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Using an approach known as human-centered automation, the University of Toronto’s Enid Montague aims to engineer a better health-care experience that helps ease the strain the current stress on the system and delivers more equitable care. 

Canada faces a critical doctor shortage that has left millions of Canadians without a primary care physician – and the after-effects of COVID-19 have only magnified the problem.

But Montague notes that the burden is not being shared equally.  

“The challenges of having too few physicians have disproportionately affected equity-seeking groups, particularly individuals who are racialized or come from low-income or rural environments,” says Montague, an associate professor in the department of mechanical and industrial engineering in the Faculty of Applied Science & Engineering.  

“We can use engineering tools to help our health-care systems do more with fewer resources and build systems that are equity-focused – while also meeting the demands of our aging population.”   

Montague’s project Automation and Equity in Healthcare Laboratory is one of seven from U of T Engineering – and 35 from across the University of Toronto – being supported in the latest round of funding from the Canada Foundation for Innovation’s John R. Evans Leaders Fund (JELF). The funding was part of a suite of recent research announcements that included new and renewed Canada Research Chairs.  

Montague doesn’t see her work as designing artificial intelligence (AI) tools to replace humans. Instead, she says it’s about using AI to free up human attention for more important work – such as spending time with patients.  

Her research includes designing systems that use AI to assist physicians with clerical tasks, leaving them more time for clinical duties. She is also building applications that use virtual agents known as chatbots to help patients seek out health care or manage their medication. 

“This support from CFI means everything,” says Montague. “I’ll be able to have a physical laboratory where we can do human-centred participatory design. A big part of understanding how to automate is understanding human capabilities and limitations.  

“I’ll be able to take data from clinical settings and analyze it in the lab to look for opportunities for automation and build models that can predict the effectiveness of those automation scenarios.”  

Montague is also developing human-centred guidelines for automation in health care. These aim to provide safeguards for the tools and ensure they lead to more equity and access to care.  

Growing up in a rural part of the United States, Montague witnessed the stark reality experienced by people without access to health care. This motivated her at an early age to find solutions that enable equitable health care for all.  

“We are already starting to see the consequences of not having enough primary care doctors in Canada, including poor diagnoses and overcrowded emergency rooms with patients who have missed their window for early disease intervention,” she says.  

“While automation isn’t always the answer, it can help free up resources and allow us to take full advantage of our global infrastructures,” she says.

“I want my work to help physicians avoid burnout and feel less burdened, and I also want to expand access to care for more communities in a way that is more equitable.”   

The other six U of T Engineering principal investigators receiving support from JELF are:  

Ali Dolatabadi , mechanical and industrial engineering – Advanced Cold Spray Facility 

Sarah Haines, civil and mineral engineering – the Indoor Microbiology and Environmental Exposures Laboratory 

 Xilin Liu, electrical and computer engineering – Integrated Circuits for Wireless Brain Implants with Multi-modal Neural Interfaces 

Emma Master, chemical engineering and applied chemistry – Accelerating Biomanufacturing Innovation Through Enhanced Capacity for Scale-up and Downstream Bioprocess Engineering 

Ibrahim Ogunsanya, civil and mineral engineering – Establishment of Metallurgical Materials and Corrosion Laboratory Group for Corrosion Microscopy Studies 

Yu Zou, materials science and engineering – Multifunctional Materials for Biomedical Applications