Lawson explores technology to support youth mental health

Researchers smiling at camera.

Lawson explores technology to support youth mental health

Puneet Seth, Jennifer Moles, Dr. Cheryl Forchuk, Dr. Sandra Fisman and Damon Ramsay spoke at the funding announcement in February 2019.

Imagine having your care team at your fingertips. Picture opening an app on your phone to schedule a virtual visit where you can have a face-to-face meeting, without ever leaving your home. What if you could fill out an online questionnaire and instantly send it to your physician to let them know how you are doing?

As technology advances, the opportunities to connect and empower patients and clients seem endless. Mental health services are rooted in these relationships. For delivery, specifically community-based and outpatient services, connection and communication between an individual and the care provider are a priority focus.

But how do we integrate technology into mental health services, without losing that sense of connection?

While it may seem easy to download an app on a phone or tablet, this can bring issues with privacy and security. Many apps are not proven effective, and some can actually do more harm than good.

In the health care sector, the use of technology needs to be carefully tested and implemented through evidence-based research, to ensure it is not only meeting the needs of those using it but also that it complies with standards for privacy and security.

Through funding from the Government of Ontario’s Health Technologies Fund (HTF), researchers at Lawson Health Research Institute (the Research Institute of London Health Sciences Centre and St. Joseph’s Health Care London) are partnering with industry to develop a unique approach to connect technology and mental health care. TELEPROM-Y is a mobile-based TELEMedicine and Patient-Reported Outcome Measurement Youth study that looks to leverage technology to improve access to specialized services and reduce inpatient mental health admissions for youth.

Technology is a regular form of communication for youth and they are a vulnerable population when it comes to mental health challenges. “Our research team is looking at how technology can assist in the delivery of mental health services for youth in a way that still supports the important components of treatment,” says Dr. Cheryl Forchuk, Assistant Scientific Director at Lawson and lead for the study. “In our work with youth, they’ve talked about wanting the technology they are already using integrated into their care.”

The majority of mental illnesses occur between the ages of 16 to 25 years old. This important transitional period in a youth’s life marks an opportunity for them to be actively engaged in their own care journey.

Researchers will use an electronic Collaborative Health Record (CHR) developed by InputHealth, an innovative Canadian digital health software company. This software allows secure communication between the patient and care team. Patients will have access to virtual visits, prompts and reminders, text or email messages, and educational materials delivered by phone or another device.

The research team is recruiting participants between the ages of 16 to 25 years old who have symptoms of anxiety and/or depression and are receiving outpatient services from a hospital-based mental health care program at London Health Sciences Centre, St. Joseph’s Health Care London, Woodstock General Hospital, or community-based services from partner organizations. A key aspect the research team is investigating is whether the technology is effective and efficient, while acceptable to both the care team and youth.

Two men demonstrating phone app.

“We know from research that remuneration on mood, or focusing deeply on mood, without communication can actually increase depression,” says Dr. Cheryl Forchuk. “We’ve only been interested in technology that supports the relationships necessary for mental health services.”

The mobile software will also be evaluated on its ability to improve access to care; monitor mood and behaviour changes for earlier intervention; enhance information exchange between patient and health care provider; and, support the overall experience for the youth.

“Careful evaluation is essential to make sure we are doing the right things for the people we serve,” adds Dr. Forchuk, who is also the Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery at Lawson and Western University.

This initiative is one of 11 that received funding from Ontario’s second round of the Health Technologies Fund (HTF), a program of the Ontario Ministry of Health and Long-Term Care administered by Ontario Centres of Excellence. This funding program supports the development of made in Ontario health technologies by accelerating evaluation, procurement, adoption and diffusion within the Ontario health system.

TELEPROM-Y received $395,109 in provincial funding with $494,630 in matching contributions for a total investment of $889,739.

“This collaboration matches financial investment from the province, along with technical tools and expertise from the private sector, with our patient-centred approach,” says Dr. Forchuk. “Together, we can bring solutions to life and translate them quickly to care delivery once shown to be effective.”

