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Record W7117248286 · doi:10.1016/j.ssmhs.2025.100164

Challenges and opportunities for policy development on digital health equity in four Canadian jurisdictions

2025· article· en· W7117248286 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
fundA Canadian funder is recorded on the work.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenueSSM - Health Systems · 2025
Typearticle
Languageen
FieldMedicine
TopicTelemedicine and Telehealth Implementation
Canadian institutionsWomen's College HospitalCollege of Physicians and Surgeons of OntarioUniversité de MontréalUniversity of SaskatchewanUniversity of AlbertaUniversity of CalgaryPublic Health OntarioUniversity Health NetworkUniversity of Toronto
FundersCanadian Institutes of Health Research
KeywordsDigital healthHealth policyEquity (law)AccountabilityHealth equityPublic policyPublic healthPolicy analysisDigital divide

Abstract

fetched live from OpenAlex

Digital health equity is an increasingly important topic, understood here as an aspirational state where everyone has access to the health-related digital technologies that support them in meeting their health-related needs. Despite strong emerging evidence regarding policy options to promote digital health equity, little policy action has been taken internationally to implement these options. The purpose of this paper is to report on a qualitative research project that explores the challenges and opportunities for policy development and implementation on digital health equity in four Canadian jurisdictions: Alberta, Saskatchewan, Ontario, and Quebec. We completed an Intersectionality-Based Policy Analysis, involving in-depth qualitative interviews with 23 participants, including both policy actors (i.e., those in positions to develop and/or implement digital health equity policy) and community leaders (i.e., those in positions advocating for the needs of structurally marginalized communities). Our findings illustrate a set of foundational policy options and more tailored policy programs for digital health equity, including the development of equity-focused accountability processes in new funding for digital health innovation. We also found challenges related to the political structure of Canada as a federation, and novel challenges related to the development of policy for digital health equity specifically. In our discussion, we explore three policy development challenges in detail: conflicting views on the priority status of health equity, challenges in building long-term partnerships with community for policy development, and conflicting views on the role of technology vendors in public policy for health care.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.921
Threshold uncertainty score0.992

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.260
GPT teacher head0.457
Teacher spread0.198 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it