WCH Institute for Health System Solutions and Virtual Care (WIHV)

The Women’s College Hospital Institute for Health System Solutions and Virtual Care (WIHV) is a living laboratory for health system solutions in Ontario and beyond.

Whether it’s evaluating provincial digital health programs, nudging primary care providers across the province to improve prescribing, or engaging structurally marginalized groups to design the future of community care, WIHV is responding to today’s most pressing health issues through research insights and solutions.

Working with stakeholders inside the health system and innovators from other sectors, WIHV identifies and evaluates ground-breaking approaches that address gaps in our healthcare system. Our work supports solutions that make care more convenient, more effective, and less costly to deliver.

For many organizations operating outside of the healthcare system, it can seem like not having the right information can hold up the design or implementation of a new digital health tool or model of care that could be beneficial to providers and/or patients.

At the same time, health system leaders may not have the time to invest in evaluating which tools to use, how best to implement them and assess their impact rigorously.

With each project we take on, we assess the extent to which models of care align with the Quintuple Aim framework:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving provider experience;
  • Improving the health of populations;
  • Reducing or holding the per capita cost of healthcare constant;
  • Enhancing equity, ensuring benefit for the most disadvantaged groups.

We also focus on solutions at the systemic level, assessing the sustainability of innovations and their capacity to scale up within a region or disseminate across different jurisdictions.

Our Teams

Women’s College Hospital is dedicated to transforming healthcare delivery locally and across Ontario. This commitment includes innovations in ambulatory care, such as the launch of Women’s Virtual, Canada’s first virtual hospital, in November 2019.

In developing this new model of healthcare delivery, it is essential that the capability for continuous and integrated evaluation is a core driver for change. Building novel, high-impact solutions requires the approach of a ‘learning health system’ which leverages technology to assemble and analyze data, including patient and provider reported measures, to enable rapid iterative improvement cycles. An evaluation strategy must measure multiple dimensions of health service innovation including the process of project implementation and feasibility, the impact on the quality of care outcomes and overall changes in the Quintuple Aim.

The goal of WIHV is to provide methodological and quality improvement expertise to support rigorous evaluations of feedback on the implementation, quality, and impact of virtual-based solutions for ambulatory healthcare to enable rapid continuous improvements and guide thoughtful leadership in healthcare delivery. The evaluations conducted by WIHV aim to answer questions around how implementation characteristics can affect the adoption of virtual care technologies, how virtual care technologies impact the 6 domains of quality as defined by the National Academies of Medicine, and how virtual care solutions can support achievement of the Quintuple Aim.

WIHV houses the Centre for Digital Health Evaluation, leveraging internal expertise and external partnerships to assess the applicability of solutions through health services research, translational research, engineering, sociology, program evaluations, market readiness, and healthcare implementation.

A breakdown of the virtual care portfolio follows:

Centre for Digital Health Evaluation (CDHE)

Our team offers high-quality large-scale evaluations of digital health technologies at various stages of maturity, harnessing a wide range of expertise and conducting research at the pace of policy in ways that can inform decisions made by the Ministry of Health, Ontario Health and other stakeholders.

Market Entry Consulting

In partnership with the National Research Council’s Industrial Research Assistant Program (NRC-IRAP), our team offers market entry consulting services at no cost to eligible small- and medium-sized Canadian enterprises.

Our services are provided by a panel of experts from across the nation, with expertise in clinical practice, policy, technology, informatics, innovation, engineering, procurement, and/or commercialization.

Interested? Contact us at cdhe@wchospital.ca for additional details.

Canadian Network for Digital Health Evaluation (CNDHE)

The CNDHE is a pan-Canadian initiative to build capacity to evaluate new and existing digital health tools and related policy supports. The network aims to build a national infrastructure and common strategy to create and strengthen evaluation in digital health through the development of a pan-Canadian digital health evaluation framework, nation-wide digital health evaluations, and a network of academics, policy-makers, evaluation experts, patient groups, providers, and learners. Our vision is to have a nation-wide strategy for digital health evaluation that facilitates learning across regions and incorporates the Quintuple Aims focusing on patient experience, provider experience, equity, cost efficiency and population level benefits.