Other project contributors include St. Michael’s Hospital Centre for Excellence in Economic Analysis Research, The Forge (McMaster University), Thunder Bay Regional Health Sciences Centre, Western University and Youth Opportunities Unlimited (Y.O.U.).

The TELEPROM-Y study is one example of how dedicated research funding can be used to drive discovery with potential to create a tangible impact on patients. Research-intensive hospitals are improving health care, creating jobs and contributing to the country’s growing knowledge economy.

Lawson is one of Ontario’s 23 research hospitals that contribute to a healthier, wealthier, smarter province. Look for other RESEARCH SPOTLIGHT posts on our Healthier, Wealthier, Smarter blog or join the conversation about why health research matters for Ontario on Twitter, using the hashtag #onHWS.

Health and Community Leaders Talk: David Hill

Ontario's health research hospitals make our province healthier, wealthier, and smarter

Health and Community Leaders Talk: David Hill

By David Hill, Scientific Director, Lawson Health Research Institute and Integrated Vice President of Research for London Health Sciences Centre and St. Joseph’s Health Care London

Dr David Hill Lawson Health Research Institute

What does health research mean to you?

Health research means delivering the best health care by pushing the boundaries of science. It’s about understanding the basis of wellness and the dysfunctions of the body and mind that result in disease. At Lawson, our research expands the full continuum of life and mirrors the clinical areas at London Health Sciences Centre and St. Joseph’s Health Care London. We make it our mission to test and deliver health care innovations for the benefit of patients in our community, in Ontario and beyond.

Health research also drives the future of health care—looking not just at where we are now but where we could be in ten or fifteen years. Ontario’s research hospitals bridge the gap between today’s discoveries and the next generation of health service and delivery. Where we could be won’t happen by chance. It will be the result of hospital-based research.

Read more: Behind the scenes at Lawson

How does health research contribute to a healthier, wealthier, smarter Ontario?

Healthier: Health research makes our patients healthier as the discovery of new treatments leads to improved health outcomes and a higher quality of life.  At Lawson, we take a “bedside to bench to bedside” approach. Our researchers focus their efforts on figuring out the clinical problem, and then take that back to the lab to develop new knowledge that can be translated directly to better patient care. At Lawson we built our strategic plan around precisely identified clinical problems and their resolution through inter-disciplinary research.

Wealthier: Health research is good for the economy as our researchers work to discover new ways to drive efficiency and reduce costs; find new methods of service delivery; improve procedures,; and create entirely new ones, like specialized molecular imaging techniques. We’re also commercializing our innovations through WORLDiscoveries®. Born out of a partnership between Lawson, Robarts Research Institute and Western University, WORLDiscoveries® is the business development arm of London’s extensive research network and the bridge between local invention and global industry.

Smarter: Health Research makes our communities smarter by attracting the best and brightest health care professionals. We’re seeing this at Lawson as we continue to grow our reputation as a leader in the life sciences sector, with over 1,500 principal investigators, research support staff, students and trainees. This growth feeds on itself, helping us to attract top talent to our city, like Dr. Chris McIntyre, a nephrology researcher who came to Lawson from the UK in 2014.

At Lawson, one thing we believe in strongly is that investment in health research is good for all of us – in London, across Ontario, and in Canada. In today’s tough funding landscape, we must ensure that health research remains a priority for health system leaders, and leaders in the broader community.


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Read more Health and Community Leaders Talk blog posts on our Healthier, Wealthier, Smarter site and share your insights on Twitter with the hashtag, #onHWS. To learn more about how health research makes Ontario healthier, wealthier, and smarter, check out our website and our other blog posts and videos.

Patients + Research: Wayne Kristoff

Patients + Research is a platform for patients to discuss their relationship and experience with the research that leads to new cures, cares and treatments.

