Clicking into healthcare: How newcomers to Canada perceive and experience virtual care

 

From finding housing to employment, the process of settling in a new country brings exciting opportunities and challenges. Accessing health care is one of the many hurdles newcomers face when they arrive in Canada. Virtual care became the primary mode of health care delivery in the wake of the COVID-19 pandemic, and like many Canadians, newcomers had to adapt to this new reality.

While the transition to virtual care was imperative, it introduced new difficulties for healthcare providers and patients alike. For newcomers, who were already navigating new systemic processes and experiencing marginalization on their settlement journeys, virtual care was yet another service to adapt to. Dr. Ibukun Abejirinde, a 2022 AMS Fellow in Compassion and AI, sought to understand how newcomers perceived virtual care and what barriers and opportunities arose.

As a Scientist at the Institute for Better Health at Trillium Health Partners, Dr. Abejirinde is an expert on how digital transformation can advance health care access and health equity for marginalized groups. She used her expertise to examine the added complexity that migration brings to a patient’s experience with virtual care.

“Ibukun’s work seamlessly advances scientific rigour, practical relevance, and a health equity agenda. While that is remarkable in and of itself, it only scratches the surface of Ibukun’s impact. It is how Ibukun builds and advances her program of work that is exceptional. She is values driven in all that she does, building capacity in others and modelling what it means to be a compassionate innovator in healthcare,” endorsed Dr. Laura Desveaux, the Scientific Director of the Institute for Better Health at Trillium Health Partners and a 2020 AMS Fellow.

In partnership with three community-based service providers, she interviewed newcomers and health care providers about their virtual care experiences. She found that health care was often not a first priority for newcomers as they prioritize housing, employment, and enrolling their children in school. Newcomers’ perception of virtual care was largely shaped by their experience with settling in Canada. Those with a more difficult transition as a result of racism and discrimination, particularly newcomers from African and Middle Eastern countries, were more hesitant about virtual care. On the contrary, the more settled newcomers became with secure housing and employment, the more they appreciated the flexibility and ease of virtual care.

With the rapid rise of digital health technologies and AI, their design and implementation need to be equitable and inclusive. Dr. Abejirinde advocates for bringing people with lived experiences into the health systems design and improvement processes. They have the ability to highlight existing inequities and inform responsive solutions. Currently, she is fostering connections and generating implementation ideas by collaborating with several stakeholders from community-based providers, primary and regional health care services, and various newcomer groups including people with lived experiences.

“It’s about who are we leaving behind. What are the resources that the system needs that are not there? If the majority is 80 percent of people, we’re not thinking about the needs of the 20 percent that are left behind. But I feel like the 20 percent should be prioritised. Everybody deserves the right to good health, because good health is integral to everything else you do in your life,” said Dr. Abejirinde.

When health systems are designed with marginalized patients in mind, it will also meet the needs of the majority. Compassionate health technologies should be viewed as a tool that will enable health care providers to find more time, space, and capacity to do exactly that—provide compassionate care. Immigrants make up nearly a quarter of Canada’s population[1] and are essential to Canada’s growth and workforce and its cultural richness. With collaborative efforts, newcomers and immigrants can access the health care they need to thrive. “There’s no algorithm for compassion. There’s no predictive model for compassion. And the only thing that technology will not be able to do is human compassion,” she said.

Dr. Abejirinde shared that the AMS Fellowship gave her the freedom and flexibility to pursue an area of research that did not have mainstream interest. Through AMS funding, the support of the AMS Healthcare community, and mentorship, she has grown a passionate team of researchers seeking answers to overlooked questions. The fellowship helped her hone her skills, confidence, and competency as a health care leader.

Since her AMS Fellowship, Dr. Abejirinde has received an AMS Grant for her e-COMPASS project, which will co-design and test an intervention to address compassion fatigue in refugee-serving community organisation. She is a Network Solution Member on a Canadian Institute for Advanced Research (CIFAR) funded project aiming to ethically deploy AI models for predicting and preventing Type 2 Diabetes. Furthermore, Dr. Abejirinde is collaborating with Ontario Health-Cancer Care Ontario to operationalise equity within learning health systems. Together, they are defining and testing a model that engage diverse voices to redesign the diagnostic phase of cancer care, informed by the lived experiences of Black, Francophone, and newcomer communities.

Dr. Ibukun Abejirinde is a Scientist at the Institute for Better Health at Trillium Health partners and an Assistant Professor (status) at the University of Toronto. She also holds an adjunct Scientist role at Women’s College Hospital Institute for Health System Solutions and Virtual Care (WHIV). With a background in clinical medicine (MD) and transdisciplinary global health, her research program focuses on translating health equity within learning health systems.

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1Statistics Canada. (2022, October 26). Immigrants make up the largest share of the population in over 150 years and continue to shape who we are as Canadians. Statistics Canada; Government of Canada. https://www150.statcan.gc.ca/n1/daily-quotidien/221026/dq221026a-eng.htm

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Read Dr. Ibukun Abejirinde’s Publications:

Abejirinde I, Ha E, Nguyen MD, Kaur D, Redditt V. Beyond Technology: Digital Health Compassion for Canadian Immigrants and Refugees. Canadian Diversity. 2023;19(4):10-14.

Abejirinde I, Khawari M, Lee KG, Herrera JV, Hailemariam S, Ddembe F, Hamra A. Digital Crossroads: Stories of Two Newcomers with Virtual Care [Comic]. 2024.