Aviv Shachak

• PhD
• Professor (Full) at University of Toronto

Health systems globally are struggling with. common issues such as access, wait times, and the delivery of new models of care such as team-based care. While it has been argued that addressing our health crisis involves better implementation of known solutions, we argue that mindset is an overly simplified representation of health system implementat...

One in five Canadians lives with one or more chronic conditions. Patients with chronic conditions often experience a high treatment burden because of the work associated with managing care. Telehealth is considered a useful solution to reduce the treatment burden among patients with chronic conditions. However, telehealth can also increase the trea...

With the rapid adoption of telemedicine since the COVID-19 pandemic, it has become imperative to teach and evaluate health professional trainees on skills important to conducting effective virtual visits. We developed a simulation-based workshop with (1) readings, (2) a lecture covering online communication and the virtual head and neck exam, (3) a...

With increasing use of information and communications technologies (ICTs) in health, and rapid technological changes, there is a pressing need to prepare current and future health professionals to use ICTs as an integral part of their practice. We propose the Technological Literacy Framework, which includes 3 interlinked elements—knowledge, capabil...

The idea that actions of people, organizations or governments may lead to Unintended Consequences (UICs) is not new. In health, UICs have been reported as a result of various interventions including quality improvement initiatives, health information technology implementation, and knowledge translation, especially those involving translation of bro...

Background: The cause of physician burnout is multifactorial. Health care systems pressures, excessive workloads, fatigue, poor self-care, administrative burdens, work hours, technological advancements, and work-home life conflicts, are all prominent themes throughout the literature. To date, little is known about whether, and to what extent, stre...

Background The purpose of educational recommendations is to assist in establishing courses and programs in a discipline, to further develop existing educational activities in the various nations, and to support international initiatives for collaboration and sharing of courseware. The International Medical Informatics Association (IMIA) has publish...

The objective of this study was to describe and assess the quality of the direct-to-consumer medical teleconsultation landscape in three Canadian provinces. An environmental scan of primary care teleconsultation platforms was conducted in January 2022 to identify medical teleconsultation platforms in Quebec (Qc), Ontario, and British Columbia (BC)....

Background Shared decision-making (SDM), a collaborative approach to reach decisional agreement, has been advocated as an ideal model of decision-making in the medical encounter. Frameworks for SDM have been developed largely from the clinical context of a competent adult patient facing a single medical problem, presented with multiple treatment op...

Background Clinical documentation – the process to charting set forth by medical professional bodies – and its quality differ in minor yet critical ways from electronic medical record (EMR) data quality. Poor quality EMR data has significant downstream effects on the computational functions of EMRs, and evidence suggests that when patients’ EMR cha...

UNSTRUCTURED The decision to accept or reject new digital health technologies remains an ongoing discussion. Over the past few decades, interest in understanding the choice to adopt technology has led to the development of numerous theories and models. In 1979, however, psychologists Kahneman and Tversky published their seminal research article tha...

UNSTRUCTURED The decision to accept or reject new digital health technologies remains an ongoing discussion. Over the past few decades, interest in understanding the choice to adopt technology has led to the development of numerous theories and models. In 1979, however, psychologists Kahneman and Tversky published their seminal research article tha...

The decision to accept or reject new digital health technologies remains an ongoing challenge among health care patients, providers, technology companies, and policymakers. Over the past few decades, interest in understanding the choice to adopt technology has led to the development of numerous theories and models. In 1979, however, psychologists K...

BACKGROUND Shared decision-making (SDM), a collaborative approach to reach decisional agreement, has been advocated as an ideal model of decision-making in the medical encounter. Frameworks for SDM have been developed largely from the clinical context of a competent adult patient facing a single medical problem, presented with multiple treatment op...

To the Editor I read with great interest the article by Pantell et al. entitled “A Call for Social Informatics.”¹ The authors bring up a very important topic of capturing and using social data in combination with health data, and the need for new methods to capture and handle these data in ethical manner. While I applaud the authors for these ideas...

In the wake of COVID-19, clinicians took to telehealth to continue providing services to their patients, mostly via telephone or videoconferencing technology. Telehealth has many promised and proven benefits including convenience to the patient, potentially less distraction from the electronic health record (EHR), saves in travel time and expenses,...