Patients + Research: Wayne Kristoff

I was diagnosed in June 2014 with Type 2 diabetes.  It was bothersome but not unexpected as I had been told by my family doctor that I was borderline diabetic for a while. My father was also Type 2 and my paternal grandmother had what was described as a “sugar problem” in the late 40’s and early 50’s.  From what has been discussed in our family, I believe that it would be called Type 2 today. At the time of my diagnosis, I was told that I would be on medication for the rest of my life.

Fast forward to mid-December 2015 and I was watching the news on CTV London when a story appeared on an upcoming Lawson Health Research Institute trial taking place at St. Joseph’s Health Care London to see if they could put Type 2 diabetes into remission for a period of time. I would do anything to make things better for my children and grandchildren and there was the possibility of managing my diabetes in another way. Also, with my background in education, I knew the value of research into finding better ways to do things.

Wayne Kristoff participated in a clinical trial at Lawson Health Research Institute for Type 2 diabetes remission

In early February 2016, I was asked to meet so that information could be gathered, expectations outlined, and generally discuss if the study was appropriate for me. Some of the expectations were that I would meet with a dietician, I would keep track of my weekly activity and steps, I would work at losing a minimum of 5% of my body weight, and I would follow the regimen to the best of my ability. I was quite eager to join the study so another appointment was established where I would have blood taken, have a check-up and be randomized, which was explained to me as whether I would be part of the control group or part of the test group.

At the next appointment, everything went well. For the next month I would have weekly visits to the clinic with telephone checks part way through the week. From late March until May, I would attend the clinic every two weeks with all the paper work completed such as a 3-day meal diary, food survey of things I ate over a year, steps, daily insulin dosage and blood testing. I have to say that the visits were a pleasure as they turned into both cheerleading and counselling.

When I went for the checkup in May, it was the end of the intensive drug therapy and I was told to start decreasing the dosage of insulin. Blood was taken for another A1C test and I was to receive a call when the results were back. I remember well where I was and what I was doing when I received the call on May 16 to tell me that the test was good and to stop all diabetic medication.

Wayne Kristoff participated in a clinical trial at Lawson Health Research Institute for Type 2 diabetes remission
Wayne shared his story at our Healthier, Wealthier, Smarter London Field Trip

Whatever the outcome in the future, I have had much more time drug-free than I ever expected when I was first diagnosed. At the end of the trial, I am still not taking diabetic medication and my family doctor will continue to monitor my progress. I am now aware that there are several options for me if and when I need to take medications again. I also have to say that my quality of life is greatly improved.  I have so much more energy than I had before the trial. Not feeling well almost constantly puts a damper on things that you want to do. In the course of this trial I have met some great people that I know are there to support me.

Research such as this at our hospitals is so important because it advances treatment options for patients. It gives the public a chance to see where money goes rather than just in some lab out of sight.  It puts every day faces on research.

In summing up, I feel very privileged to be part of this trial. I would encourage anyone who sees a trial that is appropriate for them to become involved.  Would I do it again?  In a heartbeat and I will certainly be looking for other ways to stay involved.

Read more about Wayne Kristoff and the REMIT study at Lawson Health Research Institute


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Add Your Voice

Want to add your voice to the Patients + Research blog series? Email or call Elise Bradt at, 416-205-1469, or direct message or tweet at us on Twitter at @CAHOhospitals.

Read more Patients + Research posts and share your own insights on Twitter with the hashtag #onHWS. To learn more about how health research makes Ontario healthier, wealthier and smarter, visit our impact page, and check out our other blog posts and videos.

HWS Field Trips: London

HWS Field Trips: London

Research hospitals play a leading role in making Ontario healthier, wealthier, and smarter. To demonstrate the world-class hospital-based research happening across our province, we took a field trip to Ontario’s Forest City—London—where researchers at the Lawson Health Research Institute (Lawson) are transforming patient care through discovery and innovation.

