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OTTAWA – Telehomecare, teleconsultations, wearable technologies, smart sensors or even artificial intelligence devices… do Francophones in Ontario no longer have a choice? What uses of digital health technologies are considered acceptable? This is the purpose of the research carried out by Sylvie Grosjean, holder of the International Francophonie Research Chair in Digital Health Technologies, at the University of Ottawa.
During a conference organized by the Center for Research on Canadian Francophonies (CRCCF), researcher Sylvie Grosjean presented the first results of her research on the future of virtual care for Francophones living in Ontario.
This full professor at the University of Ottawa adopted a sociotechnical perspective to address the complex relationship between the technological and the social. Several elements indicate that Francophones are open to the use of technological tools in health care… under certain conditions.
Here, it is a question of the usefulness of telecare, teleconsultation and mobile applications.
To support the offer of virtual care among Francophones, several accessibility and acceptability factors come into play, according to Ms. Grosjean. It seems that the survey conducted by the researcher highlights the rather complementary rather than substitutive side of health technologies.
“Technology is not the solution to the problems of shortage, otherwise we are going straight into the wall”, she affirms.
For Francophones, these tools are an acceptable means of receiving care in French and have the potential to improve access to services in French. In addition, these technologies might improve the quality and frequency of communications with healthcare professionals.
However, several conditions apply. You have to “offer a technology that ”speaks” French”, ie the user interface. For those surveyed, this linguistic concordance must be integrated into an offer of existing services in French.
100% free or nothing
Although the reception was positive, some participants added that they “wouldn’t want telecare to compensate for the lack of health professionals who speak French. The criterion must be health and not compensate for linguistic disabilities. »
One of the major issues raised by the survey is that we need access to these technologies, designed, thought out and developed in French. This is an approach that would take into account the underlying conditions of acceptability by Francophones.
In addition, we must “include the Francophone community in the development and use of digital health technologies to support access to virtual care in French,” says Sylvie Grosjean in her presentation.
In her surveys and workshops, the researcher proposed several possible scenarios to understand the level of acceptability of Francophones to the use of certain technological tools.
As for telecare, one of the examples highlights the experience of Maria, 55, “who has heart failure”.
Followed remotely for six months by her healthcare team, Maria “received a digital health kit”. This tool includes, for example, a “beep” on a tablet that tells him when to take his weight, use an electronic blood pressure monitor to take his blood pressure, check the oxygen in his blood using the pulse oximeter and then respond to questions regarding his health. All this data will then be sent to a nurse who will provide remote monitoring.
This example revealed several reactions and a “use trajectory” among respondents. The participants state several conditions related to the learning and integration of these tools.
But among the recommendations, it is above all the need for access to services in French, medical follow-up in French and a relationship built with technology that stands out.
Reduce inequalities of access
The use of virtual care has increased from 10% in 2019 to 60% in 2020 in Canada. Virtual care has become widespread since the pandemic.
“Yet, although virtual care has the potential to increase access to medical and health care, it can also exacerbate inequalities in access to care,” reports the researcher.
Ms. Grosjean mentions several observations made by the Réseau des services de santé en français de l’Est (RSSFE), also indicating that “no target or requirement in terms of digital health services in French for the Francophone community resides in the plan. Digital Health for Ontario”.
In fact, in 2019, the provincial government published its digital health priorities stating that this strategy offered more virtual care options and improved access to data for patients. In this plan, Francophones are not represented, whereas in 2018, the Office of the French Language Services Commissioner of Ontario recommended “having a digital health development strategy that takes into account the cultural and linguistic differences of communities French speakers”.
The use and design of digital health technologies has grown since the pandemic. Where these advances allow more widespread access to care. However, Francophones do not always find what they are looking for in Ontario.
This is why several questions persist: are underserved populations equipped with technologies? Here once more, is the Internet sufficiently deployed in French-speaking localities?
For virtual care for Francophones to also be equitable, the RSSFE’s response would already give food for thought: “The needs of the Francophone population must be taken into consideration in the development and implementation of programs, policies and procedures. In addition, the services received in French must be equivalent to those provided in English, be offered simultaneously, and be of the same quality. »
