Current research interests and expertise

Dr. Elizabeth Borycki, HBSN (Lakehead) RN, MN (Manitoba), PhD (Toronto)

Dr. Elizabeth Borycki joined the University of Victoria in 2005 and she is currently an Associate Professor in the School of Health Information Science and also an Adjunct Associate Professor in the School of Nursing. She has conducted pioneering research in safety of healthcare information systems and education in nursing informatics. Prior to coming to UVic Professor Borycki has worked in numerous roles among them an Emergency Program Coordinator, Disease Management Specialist, Clinical Informatics Specialist, Consultant and Researcher. Elizabeth teaches organizational behaviour and change management, systems evaluation, quality improvement, research methods and biomedical fundamentals in the undergraduate and graduate programs. Her research interests include clinical informatics, organizational change management, health information system implementations, patient safety, project management and information seeking involving health information systems. Elizabeth has co-authored many papers examining the effects of health information systems upon Patient Safety. She has authored over 150 articles and numerous books.

Dr. Borycki has been a leading researcher in the world the area of reducing errors in healthcare and eSafety since 2004. Her work identified a new class of error, which is now termed “technology-induced error”. The focus of her research has been on developing methods and frameworks that can be used to address technology-induced errors prior to and after systems implementation. Dr. Borycki was also the founding Chair of the International Medical Informatics (IMIA) Working Group on Health Informatics for Patient Safety and is currently the Vice-Chair of this group. She is VP Special projects of the International Medical Informatics Association and co-chair of the scientific committee of the International Medical Informatics conference in China. Dr. Borycki recently spoke at COACH’s National eSafety Summit in Edmonton Alberta on October 27th, 2015. The title of the invited talk was about: “Improving Understanding and Education About Technology-induced Errors and eSafety: The University of Victoria Perspective.”

Dr. Elizabeth Borycki is also working on mobile health and is a coinvestigator on a research grant entitled “Caring near and far – a multi province investigation of remote monitoring technologies connecting community based older adults and their care team”. Led by a team of researchers from the University of Western Ontario (Dr. Regan and Dr. Donelle), the focus of the research will be on the development and scale up of a Remote Monitoring Home Care Model (RMHC). The work will build on an already established remote monitoring service in place in several provinces. The grant received $1,480,742 (cash and in-kind) from the Canadian Institutes of Health Research (CIHR): eHealth Innovations Partnership Program (eHIPP).

Dr. Karen L. Courtney, BA (University of North Carolina), BSN (University of North Carolina), MSN (Duke University), PhD (University of Missouri-Columbia)

Dr. Courtney’s area of research interest is broadly defined as health systems research. She is interested in how place or location can affect health outcomes on both an individual level and a population level. Some of her past research at an individual level has looked at how privacy in residential care facilities can affect an older adult’s decision to adopt information-based assistive technologies. On a population level, her research has examined nursing workforce distribution and community health outcomes. Her work on research grants includes the following:

Primary Investigator: R. Schulz, University of Pittsburgh (subcontract with Carnegie Mellon University Principal Investigator T. Kanade) Funding Source: National Science Foundation
Title: Quality of Life Technology Engineering Research Center (Person and Society Thrust)
Period: 2009-present

Primary Investigator: J. Lingler, University of Pittsburgh Funding Source: Steven D. Manners Faculty Development Award, University of Pittsburgh Title: Feasibility of a Web-Based Intervention to Improve Family Caregivers’ Communicative Skillfulness during Patients’ Medical Visits Period: 2010-2011

Dr. Alex Kuo, MBA (National Defense University of Taiwan), PhD (University of Nottingham)

Alex Mu-Hsing Kuo holds a PhD from the Department of Computer Science, University of Nottingham, UK and a MBA from the National Defense University of Taiwan. Dr. Kuo worked in Taiwan at the public and private sectors as well as at the Electronic Commerce Resource Center (ECRC), Georgia Tech. USA. Now, he is a visiting scholar at the School of Medicine, Stanford University.

Dr. Kuo's current research focuses are in health Big Data Analytics, health data interoperability, health database & data warehousing, data mining application in healthcare, e-health and clinical decision support system. Dr. Alex Kuo took his sabbatical leave opportunity to join the Center for Expanded Data Annotation and Retrieval (CEDAR) as a visiting scholar at the School of Medicine, Stanford University. The CEDAR was a newly funded Center of Excellence supported by the US NIH Big Data to Knowledge (BD2K) initiative. Its main objective was to create a unified framework that researchers in all scientific disciplines can use to create consistent, easily searchable metadata. Alex’s main work at CEDAR was to study new machine learning algorithm/tool for authoring good metadata and facilitating Big Data management. 