Lawson is the joint research institute of London Health Sciences Centre and St. Joseph’s Health Care London. We took a behind-the-scenes tour of the Lawson labs and clinical research space, and were delighted to be joined by patients, researchers, hospital CEOs and local politicians MP Karen Vecchio, MPP Jeff Yurek, and City Councillor Harold Usher along the way.

This blog post highlights only a fraction of the research we learned about on our field trip – but we also live tweeted every minute! To take the full live-tweeted tour, scroll through our Storify story here.


The Kick-Off

Patients, community members, hospital CEOs, senior staff, researchers, and representatives from all three levels of government were on hand to celebrate and champion the game-changing health research underway at the Lawson Health Research Institute (Lawson). Dr. David Hill, Scientific Director of Lawson, kicked off the tour by sharing a few words about the role of health research in building a healthier, wealthier, smarter province. “It’s research-based hospitals in Ontario that bridge the gap between discovery and the next generation of health service and delivery,” said Dr. Hill.

We were honoured to be joined by City Councillor, Harold Usher, who remarked that health research is a key contributor to London’s economy. We also heard from two members of the London community who have participated in health research at Lawson.

Councillor Harold Usher meets health research participants Michael Allan and Wayne Kristoff. /// Hospital staff, community leaders, researchers, MPs, MPPs and more all ready for the tour!

Dr. David Hill, Scientific Director of Lawson /// Councillor Harold Usher, London City Councillor

Patients + Research: Wayne Kristoff joined a clinical trial aimed at putting his type 2 diabetes into remission for an extended period of time. “I remember where I was on May 16, 2016,” said Wayne recounting his experience undergoing the treatment regimen, “when I received that call to say the test results were good, and that I could stop taking my diabetes medication.” Wayne has been off of his diabetes medication since then.

Michael Allen, a 2-time cancer survivor, participated in a personalized medicine research study with Dr. Richard Kim, a leader in personalized medicine not only in London, but around the world. “You can’t take a cookie cutter approach,” said Michael. “Medicine is personalized to each patient, and that’s something that Dr. Kim took the time to explain to me.”

Wayne and Michael’s stories drove home the punchline of our tour: health research is a necessity, not a luxury. It saves lives and improves outcomes for patients and families across Ontario. With Wayne and Michael’s stories in mind, a group of over 10 health research champions headed to the personalized medicine labs to begin the tour.

Wayne Kristoff /// Michael Allan

MPP Jeff Yurek, MP Karen Vecchio and Dr. David Hill strike a healthier, wealthier, smarter pose for the #onHWS Twitter audience. /// And off we go! Dr. Gillian Karnaghan (President & CEO, St. Joseph’s Health Care London), Murry Glendining (President & CEO, London Health Sciences Centre), MPP Yurek, MP Vecchio, Karen Michell (Executive Director, CAHO), Dr. David Hill (Scientific Director, Lawson).


STOP 1: Personalized Medicine Program

Our first tour guide of the day was Dr. Richard Kim, Director of the Centre for Clinical Investigations and Therapeutics (CCIT), and leader in personalized medicine research. The CCIT was the first clinical research centre of its kind in Canada, uniquely built for an academic health sciences centre to serve a dual purpose: enable hospital-based research and attract industry-sponsored clinical trials, supporting the city’s innovation and knowledge-based economy.

Better health at a better price: “Personalized medicine is more than something that sounds cool,” said Dr. Kim. “We’re finding that it’s actually better for patients and cheaper for the system.” For example, at his personalized medicine clinic, Dr. Kim runs genetic testing on patients prescribed the blood thinner drug, Warfarin, to determine the appropriate dosage for each particular patient. This is helping to ensure the safest, most appropriate level of medication while reducing unnecessary care.

Lab space in the CCIT is set up for industry use, drawing investment into London. /// Dr. Richard Kim tells the group about Dr. Wendy Teft’s research using personalized medicine to alleviate side effects for patients with colorectal cancer, while leading to better outcomes.