BACKGROUND As COVID-19 moves the world towards virtual options, digital tools have become a viable means for patients to address their health and information needs. Governments and health care organizations are offering digital tools such as self-assessment tools, symptom tracking tools, or chatbots. In addition, other sources of digital tools are...

Background In recent years, digital tools have become a viable means for patients to address their health and information needs. Governments and health care organizations are offering digital tools such as self-assessment tools, symptom tracking tools, or chatbots. Other sources of digital tools, such as those offered through patient platforms, are...

Objective Shared Decision-Making (SDM) has been advocated as an ideal model of decision-making in the medical encounter. Much of the research into SDM has focused on measuring if SDM is happening, or facilitating SDM by developing specific models and tools. Understanding SDM as an activity in context, has remained mostly absent from the research. T...

Background Electronic medical record (EMR) use by primary care physicians (PCP) in the United States and Canada is suboptimal, especially for supporting chronic diseases like diabetes. PCPs need postimplementation training to achieve value-adding EMR use. Video tutorials demonstrate how to accomplish tasks using software. However, there is a dearth...

There is currently a paucity of evidence‐based strategies that have been shown to increase citations of peer‐reviewed articles following their publication. We conducted a 12‐month randomized controlled trial to examine whether the promotion of article links in an online cross‐publisher distribution platform (TrendMD) affects citations. In all, 3,20...

The Technology Acceptance Model (TAM) and Unified Theory of Acceptance and Use of Technology (UTAUT) have been used widely in studies of health information technology (HIT) implementation. However, TAM and UTAUT have also been criticized for being overly simplistic (TAM) and for taking a narrow perspective, which focuses only on individual adopters...

Objective: This study evaluated the potential for electronic medical record (EMR) video tutorials to improve diabetes (type 1 and 2) care processes by primary care physicians (PCP) using OSCAR EMR. Design: A QUAN(qual) mixed methods approach with an embedded design was used for the overall research study. EMR video tutorials were developed based...

The benefits of Health Information Technology (HIT) depend on the way they are being used. Education and training are often needed to move from basic to advanced, value-adding, use. In this article, we describe three educational approaches that can help in achieving this goal: “productive failure,” video tutorials, and simulation. We describe the r...

Canada has struggled to make digital health a reality. We identified 6 key issues that appear to impede progress: 1) an inability to coordinate the actions of a rapidly evolving set of stakeholders, 2) patients who lack the ability and resources to play a meaningful role in health system decision-making, 3) world-class innovation that doesn't reach...

This paper outlines a framework for identifying and classifying different types of patient engagement tools, available on online patient platforms, according to the flow of information and patient engagement concepts. We demonstrate the application of the framework using data collected from a purposive sample of eleven patient platforms, stratified...

This chapter discusses the evaluation of educational interventions in general, and interventions for preparing health care professionals to practice in the information and information and communication technology (ICT)-rich environment of the twenty-first century in particular. It starts by providing an overview of evaluation including the relation...

Medicine and medical education are changing, as rapid changes in technology occur. In Canada, two organizations—the Association of Faculties of Medicine of Canada (AFMC) and Canada Health Infoway (Infoway) recognized a need to prepare the next generation of physicians to practice in a digitally enabled practice setting. In response to recommendatio...

Health Professionals' Education in the Age of Clinical Information Systems, Mobile Computing and Social Networks addresses the challenges posed by information and communication technology to health professionals' education, and the lessons learned from field experiences and research. This book is divided in three parts: "the changing landscape of i...

Prior research shows that article reader counts (i.e. saves) on the online reference manager, Mendeley, correlate to future citations. There are currently no evidenced-based distribution strategies that have been shown to increase article saves on Mendeley. We conducted a 4-week randomized controlled trial to examine how promotion of article links...

Background Mobile phone screens can facilitate stimulation to various components of the visual system and many mobile apps are accepted as a means of providing clinical assessments for the oculo-visual system. Although many of these apps are intended for use in clinical settings, there is a growing number of apps in eye care developed for self-test...

Key points With over 6,000 new peer‐reviewed articles published daily, scholarly content providers face growing challenges of reaching their target audience. There are few evidenced‐based strategies for disseminating online scholarly content to a targeted audience. TrendMD increased weekly page views by 49% relative to baseline traffic for a group...

Objective Patient-clinician communication has been associated with increased patient satisfaction, trust in the clinician, adherence to prescribed therapy, and various health outcomes. The impact of health information technology (HIT) on the clinical encounter in general and patient-clinician communication in particular is a growing concern. The pu...