Recently, Alex Kuo and his associate Ken Tan have received a grant of $15,000 from the inaugural 2015 Collaboration Research Grant Competition sponsored by Island Health. The research will be based on the submitted abstract, “Design and Implementation of a Big Data Analytics Framework for Health Applications.”  Dr. Kuo is also running an IEEE sponsored educational initiative in big data worldwide.

Dr. Andre Kushniruk, BSc, BA (Brock), MSc (computer science - McMaster), PhD (cognitive psychology – McGill)

Dr. Andre Kushniruk is a Professor and Director of the School of Health Information Science at the University of Victoria. Dr. Kushniruk is also an Adjunct Professor in the faculty of engineering and science at Aalborg University, an Honorary Professor in the faculty of education at the University of Hong King and an adjunct associate professor at the Mt. Sinai School of Medicine in New York. He was previously an Associate Professor in Information Technology at York University. Dr. Kushniruk conducts research in a number of areas including evaluation of the effects of technology, human-computer interaction in health care and other domains as well as cognitive science. His work is known internationally and he has published widely in the area of health informatics with over 170 peer reviewed papers.

Dr. Kushniruk focuses on developing new methods for the evaluation of information technology and studying human-computer interaction in health care and he has been a key researcher on a number of national and international collaborative projects. His work includes the development of novel methods for conducting video analysis of computer users and he is currently extending this research to remote study of e-health applications and advanced information technologies, including computerized patient record systems. Dr. Kushniruk has held academic positions at a number of Canadian universities and he has taught courses in areas such as human-computer interaction, database management and systems analysis and design. He holds undergraduate degrees in Psychology and Biology, as well as a M.Sc. in Computer Science and a Ph.D. in Cognitive Psychology from McGill University. His current research interests and expertise include:

• Evaluation of the use and usability of information systems
• Design and evaluation methodologies
• eHealth and telemedicine
• Consumer health informatics
• Cognitive aspects of decision support systems
• Computerized patient record systems
• Intelligent information filtering
• Usability engineering
• Knowledge representation
• Design of health care user interfaces and human-computer interaction in complex domains
• Personalized medicine

Dr. Andre Kushniruk recently presented his work at the American Medical Informatics Association Fall meeting in San Francisco. This work focussed on research in the area of human factors of healthcare interoperability. The work was conducted with colleagues from the Bronx Veteran’s Affairs and has characterized usability issues and human factors issues that occur when attempting to integrate a large electronic health record system with patient information from a local health information exchange. The findings are being used to streamline and improve the exchange of information across systems and have implications for designing better user interfaces not just in the United States but also in Canada and internationally.

Dr. Kushniruk has recently published in the area of participative design for healthcare IT and is writing a paper on the Danish approach to providing citizens with a national eHealth portal, that allows all citizens (patients, health professionals and providers) secure and web-based access to their health data.

Recent work of Dr. Kushniruk in the area of personalized medicine has included collaboration with leading genomic researchers to develop useful end user interfaces for use by both physicians and genetic counsellors to provide genomic information through electronic health record systems and bioinformatics tools.

Dr. Claudia Lai, BSc (University of Toronto), MSc (University of Toronto), PhD (University of Toronto)

Dr. Claudia Lai is a clinician researcher with over 15 years of policy and research experience. Her research builds on her extensive professional experience from all levels of the health system (including home and community care, government, provider organizations, hospital, and academic settings). She holds a PhD in Health Services Research, Health Informatics, from the University of Toronto, Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health. After completing her PhD, she held a post-doctoral fellowship at the University of Laval in Shared Decision Making and Knowledge Translation. Since the pandemic, she has been working with patient partners who are highly motivated to fix health care. Together with community partners, she seeks to explore how individuals with lived experiences, caregivers and interdisciplinary health and social care providers can inform a more equitable health system. Her research draws on advances in theory and methodology to co-design and evaluate digital innovations to improve health care output quality and consequential outcomes for all.