In the genotyping lab, Cameron Ross can processes blood and tissue samples for DNA variants in about 2 hours for personalized medicine. /// In the analytical lab, researchers look at drug concentrations in the body through blood and tissue samples to ensure efficacy and safety.

Read more about personalized medicine research at Lawson.


STOP 2: Lawson Imaging

As a key intersection for discovery and innovation, the Imaging team finds itself at the heart of Lawson research activity. Why? The unique technology developed and used here enables researchers in all fields of study (cancer, heart disease, stroke, brain health, and more) to employ new techniques and tactics for solving today’s greatest health challenges. One key piece of technology housed in London is the cyclotron – only one of two in Ontario.

Dr. Frank Prato shares that St. Joseph’s Health Care is home to Canada’s first MRI scan. /// Lawson is also home to Canada’s only molecular imaging training program, explains Dr. Savita Dhanvantari.

Cyclotron 101: PET scans (positron emission tomography) measure activity in parts of the body to help detect different diseases. For example, they can show blood flow to the heart to help detect heart disease, or how sugar metabolizes in cells to help detect cancers. The PET scan image is created by positron emission from radioactive pharmaceuticals that are given to patients in advance of the scan. The cyclotron is the technology that makes these radioactive pharmaceuticals, which can be tailor-made to study a variety of disease areas.

The cyclotron is also helping to make Ontario Healthier, Wealthier, Smarter. The Lawson Imaging team is able to sell the radioactive pharmaceuticals that they manufacture to other clinics across Ontario, from Toronto to Windsor. All of the revenue goes back into the research that’s advancing scientific knowledge and improving patient outcomes.

Dr. Mike Kovacs explains how the cyclotron produces radioactive isotopes. Did you know that they have a half life of 110 minutes? They are stored in pressure-controlled chambers with lead walls.  

Read more about imaging research at Lawson.


STOP 3:  Parkwood Institute Research

The tour made its way over to Parkwood Institute, where a clinical research program focuses on advancing innovations and discoveries directly related to patient care, in the areas of cognitive health, mobility, and mental health.

Parkwood Institute is home to a collaborative rehabilitation clinic – an open space where patients, caregivers, physiotherapists and occupational therapists are working together, using a variety of high and low tech devices and techniques to achieve daily rehabilitation goals while informing the research studies underway.

Stronger every day:  A research patient who has experienced a spinal cord injury inspired us all as he walked, step by step, around the room wearing an exoskeleton, a machine that sends electronic pulses to his muscles helping him stand upright and move. In the long-term, researchers hope to better integrate this technology with the wearer’s rehabilitation training by enabling the wearer’s brain to control the rhythm of the electronic pulses. Read more about how this technology is having an impact on the daily lives of members of the London community in this London Free Press story.

A research patient demonstrates the Lokomat – a robotic system that automatically moves the legs while on the treadmill. /// A research patient makes his way around the rehabilitation clinic in an exoskeleton.

Predicting dementia: We also visited the Gait and Brian Lab, where Dr. Manuel Montero-Odasso is taking an integrated approach to studying mobility and cognition. Right now, the team is working on a gait study, which explores whether changes in the way an individual walks while doing a mental activity might be able to help predict how long it will take people with Mild Cognitive Impairment (MCI) to progress to dementia.

Karen Michell, Executive Director of CAHO, takes the gait test. She walks down the sensor mat first without distraction, and again while thinking through a complex math problem as researchers measure any changes in her gait.

Read more about Parkwood Institute Research.


STOP 4: Kidney and Cancer Research

Did you know that there are over 23,000 Canadians on dialysis? Dr. Chris McIntyre, who came to Lawson from the UK in 2014, explained that the biggest challenge for these patients is often not receiving a transplant, but remaining healthy long enough to get one. Over time, dialysis causes injury to other systems in the body, with the most common cause of death for dialysis patients being sudden cardiac death.

