The influence of artificial intelligence (AI) is driving transformation in healthcare systems in parallel with similar disruption in other sectors and society at large. In this article, we draw on Kueper and Pandit's (20...The influence of artificial intelligence (AI) is driving transformation in healthcare systems in parallel with similar disruption in other sectors and society at large. In this article, we draw on Kueper and Pandit's (2025) paper to emphasize that this global infusion of AI requires immediate attention from the world's largest group of healthcare practitioners. Nurses have a critical role to play not only in how this technology will change healthcare delivery and their professional practice but also in how it will change the world. Promising nursing-led AI initiatives include improved clinical decision making and prediction, personalized care, digital documentation and resource allocation.
Artificial intelligence (AI)-enabled tools are transforming healthcare, offering potential benefits such as alleviating administrative burdens, optimizing workflows and supporting diagnostics and personalized treatment f...Artificial intelligence (AI)-enabled tools are transforming healthcare, offering potential benefits such as alleviating administrative burdens, optimizing workflows and supporting diagnostics and personalized treatment for improved patient outcomes. With the increasing availability of AI-enabled tools, it is important to consider the potential for both benefit and harm and what is needed to support generalizable and beneficial, equitable progress. This paper provides a brief history of AI advancements leading to the current state in Canada, reviews trends in applications and research, and discusses the balancing act between achieving positive and negative outcomes. Woven throughout are high-level overviews of concepts and references to key initiatives, regulations and guidelines relevant to the Canadian context as well as more in-depth, contrasting examples to highlight how the apparent explosion of AI is happening at varied paces across applications, specialties and regions. The piece includes system- and population-level perspectives on suspected future implications and needs as the number and type of AI-enabled tools used in healthcare increases.
The application of artificial intelligence (AI) in healthcare is not a "flash in the pan." As Howell et al. (2024) have described, AI has been evolving since the 1950s, from decision trees to machine learning to generati...The application of artificial intelligence (AI) in healthcare is not a "flash in the pan." As Howell et al. (2024) have described, AI has been evolving since the 1950s, from decision trees to machine learning to generative AI that can create new content. These developments were foreshadowed by science fiction writer Isaac Asimov in a story first published in 1942 in which he outlined three rules of robotics, to the effect that they must not harm humans (Asimov 1950). Fast forward to 2015; Ashrafian (2015) proposed an additional law for AI systems that interact with each other: "all robots endowed with comparable human reason and conscience should act towards one another in a spirit of brotherhood."
Healthc Pap
· 2025 Jan · PMID 40116252
·
Publisher ↗
In responding to the reforms proposed in Medicare Makeover, our peers provide valuable insights and suggestions. We appreciate, for instance, underscoring complexities inherent in implementing our call for evidence-base...In responding to the reforms proposed in Medicare Makeover, our peers provide valuable insights and suggestions. We appreciate, for instance, underscoring complexities inherent in implementing our call for evidence-based processes to define publicly-funded services and concerns regarding variation in accessibility and coverage standards across Canada. While some responses advocate for greater federal direction, we argue that fractured accountabilities have contributed to current challenges. It is essential that reforms establish a clear line of accountability: the federal government must ensure provinces, territories and Indigenous governments implement transparent processes to set standards for reasonable access and coverage and, in turn, provincial, territorial and Indigenous governments must be accountable for delivering on those standards to their voters.
Healthc Pap
· 2025 Jan · PMID 40116251
·
Publisher ↗
In "Medicare Makeover: Reimagining the Canada Health Act at 40," Flood and Thomas (2025) study access and comprehensiveness in the (1985). They note a decline in timely access to care and advocate for the establishment...In "Medicare Makeover: Reimagining the Canada Health Act at 40," Flood and Thomas (2025) study access and comprehensiveness in the (1985). They note a decline in timely access to care and advocate for the establishment of benchmarks for access, suggesting provinces should meet those standards in exchange for federal funding. They call for a re-evaluation of what constitutes "medically necessary" services, proposing a broader list of supports while ensuring equitable access regardless of financial status. Building on their recommendations, we argue for deeper systemic reform to Canadian medicare. Collaborative care models and decision making by local teams will enhance service delivery and outcomes. We also expand on the process for determining insured services, including a multi-government task force and public consultation. We suggest that proactive measures should be implemented immediately while advocating for a stronger legislative framework as proposed by Flood and Thomas to ensure the sustainability of Canadian medicare.
