Current Projects
Smart Text Analytic Tools (STAT) for analysis of patient-centred communications to strengthen health systems in BC (British Columbia) Our team is using advanced information technologies, including information visualization, natural language processing and machine learning to develop a novel medical conversation analytics system (ConVIScope) to analyze patient and care provider communication data in the form of open language text. The four-year innovation-to-commercialization grant from the Michael Smith Foundation of Health Research enables the team to commercialize the system into a sustainable product that can generate insights for care teams to provide better, faster and more affordable care.
COVID-19 Public Health Monitoring This two year CIHR funded project explores the role of digital health in 1) supporting and following up with cases and contacts of COVID-19 patients, and 2) enhancing access to care for patients who require regular follow up during physical distancing. Our areas of focus are maternal and child health, HIV and TB, and COVID-19 emergency response in Africa, Canada and the UK. 4a. National WelTel Implementation in Rwanda Our mHealth intervention, WelTel, has been implemented nationally in Rwanda to support communications with COVID-19 patients in addition to help manage their contact tracing. We are working with the Rwanda Biomedical Centre to evaluate how useful its contact tracing functionality is, and if both patients and health care practitioners found it effective as a communication tool during the pandemic. 4b. WelTel Implementation in Kenya We are coordinating with teams in Samburu County and at Pwani University in Kilifi, Kenya to determine how WelTel supports patient care at maternal and child health clinics, HIV clinics, and TB clinics while being used as a tool for the COVID-19 emergency response.
WelTel in Pediatric Cardiology Our research projects in The Children’s Heart Centre, BC Children’s Hospital, Vancouver, Canada focus on the impacts of providing virtual care to at-risk pediatric populations, particularly in times of COVID-19. Our aim is to assess how access to care has changed throughout the COVID-19 pandemic as well as understand the patient/provider experiences of using virtual care. The study is funded by CIHR.
Virtual Mental Health Care This pilot study, held at the Segal Centre in Vancouver, Canada, will evaluate whether text messaging using our WelTel service, improves follow-up experiences from patients discharged from inpatient psychiatric units. Our aim is to provide higher quality and safer transitions for patients as they navigate their return to their communities. The study is funded by VCH Research Institute Team Grant.
Hospital Readmissions and mHealth: From Hospital to Home (H2home) This study aims to evaluate if 2-way texting technology can streamline discharge and follow-up
The Cedar Project - Supporting Indigenous Youth Since 2003, this research project has examined connections between impacts of colonization and intergenerational trauma on HIV and hepatitis C virus among Indigenous youth who use drugs in Vancouver and Prince George. This initiative, which has been using WelTel as a support tool, received CIHR funding and continues operating during COVID-19.
Principal Investigator: Dr. Richard Lester To implement a text-messaging service (WelTel) to improve maternal and child health at several clinical sites across Kenya.
WelTel Implementation Science Principal Investigator: Dr. Richard Lester This implementation science project is focused on culminating information gathered from our international sites who implemented WelTel during the COVID-19 pandemic. Our validated, published tool, mCFIR (modified Consolidated Framework for Implementation Research), can be used to survey the experience patients, health care practitioners, clinical implementation managers, external stakeholders, and policy makers had during WelTel implementation. The priority of this research project is to determine what facilitators and barriers were present during WelTel implementation and how they varied between our Canadian, Rwandan, and Kenyan sites. We anticipate being able to use this knowledge to optimize mHealth implementation at various future sites.
processes while reducing unplanned hospital readmission rates at Vancouver General Hospital (VGH). Our goal is to gain a better understanding of the reasons behind readmissions while improving patient experience and satisfaction with post-discharge care. The study is funded by VCH Research Institute Innovation and Translational Research Award.
Past Projects
Managing Asthma with Tele-health Technology: A Feasibility Study (British Columbia) Principal Investigator: Dr. Mark Fitzgerald Co-Investigator: Dr. Richard Lester The Asthma Telehealth project is a randomized trial testing the adaptation of the WelTel platform to link patients with moderate to severe asthma to their previously validated Asthma Action Plans, thus supporting outpatient self-management.