Making dialysis safer: Dr. Chris McIntyre is working with imaging scientists to take a closer look at the causes for sudden cardiac death. By mapping out the problems, Dr. McIntyre and his team will begin to understand where changes are needed to improve dialysis and give patients a better quality of life. In the future, the goal is to conduct personalized imaging so that dialysis improvements are tailored to each patient’s unique needs.

Lawson has about 100 researchers dedicated to nephrology, including Dr. Chris McIntyre. /// See the small white mass? Dr. Aaron Ward explains that it’s a tumour in the lung.

Smarter care with smart tech: Dr. Aaron Ward is also using imaging to improve prediction of lung cancer recurrence after radiation therapy. Lung cancer is the leading cause of cancer death in Canada, and while radiation therapy is a less invasive treatment than surgery, it doesn’t always work the first time. Complicating matters, this therapy can sometimes result in non-permanent lung injury that can often be confused with cancer regrowth on CT scans after the treatment. The challenge for clinicians is accurately assessing whether the scans show an injury that’s healing, or a tumour that’s growing.

To help solve this problem, Dr. Ward is developing a computer-assisted decision support tool that clinicians can use when assessing the results of treatment. By accurately assessing injury, patients will avoid unnecessary treatment, and by accurately assessing cancer regrowth, patients gain faster access to a second round of radiation.

Learn more about this work from Sarah Mattonen, a trainee in Dr. Ward’s lab, and about nephrology and cancer research at Lawson.


STOP 5: Children’s Health Research Institute

Does past research about fetal health still hold true with today’s population of pregnant moms? This is just one of the questions being answered at Children’s Health Research Institute, a Lawson program.

Measuring fetal health: Dr. Barbra deVrijer, who came to London from the Netherlands, is studying whether our measures for normal fetal metabolism are still appropriate for babies today, given potential differences among pregnant women such as lifestyle, weight, or stress. Her challenge was to find an innovative method of examining the fetus against past evidence-based measures for health – without causing harm to baby or mom.

Like much of the research on our London tour, her solution came through a collaboration with another researcher. Dr. Charles McKenzie developed novel techniques that use an MRI to monitor fat development, track rate of blood flow through the placenta, measure oxygenation and more. In fact, his team is the first in the world to use imaging to measure placenta metabolism.

Dr. Charles McKenzie explains how he is able to measure fat development without causing harm to fetus or mom. /// 3D image of a fetus demonstrates the types of images the team is able to get using their technology.

Read more about children’s health research at Lawson.


Health research in action: After a full day of inspiring people and incredible research, it’s clear that London is a powerhouse with expertise in a diversity of fields. Regardless of the many research areas, all teams are working together to discover new ways of providing better care.

“Research collaborations happening across the city are providing immense value for our patients and the health care system,” said Murry Glendining, President & CEO of London Health Sciences Centre.

“Over time, new questions capture the minds of our researchers – and so the cycle continues,” added President & CEO of St. Joseph’s Health Care London, Dr. Gillian Kernaghan.

We look forward to seeing how curiosity and health research leadership will continue to drive discovery in London, and we want to extend our sincere thanks to our hosts at the Lawson Health Research Institute, London Health Sciences Centre and St. Joseph’s Health Care. We would also like to thank Councillor Usher, MPP Yurek, MP Vecchio for joining us, as well as the health research champions who came out for the tour kick-off and followed along on Twitter. Finally, we want to thank Wayne Kristoff and Michael Allan for sharing their lived experience with us, and reminding us of the value and need for health research in Ontario.


Why does health research matter to us? We know that it generates new discoveries, better care, and greater efficiency all while contributing to our knowledge-based economy. That’s how it makes Ontario healthier, wealthier, and smarter today. Investing in research hospitals will help us continue to build a healthier, wealthier, smarter Ontario tomorrow. Discover more health research and patient stories by signing up for our monthly newsletter or joining the #onHWS conversation on Twitter.

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