Beyond Technology, Beyond Healthcare

Beyond Technology, Beyond Healthcare: Promoting Integrated Health and Social Services for Newcomers to Canada

Background

The COVID-19 pandemic was marked by unprecedented shifts in healthcare service delivery, particularly at the community level where most preventive and first line care occurs. Most services transitioned rapidly from the traditional in-person model to virtual health care – “any interaction between patients and/or their circle of care occurring virtually, using any form of communication or information technologies, with the aim of facilitating or maximizing the quality and effectiveness of patient care”.  While many Canadians have benefited from the convenience provided by digital technologies like virtual care, evidence shows that underserved and marginalized populations have not benefited equally. For example, health inequities are exacerbated for those without the required technology or digital literacy to interact with their health care providers virtually. Consequently, despite rapid uptake and near universalism of technology, newcomers have been inequitably excluded from its benefits.  

Purpose

The purpose of this project was to promote collaborative understanding about equitable virtual care services for newcomers to Canada using an Intersectionality-Based Policy Analysis framework (IBPA) with a lens of appreciative inquiry. 

Objectives 

  1. Facilitate collaboration between community and settlement organizations, health care providers, and postsecondary institutions to improve newcomers’ access to quality virtual care 
  1. Share best practices for providing virtual care to Canadian newcomers 
  1. Co-develop and disseminate policy recommendations on integrated (i.e., health and social) virtual care services for Canadian newcomers.  

The aim of this project was to co-develop of an intersectionality-informed toolkit to guide community organizations and policy actors on how settlement and health care services can be better integrated to support the migration transitions of new arrivals to Canada.  

INCLUDE note on newcomers terminology

Events & Projects

A formal project launch was held as part of the Metropolis Social Determinants of Health Summit in Gatineau, Quebec. The roundtable discussion was a structured informal dialogue on how human touch and compassion in health care can be prioritised for newcomers and refugees considering the increased technological complexity and limited resources. The discussion also shared findings from lessons learned in understanding digital health compassion and the opportunities that technology presents for equitable and responsive service delivery.  

Over the past year, we collaborated with three community organizations in Toronto that provide primary health care and social services to newcomers – Access Alliance Multicultural and Health Services, Crossroads Refugee Clinic, and FCJ Refugee Centre, in conducting research which seeks to better understand how compassionate virtual care has been experience by newcomer groups within the context of the COVID-19 pandemic. 

 Preliminary study findings from our exploratory research suggests that in some circumstances, virtual care acts as a bridge – enabling newcomers to conveniently access health care. However, it can also serve as a wall – disconnecting patients and providers from the therapeutic relationship that is central to benefitting from quality care. Importantly, our soon to be published findings show that newcomers’ experiences and expectations of virtual care are shaped by factors beyond health care. Specifically, broader social, systemic, and interpersonal factors that accompany their settlement transition including anti-black racism, immigration status and country of origin have trickle down effects that influence their views on virtual care. These suggest that one-size-fits-all approaches to equitable virtual care or that only focus on the technology or that simply operates within the boundaries of health care without integrating social factors, are not sufficient.  

Future Work