Electronic health records (EHRs) are becoming ubiquitous in healthcare practice. However, their use in medical education has been slower to catch on and a new category of EHRs is beginning to emerge known as eduEHRs. These systems allow learners to explore and experiment with EHRs in the context of medical education. However, current eduEHRs have l...

We previously developed a prototype computer-based simulation to teach residents how to integrate better EMR use in the patient-physician interaction. To evaluate the prototype, we conducted usability tests with three non-clinician students, followed by a pilot study with 16 family medicine residents. The pilot study included pre- and post-test sur...

hPurpose/Objective: As electronic medical records (EMRs) become ubiquitous, concerns have been raised about their impact on patient-clinician communication. Communication has been associated with patient satisfaction, conflict resolution, adherence to treatment, and a myriad of health outcomes. Research has shown that the use of EMRs affects patien...

Despite the growing interest in engaging patient in their health care process, particularly with technology, it is not clear how best to do so. Based on a narrative literature review and pilot analysis, we propose a preliminary framework to explore mechanisms used by social media platforms to engage users in health and information sharing processes...

Introduction and background: Although end-user support has been widely acknowledged as an important factor in health information technology (HIT) implementation [1] the ways in which it affects HIT success have rarely been studied. Here we present preliminary findings from a qualitative case study of the relationships between end-user support and a...

Patient-clinician communication has been associated with patient satisfaction, compliance/ adherence and better health outcomes. Although electronic medical records (EMRs) have many benefits, one concern that remains is their impact on communication and especially on psychological and emotional exchange, establishing rapport and maintaining eye con...

Background: In primary care settings, users often rely on vendors to provide support for health information technology (HIT). Yet, little is known about the vendors' perspectives on the support they provide, how support personnel perceive their roles, the challenges they face and the ways they deal with them. Objective: To provide in-depth insig...

To the Editor The Viewpoint by Drs White and Danis1 illustrated some of the ways in which using the EHR can enhance patient-physician collaboration and patient activation.We would like to point out some additional issues. First, patient-centeredness requires consideration of the patient’s perspective. Not only do the styles of physicians using the...

Support is considered an important factor for realizing the benefits of health information technology, but there is a dearth of research on the topic of support, especially in primary care. We conducted a qualitative multiple case study of four family health teams and one family health organization in Ontario, Canada in an attempt to gain insight i...

Health Information Technologies, such as electronic health records (EHR) and secure messaging, have already transformed interactions among patients and clinicians. In addition, technologies supporting asynchronous communication outside of clinical encounters, such as email, SMS, and patient portals, are being increasingly used for follow-up, educat...

Tutorials and user manuals are important forms of impersonal support for using software applications including electronic medical records (EMRs). Differences between user- and vendor documentation may indicate support needs, which are not sufficiently addressed by the official documentation, and reveal new elements that may inform the design of tut...

The objectives of this study are to 1) create a quality assessment tool for socio-demographic data aligned with the needs of Community Health Centres (CHCs) and based on the data quality framework of the Canadian Institute for Health Information (CIHI), and 2) test the feasibility of the tool in CHCs. The tool was developed based on both theoretica...

In this paper, we discuss the importance of face to face consultation. We argue that information systems such as electronic medical records (EMRs) have both positive and negative impacts on the patient-clinician interaction. We propose computer based game-like simulation as a tool for training clinicians in integrating EMR use into the consultation...

Purchasing electronic health records (EHRs) typically follows a process in which potential adopters actively seek information, compare alternatives, and form attitudes towards the product. A potential source of information on EHRs that can be used in the process is vendor websites. It is unclear how much product information is presented on EHR vend...

Support is often considered an important factor for successful implementation and realising the benefits of health information technology (HIT); however, there is a dearth of research on support and theoretical frameworks to characterise it. To develop and present a comprehensive, holistic, framework for characterising enduser support that can be a...

Background: Web sites with health-oriented content are potentially harmful if inaccurate or inappropriate medical information is used to make health-related decisions. Checklists, rating systems and guidelines have been developed to help people determine what is credible, but recent Internet technologies emphasize applications that are collaborati...