Healthc Pap
· 2025 Jan · PMID 40116250
·
Publisher ↗
Should oral healthcare be part of Canada's universal healthcare system? If so, how? To effectively deal with oral healthcare within broader healthcare policy, we must first gain clarity on what comprehensiveness and acce...Should oral healthcare be part of Canada's universal healthcare system? If so, how? To effectively deal with oral healthcare within broader healthcare policy, we must first gain clarity on what comprehensiveness and access should mean for oral healthcare. To do this, we will need a fair process of deliberation to determine what Canadians think is a reasonable level of oral health and what oral healthcare services go alongside it, irrespective of how that ultimately becomes organized, financed and delivered.
Healthc Pap
· 2025 Jan · PMID 40116249
·
Publisher ↗
The 40th anniversary of the (CHA) (1985) comes at an auspicious time in healthcare history, having just experienced a major global pandemic that tested both the foundations and the flexibility of Canadian medicare. Seve...The 40th anniversary of the (CHA) (1985) comes at an auspicious time in healthcare history, having just experienced a major global pandemic that tested both the foundations and the flexibility of Canadian medicare. Several services suffered under the pressure of the pandemic, including mental health. Despite its historic position as a public or charitable service, mental health and addiction care has been pushed to the edges of our publicly funded health system. On this anniversary of the CHA, the author reflects on this historical trajectory by revisiting the origins of medicare and the impact of psychiatric deinstitutionalization.
Healthc Pap
· 2025 Jan · PMID 40116248
·
Publisher ↗
As pressure mounts to improve access to the front door of Canada's health systems, primary care has become a lightning rod. The (CHA) (1985) has the necessary components to help health systems achieve shared goals, but...As pressure mounts to improve access to the front door of Canada's health systems, primary care has become a lightning rod. The (CHA) (1985) has the necessary components to help health systems achieve shared goals, but it has not been sufficient to meet contemporary challenges. Unimaginative and over-restrictive interpretations of this iconic legislation by federal and provincial/territorial governments, as well as opportunistic workarounds of private actors, are pushing health systems away from the vision of the Act's authors and the expectations of Canadians. Nowhere is this more critical than in primary care. Public expectations of primary care have been profoundly shaped by the CHA, and we suggest leveraging the well-timed and rigorously produced OurCare Standard to guide the path forward. While legislative reform is an option to achieve the Standard and the CHA principles, another is a pan-Canadian health organization mandated to build equity and evidence-informed recommendations for public coverage, bolstering the CHA rather than re-opening it.
Healthc Pap
· 2025 Jan · PMID 40116247
·
Publisher ↗
The (CHA) (1985) has fostered gaps in Indigenous healthcare services, through its ambiguous inclusion of Indigenous communities without acknowledging their unique needs and failing to engage the fact that provincial/ter...The (CHA) (1985) has fostered gaps in Indigenous healthcare services, through its ambiguous inclusion of Indigenous communities without acknowledging their unique needs and failing to engage the fact that provincial/territorial, federal and Indigenous governments all act as primary care providers. While the CHA symbolizes Canada's commitment to equitable access, Canada has not respected this principle when it is the healthcare provider. The paper argues for a modernization of the CHA to remedy these deficits, or federal intervention through regulations, and not waiting on the enactment of distinctions-based Indigenous health legislation which may never be passed.