Dr. Francis Lau, PhD (University of Alberta)

Dr. Lau is a Professor in the School of Health Information Science at the University of Victoria. Dr. Lau is a PhD graduate in medical informatics specialized in the design, implementation and evaluation of health information systems. He has a diverse background in business, computing and medical sciences, with 14 years of professional experience in the IT industry. Prior to joining the University of Victoria in 2001 he was an Assistant Professor in the Dept. of Accounting and MIS in the Business School at the University of Alberta. Dr. Lau's current research foci are in health information system evaluation, clinical vocabularies, and palliative care informatics. He is the recipient of the eHealth Chair funded by CIHR/Infoway to establish an eHealth Observatory to monitor the impact of health information system deployment in Canada.

Palliative Care Informatics Research – Since 2004, Dr. Lau has dedicated a substantial portion of his research effort to establishing a program of clinical informatics research within the domain of hospice palliative and end-of-life (HPEOL) care. He received a 5-year CIHR New Emerging Team grant in Palliative and EOL Care entitled “Overcoming Communication Barriers in EOL Transitions.” This was followed by a 3-year CIHR Partnership in Health System Improvement grant to “enhance access to EOL care through improved survival prediction.” Dr. Lau’s research is to improve HPEOL prognostication by clinicians with easy-to-use prognostic tools and routinely collected assessment data such as symptom distress and functional status. A tangible output to date is the creation of the largest known anonymized Palliative Performance Scale assessment database that can be used to examine survival patterns and dying trajectories of HPEOL patients from different care settings. He is currently leading a consortium of healthcare partner/collaborator organizations in BC, Alberta, Yukon and Ottawa to create a Canadian End-of-life Care Surveillance Team Network funded by the Canadian Partnership Against Cancer. For more detail of this surveillance network see: https://hpeol.phsa.ca/

Information System Research and Evaluation Methods – Dr. Lau has made a major contribution to advance the health informatics discipline in health information system (HIS) research and evaluation methods. He is the recipient of the CIHR/Infoway eHealth Chair award responsible for the creation of an eHealth Observatory to monitor the effects of HIS deployment in Canada. This mandate includes the development of rigorous yet pragmatic HIS evaluation models, methods and metrics for use by HIS practitioners and researchers. An example of the output to date is the Benefits Evaluation Framework that has now been adopted by Canada Health Infoway as the overarching Framework to evaluate the impacts of electronic health record (EHR) implementation initiatives across Canada. Another is the recent publication of a meta-synthesis of 50 HIS reviews on the current state of HIS knowledge with recommendations on ways to improve HIS adoption. Dr. Lau’s team has also created a Rapid Response Evaluation Method (RREM) toolkit that can be used to evaluate the adoption/use and impact of HIS. For more detail of the eHealth Observatory see: http://ehealth.uvic.ca/index.php

Adoption/Use and Impact of Health Terminology Standards – Another research area for Dr. Lau is in health information standards, especially with the reference terminology standard SNOMED CT. He was the Canadian representative on the Research and Innovation Committee of the International Health Terminology Standard Development Organization, where he had established an international reputation as one of the handful of terminology researchers in Canada with a focus on SNOMED CT adoption/use and impact issues. Dr. Lau has published scientific papers in SNOMED CT encoding methodologies and adoption/use issues. He has established an emerging research program in standards with the successful completion of a pilot project to explore clinical use of SNOMED CT in Alberta in 2008. He has a small team of research trainees and colleagues where the terminology related work is aligned with palliative and primary care as the clinical domains. Dr. Lau’s current work involves the cleaning and encoding of EMR data to improve its quality in physician offices. For more detail see: http://htg.his.uvic.ca/

Purpose and Design - This was a 30-month project to translate best practice knowledge in end of- life (EOL) care into a set of tools in the electronic medical record (EMR) for use by care providers in the community setting. The tools contain EMR specific data entry templates, query/reporting functions, and access to downloadable resources such as advance care plans. They are based on the EOL learning module from the BC General Practice Services Committee Practice Support Program to improve EOL care by primary care providers in the province.  This knowledge translation (KT) project had five stages: (1) needs assessment to identify EMR features that support best practices in EOL care; (2) tool design to define generic requirements and build EMRspecific tools; (3) tool dissemination to promote the adoption of the EMR-specific EOL care tools by providers; (4) documentation analysis to identify the extent that EOL care is captured in existing EMRs; and (5) EMR user feedback on the utility of the tools.