Interested in joining the network? Please visit our network page to register or contact us at cndhe@wchospital.ca for additional details.

The Access + Policy (A+P) Team uses qualitative and program evaluation approaches to generate insights related to health equity, access to care, innovation and policy with a specific focus on equitable digital health, integrated care and community care. The A+P team collaborates with a range of partners including community organizations, municipal and provincial governments, pan-Canadian agencies, and other researchers.

Highlighted projects

  1. Futures of Health Equity in Community Care: A Strategic Foresight Project for Equity-Promoting Community Care in Toronto
  2. Optimizing the use of Virtual Primary Care: Equity, Policies and Workflows (Project 1: Equitable Virtualization of Primary Care)
  3. Virtual Care in the COVID-19 Era (Stream 2: Equity)
  4. Commentary: Community Knowledge for Equity in Healthcare
  5. Digital Health Technologies for More Equitable Health Systems: A Discussion Paper
  6. Innovative Strategies for Inter-sectorial Collaboration between Mental Health, Housing, and Health Care

The Office of Spread and Scale (OSS) aims to amplify successful models of care and innovative programs beyond our hospital walls, while learning from the success of others. To achieve this goal, we conduct research, consulting, and capacity building activities related to:

  • How to include principles of implementation science in your work, projects, and research grants to help you consider sustainability, spread and scale from the beginning.
  • Assessing readiness for implementation and options for spread and scale, including potential barriers and enablers.
  • How to consider sustainability, spread and scale within digital health evaluations.
  • Strategies for encouraging and supporting patient engagement and involvement of all relevant decision makers.
  • Potential ways to spread and scale your work to similar and new contexts, populations, and settings.
  • How to scale successful initiatives requiring policy changes to allow for successful adoption.


To learn more about the team’s work and services available, please click here.

Key Findings

Cost and Impacts of Virtual Care on Older Adults Before and During the COVID-19 Pandemic Executive Summary

Digital Health Technologies for More Equitable Health Systems: A Discussion Paper

Effect of Antibiotic-Prescribing Feedback to High-Volume Primary Care Physicians on Number of Antibiotic Prescriptions – JAMA

Using Administrative Data to Explore Potentially Aberrant Provision of Virtual Care During COVID-19: Retrospective Cohort Study of Ontario Provincial Data – JMR

Outbreak of SARS-CoV-2 infection at a large refugee shelter in Toronto, April 2020: a clinical and epidemiologic descriptive analysis – CMAJ

Building Health Services in a Rapidly Changing Landscape: Lessons in Adaptive Leadership and Pivots in a COVID-19 Remote Monitoring Program – JMR

Clinical Considerations when Applying Machine Learning to Decision-Support Tasks Versus Automation by Dr. Trevor Jamieson and Avi Goldfarb

Collateral Damage: The Unintended Consequences of Misguided Hospital Funding Reform by Dr. Noah Ivers, Karen S. Palmer & Dr. David Wasserstein

Strategies for Health Systems to Engage the IT-Enabled Consumer by Dr Onil Bhattacharyya, Lovisa Gustafsson & Dr. Eric Schneider

Beyond “implementation:” digital health innovation and service design by Jay Shaw, Dr. Payal Agarwal, Dr. Daniel Cornejo Palma, Vess Stamenova, Dr. Trevor Jamieson, Rebecca Yang, Dr. Sacha Bhatia & Dr. Onil Bhattacharyya

Drawing lessons from Canada’s experience with single-payer health insurance by Dr. Noah Ivers, Steini Brown & Allan Detsky

Virtual Healthcare Revolution Here to Stay by Dr. Sacha Bhatia, Trevor Jamieson, James Shaw, Carole Piovesan, Leah Kelley, & Will Falk

Community Knowledge for Equity in Healthcare by James Shaw, Philina Sky and Shivani Chandra

Futures of Health Equity in Community Care: A Strategic Foresight Project for Equity Promoting Community Care in Toronto