To develop a classification system to improve the reporting of observational studies of the use of information technology (IT) in clinical consultations. Literature review, workshops, and development of a position statement. We grouped the important aspects for consistent reporting into a "faceted classification"; the components relevant to a parti...

List of Journal's of General and Internal Medicine Included/Excluded and Comments. (DOCX)

Qualitative research appears to be gaining acceptability in medical journals. Yet, little is actually known about the proportion of qualitative research and factors affecting its publication. This study describes the proportion of qualitative research over a 10 year period and correlates associated with its publication.A quantitative longitudinal e...

The implementation of electronic health records (EHRs) holds the promise to improve patient safety and quality of care, as well as opening new ways to educate patients and engage them in their own care. On the other hand, EHR use also changes clinicians’ workflow, introduces new types of errors, and can distract the doctor’s attention from the pati...

Web sites with health-oriented content raise concerns about the potential for harm if members of the public use inaccurate or inappropriate medical advice to make health- related decisions. Checklists, rating systems and guidelines have been developed to help people determine what is credible, but recent Internet technologies emphasize applications...

The implementation of electronic health records (EHRs) holds the promise to improve patient safety and quality of care, as well as opening new ways to educate patients and engage them in their own care. On the other hand, EHR use also changes clinicians’ workflow, introduces new types of errors, and can distract the doctor’s attention from the pati...

The effect of Electronic Medical Record (EMR) use on Patient-Doctor Communication (PDC) has rarely been studied. As data accumulate, the purpose of this article is to review the literature on EMR effect on PDC, to identify recurring themes and to offer preliminary guidelines and future directions for medical education and research. A database searc...

Clinical practice guidelines are important instruments for improving the quality of care; in paper form, however, they are not used as effectively as possible. In order to develop a guideline-based decision support system (DSS) prototype to help clinicians deal with diabetic patients' foot problems, we drew on methodologies from qualitative researc...

To describe physicians' patterns of using an Electronic Medical Record (EMR) system; to reveal the underlying cognitive elements involved in EMR use, possible resulting errors, and influences on patient-doctor communication; to gain insight into the role of expertise in incorporating EMRs into clinical practice in general and communicative behavior...

Proper and timely diagnosis and management of diabet ic foot has major clinical and economic impact. Recently, w e have developed a DSS (1) for diabetic foot care based on written guidelines for diabetic foot disorders developed by the Ameri- can College of Foot and Ankle Surgeons (2). The encod ed guideline, in the GLIF3 (3) format, was linked wit...

Purpose This paper seeks to describe and discuss a tagging experiment involving images related to Israeli and Jewish cultural heritage. The aim of this experiment was to compare freely assigned tags with values (free text) assigned to predefined metadata elements. Design/methodology/approach Two groups of participants were asked to provide tags fo...

A recent development in biological research is the emergence of bioinformatics, which employs novel informatics techniques to handle biological data. Although the importance of bioinformatics training is widely recognized, little attention has been paid to its effect on the acceptance of bioinformatics by biologists. In this study, the effect of tr...

To date, primary care doctors' (PCDs) evidence-based medicine (EBM) skills have rarely been studied. We conducted a cross-sectional study to evaluate PCDs' practical EBM skills and to determine risk markers associated with these skills. The study sample consisted of 70 PCDs (70.7% response rate) practising in a busy urban setting from a large healt...

Attitudes and barriers to implementing EBM have been examined extensively, but scant evidence exists regarding the impact of EBM teaching on primary care physicians' point of care behavior. Gaining insight into behavioral and attitudinal changes of facilitators and participants during a multifaceted EBM educational intervention. A qualitative study...

In recent years there has been an explosion of biological data stored in large central databases, tools to handle the data, and educational programs to train scientists in using bioinformatics resources. Still, the diffusion of bioinformatics within the biological community has yet to be extensively studied. In this study, the diffusion of two bioi...

The need to support bioinformatics training has been widely recognized by scientists, industry, and government institutions. However, the discussion of instructional methods for teaching bioinformatics is only beginning. Here we report on a systematic attempt to design two bioinformatics workshops for graduate biology students on the basis of Gagne...

Dormancy-related inflorescence bud protein IBP32 of Pistacia vera (pistachio) was detected in the bark of pistachio showing immunological cross-reaction with bud and bark proteins of several phylogenetically unrelated species. In the bark of P. atlantica, a 32-kDa protein was detected. Other positive immunological reactions were obtained with a pro...