Healthc Pap
· 2025 Jan · PMID 40116246
·
Publisher ↗
This commentary responds to Flood and Thomas (2025) by focusing on the often-overlooked principle of portability in the (1985). It argues that Canada's healthcare system remains essentially the sum of its parts: provinc...This commentary responds to Flood and Thomas (2025) by focusing on the often-overlooked principle of portability in the (1985). It argues that Canada's healthcare system remains essentially the sum of its parts: provincial and territorial health plans, guided by similar values, adhering to principles that have financial strings attached and together by portability and the spirit of reciprocity. To strengthen this sense of shared purpose and responsibility, we need to allow space for the federal government to encourage such reciprocity and to find ways of allowing intergovernmental relationships between the provinces/territories to be enhanced.
Healthc Pap
· 2025 Jan · PMID 40116245
·
Publisher ↗
The (CHA) (1985) stands as a symbol of Canada's commitment to universal healthcare. However, there remain critical gaps that undermine the original vision of equity in healthcare. In this rejoinder to Flood and Thomas's...The (CHA) (1985) stands as a symbol of Canada's commitment to universal healthcare. However, there remain critical gaps that undermine the original vision of equity in healthcare. In this rejoinder to Flood and Thomas's (2025) analysis, we recommend a fundamental reinterpretation of the CHA to address persistent inequities. While the CHA has succeeded in removing financial barriers to medically necessary services, it has not fully achieved vertical or horizontal equity. A broader understanding of equity, extending beyond income, is necessary to address deeper, structural determinants of health. We provide theoretical reflections on equity and applied examples to advance our policy recommendations.
Healthc Pap
· 2025 Jan · PMID 40116244
·
Publisher ↗
Although the (CHA) (1985) has largely achieved its original purpose over the past 40 years, the challenges facing the Canadian health system today call for substantive updating and strengthening. This CHA 2.0 would reco...Although the (CHA) (1985) has largely achieved its original purpose over the past 40 years, the challenges facing the Canadian health system today call for substantive updating and strengthening. This CHA 2.0 would recognize a major shift in primary care and include as insured services primary care providers beyond physicians. Other areas that should be addressed include ensuring substantive and timely access to insured services (with a proposed primary care guarantee) and provisions for greater transparency and accountability. These improvements would be better achieved through a CHA 2.0 and a more accountable Canada Health Transfer rather than companion legislation or time-limited federal transfers to provinces and territories. Unlike the CHA, companion legislation would be more easily dismantled by future governments and work against efforts to better integrate health services.
Healthc Pap
· 2025 Jan · PMID 40116243
·
Publisher ↗
The 40th anniversary of the (CHA) highlights Canada's commitment to equitable healthcare but underscores its core failing: fractured accountabilities between federal and provincial governments. This misalignment perpetu...The 40th anniversary of the (CHA) highlights Canada's commitment to equitable healthcare but underscores its core failing: fractured accountabilities between federal and provincial governments. This misalignment perpetuates inadequate access to primary and specialist care and outdated standards of comprehensiveness, excluding critical services like outpatient pharmaceuticals and mental healthcare. To address these gaps, the CHA requires a fundamental update. We propose a solution: the federal government must require, as a condition for funding, that provinces and territories implement a transparent, evidence-based process to establish clear benchmarks for accessibility - such as wait times - and define the scope of universal publicly funded services. By ensuring the CHA is fit for purpose, it can meet the healthcare needs of Canadians for another 40 years.
Healthc Pap
· 2025 Jan · PMID 40116242
·
Publisher ↗
This special issue marks the 40th anniversary of the (1985). Though it remains an iconic symbol of national pride, it may not be untouchable. The papers in this issue critically examine the strengths and limitations of...This special issue marks the 40th anniversary of the (1985). Though it remains an iconic symbol of national pride, it may not be untouchable. The papers in this issue critically examine the strengths and limitations of the in the context of persistent health system challenges and gaps in coverage. They also provide constructive recommendations for a path forward for a reimagined legislative framework to better achieve the agreed-upon goals of reasonable and equitable access to a comprehensive basket of health services in Canada.
Healthc Pap
· 2025 Jan · PMID 40116241
·
Publisher ↗
A new book, by Greg Marchildon, of interest to all health system leaders, provides a riveting and detailed account of the origins of our health system by tracing the life and influence of arguably one of the greatest Can...A new book, by Greg Marchildon, of interest to all health system leaders, provides a riveting and detailed account of the origins of our health system by tracing the life and influence of arguably one of the greatest Canadians.