EmPhAsIS: Empowering Pharmacists in Asthma management through Interactive SMS (British Columbia) Principal Investigator: Dr. Mary de Vera Co-Investigator: Dr. Richard Lester This clustered randomized control trial at 75 pharmacies in BC is designed to examine whether an adaptation of the WelTel intervention into pharmacy’ services improves adherence to asthma medication.
WelTel Big River: Engaging people living with HIV and Hepatitis C in a text-message intervention (Saskatchewan) Principal Investigator: Dr. Richard Lester Co-Investigator: Dr. Stuart Skinner This new study emerged from a CIHR/CTN funded Rural Engagement in HIV Care meeting of national researchers and stakeholders in Saskatoon in 2013, at which WelTel was voted as the highest priority research area. Additional funding was secured through CTN to initiate a pilot study using WelTel to improve engagement in HIV services in the northern First Nations community of Big River.
WelTel OAKTREE: Text Messaging to Support Patients with HIV/AIDS in British Columbia (British Columbia) Principal Investigator: Dr. Melanie Murray Co-Investigator: Dr. Richard Lester Following a successful pilot study of the intervention at the Oak Tree Clinic, additional funding was secured by the Oak Tree team to recruit 100 participants for a further evaluation involving clinical outcomes one year before and one year after implementation of the intervention, as well as its cost-effectiveness.
University of Toronto - Postexposure Prophylaxis (Toronto)
Using text messaging to improve health system efficiencies in the treatment of latent tuberculosis (British Columbia) Funder: CIHR Foundation Grant Principal Investigator: Dr. Richard Lester This is a dually funded project by the BC Lung Association and CIHR PHSI. It evaluates the effect of WelTel on treatment completion among patients with Latent Tuberculosis Infection (LTBI) in a randomized controlled trial at two TB clinics. The study includes a cost-effectiveness evaluation and stakeholder assessment for healthy system integration (ClinicalTrials.gov identifier: NCT01549457).
Engaging clients in the field: WelTel Outreach (British Columbia) Funder: BCCDC Foundation for Public Health Principal Investigator: Dr. Victoria Cook Co-Investigator: Dr. Richard Lester In this study, WelTel digital health platform will replace the existing practice of individual client-provider text messaging and immediate deletion as per agency policies, and will provide a secure, centralized platform where all text-message correspondence between team members and between clients and providers can be accessed by relevant TB Services clinicians with a user name and password with eventual upload to the clinical registry. The team will apply lessons learned from this pilot to pursue further application of the digital health platform in the area of Video Observed Therapy. The overarching goal of this proposed study is to support communications and delivery of care throughout the Lower Mainland.
Funder: Doctors of BC Principal Investigator: Dr. Tracy Morgan Co-Investigator: Dr. Richard Lester This project will utilize a digital health technology in a primary care setting to improve access to care and self-management for patients diagnosed with one or more chronic illnesses (chronic obstructive pulmonary disease, congestive heart failure, diabetes mellitus and/or hypertension). This study will assess the impact of the technology on health indicators, including HbA1c and blood pressure, and self-efficacy and health-related quality of life WelTel Kenya2 Principal Investigator: Dr. Richard Lester This second phase ‘transition to scale’ project, Changing Global Health One Text at a Time, is co-supported by Grand Challenges Canada and Amref Health Africa. The aim is to scale-up the WelTel intervention in Kenya’s vast northern and arid lands as part of a government-hosted consortium of health-strengthening initiatives, using the Integrated InnovationTM framework (social, technological, and business innovation).
WelTel Retain NIH Funded Principal Investigator: Dr. Richard Lester This randomized control trial (ClinicalTrials.gov identifier: NCT01630304) aims to assess whether the WelTel intervention improves retention in care in the first year of care after HIV diagnosis.
Grand Challenges Principal Investigator: Dr. Richard Lester To implement a text-messaging service (WelTel) for TB treatment adherence at several clinical sites across Kenya.