Family doctor honoured for ‘big idea’

When it comes to big new ideas in family medicine in this country, the biggest comes from a Halifax family doctor. That’s not just an opinion. Last week, delegates to the annual conference of the College of Family Physicians of Canada (CFPC) voted a concept presented by Halifax family physician Dr. Ajantha Jayabarathan — widely known as Dr. AJ — as the winner of the CFPC’S annual Big Ideas Soapbox contest.

The Big Ideas session at the virtual CFPC conference heard from four finalists, after whittling down submissions from family doctors across Canada, and then named Dr. AJ’S presentation the best.

So, what exactly was her big idea?

Imagine if a family doctor, with a glance at a computer screen, could review the external factors that, based on where a particular patient lives, can impact that person’s health.

Imagine software that, by using colour-coded maps and simple graphics, could inform physicians about their patients’ socioeconomic, environmental and other circumstances, all of which have been conclusively linked to health outcomes.

Such a tool could potentially help family physicians — and other health-care providers — provide more focused, effective care.

That, in a nutshell, is Dr. AJ’S big idea. It was developed over the last year with the help of Dalhousie University engineering students and Esri Canada.

It’s great to see a Nova Scotia-based physician getting such recognition, of course.

But beyond that, it’s also a signpost of the direction medicine increasingly must be taking.

Virtual health care, which has expanded during the pandemic, is going to keep playing an enhanced role in our lives well into the future.

Doctors will continue being in short supply, especially in rural areas. Virtual care — which makes distance irrelevant — improves access to the health-care system.

Let’s look at how Dr. AJ’S big idea would work in practice.

In her presentation at the CFPC conference — titled Geoview, an Essential Component of Virtual Care — she takes a hypothetical example of a new patient, Maggie, with two children, one with autism, who lives in Cumberland County with aging parents. Maggie has just contracted COVID-19.

Once Dr. AJ puts Maggie’s address into Health Geo-view, up pops a screen displaying all kinds of socio-economic information about where she lives, including income levels, age distribution, ethnicity, etc. A factor called dependency ratio (the percentage of dependents, young and old, relative to those of working age) measures the capacity for caregiving within families and communities.

One map shows locations of specialists, pharmacies and other health-care providers in relation to where she lives. Another offers drive-time analyses to show the time that would be required for that patient, in normal conditions, to physically go to a given healthcare provider.

All this knowledge is useful in knowing how to best treat Maggie.

Health Geo-view can also display the location of all Dr. AJ’S patients, so she quickly knows which have to come the furthest for an in-person visit. Some of her patients, Dr. AJ told me, actually travel up to five hours just to spend 15 minutes with her.

The tool also maps environmental risk factors like radon and arsenic. That can be used, she said, to warn patients living in areas with dangerous concentrations and also to proactively screen people who might be at higher risk of lung and kidney cancer.

Dr. AJ’S health-care mapping concept and the other finalists’ big ideas will all be written up in the CFPC’S journal. Because presentations were recorded, family doctors from across Canada will also be able to watch or rewatch them on their own time.

Dr. Jayabarathan has been nurturing this idea for a decade.

Sadly, she attempted, at various times, to interest governments of the day, as well as the Nova Scotia Health Authority, in the concept but was consistently rebuffed.

Perhaps now the idea will finally get more traction in her home province.

The next step, says Dr. AJ, is working with commercial providers of health-care information systems, like electronic medical records (EMRS), patient health records, hospital information system and others, so her mapping tool can be integrates seamlessly.

More research is also planned to make the use of data “even more robust,” she says.

Dr. AJ says she has no interest in profiting from the concept. Details about how to maintain the software still have to be worked out, but she wants, as much as possible, to give it away.

“My feeling is that this should be available to all doctors and the health information systems that are in hospitals.”

Dr. AJ calls it “the dandelion effect; for it to seed wherever it can.”