through staff outreach to families.
The autonomous care unit is a fit, and the Villa Ste-Rose team is working closely with Baüne on how the project will unfold and be implemented, Bélanger said. “Integration into the daily workflows is a priority, so we’re focused on ensuring that residents and the staff feel comfortable using the system and that it’s deployed properly in the coming months.”
Rosenthal views the CIUSSS project as a model for organizations globally. “Overall, this technology represents a promising advancement in improving access to care, not only in Canada but also in other countries, particularly in regions where medical care is difficult to access,” he said. “It’s an exciting project that could, in the future, transform primary care, especially in urgent or geographically isolated contexts.”
Galindo has been participating in several Canadian Trade Commissioner programs in the United Kingdom, Germany, Mexico, and Dubai. “We’ve gotten attention to the point that representatives of these countries are waiting to see the results of our pilots. I do believe the impact could be global, but we need to go one step at a time to build something strong and reliable.”
For now, she added, “We are working directly with representatives in these regions and countries to understand how to adjust the technology for the location,” she said. “It’s not one-size-fits-all. We need to address language, we need to address cultural practices, and we need to address the environment the unit is in. All that must be taken into consideration as we move forward.”
Galindo, Bélanger, and Rosenthal reported having no relevant financial relationships.
Marilynn Larkin, MA, is an award-winning medical writer and editor whose work has appeared in numerous publications, including Medscape Medical News and its sister publication MDedge, The Lancet (where she was a contributing editor), and Reuters Health.