The evolving concept of "[a]geing in the right place (AIRP)" (Iciaszczyk et al. 2022: 1) underscores the importance of enabling older adults to receive comprehensive care and support across various settings. There is gro...The evolving concept of "[a]geing in the right place (AIRP)" (Iciaszczyk et al. 2022: 1) underscores the importance of enabling older adults to receive comprehensive care and support across various settings. There is growing evidence that innovative technologies can empower more persons to maintain their autonomy while better ensuring their safety, well-being and quality of life and also improve the experience of family caregivers and paid care providers. While there exists a powerful belief that technologies can solve all problems, the reality is that they can also present risks, particularly around cybersecurity, privacy and ethical concerns and not deliver any real benefits and in some cases, cause users harm. This paper summarizes a number of pragmatic strategies for addressing these challenges and maximizing the impact of technology in supporting AIRP.
Technology to support aging in the right place (AIRP) has much promise, but the potential is not yet being met. In their paper outlining the opportunities and challenges in the use of technology to support AIRP, Kokoreli...Technology to support aging in the right place (AIRP) has much promise, but the potential is not yet being met. In their paper outlining the opportunities and challenges in the use of technology to support AIRP, Kokorelias et al. (2024) provided a roadmap for the next steps. Our commentary focuses on two questions they raised: (1) How can technology be designed and developed to better meet the specific needs, preferences and abilities of older adults? (2) How do we evaluate technology in natural settings? Widespread technology adoption will emerge from consideration of the users; an understanding of their unique needs; iterative participatory design and user testing; and support for facilitating conditions to ease deployment into people's lives and minimize abandonment.
While residential long-term care (LTC) settings can be the places to age well, they have received relatively little attention in research and policy conversations about technology. In this commentary, we discuss how tec...While residential long-term care (LTC) settings can be the places to age well, they have received relatively little attention in research and policy conversations about technology. In this commentary, we discuss how technologies are currently being integrated into LTC, the ethical challenges and considerations this raises and the potential for improving how technologies are designed and implemented to empower and make the lives of older residents better. We advocate for innovative policy reforms and standards to ensure that technology design and development are equitable and inclusive and better aligned with the wishes and values of older adults and their families.
In their insightful commentary, Kokorelias et al. (2024) explore the potential of technology in supporting aging in the right place, addressing both opportunities and challenges from individual to societal levels. Our co...In their insightful commentary, Kokorelias et al. (2024) explore the potential of technology in supporting aging in the right place, addressing both opportunities and challenges from individual to societal levels. Our commentary specifically focuses on recent empirical evidence for technology's benefits in enhancing social connectivity and reducing loneliness for older adults, both with and without cognitive impairments. It emphasizes the need for a proper balance between the use of technology and face-to-face interactions and highlights the importance of addressing concerns related to privacy, cybersecurity and safety in this domain. In addition to the barriers outlined by Kokorelias et al. (2024), we discuss challenges related to the transfer of technology, the necessary steps required to ensure that technological interventions are effective beyond well-controlled studies and the responsibility of industries to design technology in such a way that innovations can benefit as many people as possible.
The aging population presents pressing societal challenges, emphasizing the importance of aging in the right place to support older individuals' quality of life. Technology can play a crucial role in facilitating aging i...The aging population presents pressing societal challenges, emphasizing the importance of aging in the right place to support older individuals' quality of life. Technology can play a crucial role in facilitating aging in place by enabling multiple factors such as remote healthcare monitoring, social connectivity and access to essential services. However, several challenges must be addressed to ensure widespread adoption and effective usage of technology among older adults. From integrating digital literacy into the United Nations' Sustainable Development Goals (United Nations n.d.) to promoting co-creation and fostering intergenerational dialogue, multiple solutions can be envisioned. This commentary emphasizes these opportunities, discusses these issues and provides a set of recommendations.