Participants and Outputs - This KT project involved primary care providers, palliative care specialists, informatics researchers, provider led/support organizations, healthcare organizations and EMR vendors/consultants. The outputs included: (1) a generic specifications blueprint document on EMR-supported EOL care; (2) specific EOL care tools for OSCAR, Profile and Med Access EMRs; (3) a Web-based method to distribute the tools; and (4) the tools being available in the Telus EMR template library for all Med Access EMR users and in the eForm library for all OSCAR EMR users. By the end of the project, there were 65 downloads of the tools with mostly favourable feedback from 23 survey respondents who had adopted the tools. The level of adoption was below expectation but explainable by the challenges faced by the project team as lessons learned.

Key Lessons - (1) primary care providers and provider led/support organizations are interested in adopting EMR supported tools to enhance EOL care; (2) despite best intent, it is difficult to engage providers due to competing priorities and demands; (3) existing EMRs are inadequate to document EOL care; (4) there is little attention from EMR vendors to support EOL care and provider workarounds have led to inconsistent EOL care documentation in EMRs; (5) inconsistent documentation has made it difficult to identify EOL patients; (6) there is a need for standardized approaches to document EOL care in EMRs that can be shared across providers and settings; (7) EOL care documentation should be consistent with how other chronic conditions are documented in EMRs to reduce provider cognitive overload; (8) alignment with healthcare organizations responsible for large scale change is needed to adopt, scale up and sustain EMR supported EOL care tools; (9) engagement of provider led/support organizations such as the Divisions of Family Practice in BC and research networks such as the Canadian Primary Care Sentinel Surveillance Network is critical to the success of KT initiatives such as this project; and (10) funders need realistic time frame and funding provision to increase the likelihood of success of large scale KT initiatives that bring transformative changes to the health system.

Dr. Helen Monkman BSc (Carleton), MA (Carleton), PhD (UVic)

Dr. Helen Monkman is an Assistant Professor and Undergraduate Advisor in the School of Health Information Science at the University of Victoria. She completed her PhD in the School of Health Information Science at the University of Victoria. She earned her BSc and MA in Psychology from Carleton University. Her mission is to improve consumer health information systems by making them easier for people to use and the information easier to understand. Through her work she seeks to empower people and help them make better health decisions as well as have better conversations with their health care providers. Her research interests include human factors, user experience, usability, information visualization, and eHealth or digital health literacy, and how these factors impact the use and understandability of consumer health information systems.

Current research interests of Dr. Monkman include the following:

• Consumer health informatics
• Human factors and ergonomics
• User experience 
• Health literacy, eHealth literacy, and digital health literacy
• Human or User Centered Design (HCD/UCD) of health information systems
• Design and evaluation of systems for health consumers with limited eHealth literacy
• Designing health information systems to meet the needs and capabilities of users
• Promoting patient engagement and participation in health care decision-making
• Design thinking
• Usability engineering
• Information visualization

Dr. Abdul Roudsari, BSc, MSc, PhD (London University)

Abdul Roudsari joined the School of Health Information Science as Director effective January 1, 2010. He received his BSc, MSc, and PhD. from London University with his PhD research being undertaken at Kings College London. Before joining the University of Victoria he taught at a number of higher education institutions in the United Kingdom. He was Professor of Health Informatics and Director of the Centre for Health Informatics (CHI) at City University London. He has been a member of the Centre since 1989, having had a particular involvement in a range of research projects concerned with the provision of decision support systems to diabetic patients. He has led a major innovative EU-funded home telecare project. This project has enabled the Centre’s already large number of international collaborations to be extended to groups in Portugal and Estonia. The research area of home telecare is one that offers opportunities for further substantial projects involving both specific application implementation studies as well as opportunities for research into evaluation methodologies.

Current research interests of Dr. Roudsari include the following:

• Electronic healthcare (eHealth): this has widely acknowledged potential to improve integration, quality, outcomes and costs in developed countries. Connecting for Health (CfH), in England, is the largest example of its kind in the world and is already at an advanced stage of development. However, there is relatively little work currently being undertaken to develop the potential of eHealth in developing countries. His research focus in this context would be based on existing research by his PhD students in the Gambia, Saudi Arabia, Iran and Mexico.
• Telecare and e-health: management of elderly and chronically-ill patients in their home environment using advanced healthcare technologies for home monitoring.
• Advanced and intelligent methods for the acquisition, processing and interpretation of data from the Electronic Patient Record and from the patient in the community for the purposes of developing Intelligent & Evidence-based Decision Support Systems for diagnosis, state prediction, management and prognosis.