News at Medicine - October 2020 - From Canada to Uganda


From Canada to Uganda
October 13, 2020
Jason Hearn’s passion for innovation and health equity led him here - to Memorial University’s doctor of medicine (MD) program. The same passion also led him to help heart failure patients 10,000 kms away in Uganda, Africa. That idea came about when he was a graduate student and the notion of combining innovation and medicine inspired Hearn’s career path.
 
Hearn is a third year MD student and Memorial University’s latest Canadian Medical Hall of Fame Award recipient; an award given for community leadership, superior communication skills and demonstrated interest in advancing knowledge. And it’s no wonder, given Hearn’s accomplishments so far in his academic career.
 

Simple, accessible and familiar

When Hearn was a masters student at the University of Toronto, he designed and developed a mobile phone-based remote management system for heart failure patients living in Uganda.
 
The culturally-informed, self-management intervention, called Medly Uganda, uses a mobile device and patients are presented with a list of options that correspond to numeric buttons.
 
“In essence, heart failure patients can access Medly Uganda from their mobile device and respond to yes-or-no questions pertaining to their related symptoms,” he explains. “Upon finishing the symptom questionnaire, the patient receives an SMS (i.e. text) message containing tailored self-care advice based on their reported symptoms and an inbuilt algorithm.”

For patients presenting with moderate-to-severe symptoms, an SMS message is also sent to a clinician (or a group of clinicians), with a brief description of the symptoms and a phone number where the patient can be reached. Through that number, the clinician can see additional patient details (e.g. long-term history, demographic information) in a web-based dashboard, before calling the patient to provide advice on the appropriate next steps.  

Hearn says the system is simple, accessible and familiar (the same platform is commonly used for “mobile money” services, where individuals can transfer or receive money via their device). The intervention can improve patient outcomes as well as overburdened cardiac clinics.
 

Tailored self-care

 The idea for Medly Uganda, was inspired by a remote management system called Medly currently deployed in Canada and developed in part by Hearn’s thesis supervisor, Dr. Joseph Cafazzo. It also enables heart failure patients to better care for themselves through tailored self-care advice and direct access to their health care team.

“When I approached Dr. Cafazzo about pursuing a global health-focused research thesis, he suggested that we consider developing a similar system for use in a low-income country.” They made some connections with Uganda-based partners and over two years, worked alongside heart failure patients and clinicians there. “Based on the formative research from my thesis, my mentors recently received a grant from the National Institutes of Health to implement Medly Uganda in Uganda.”
Inspired by a pioneer
 
When applying for the CMHF award, Hearn was inspired by 2010 CMHF Laureate Dr. Calvin Stiller, who pioneered the first multi-organ transplant program in Canada. Hearn says he admires Dr. Stiller’s commitment to community involvement including his promotion of organ donation, resulting in an increase in public awareness of organ donation and the initiation of the Organ Donor Card now attached to drivers’ licenses in Canada.
 
“I was truly inspired by the way Dr. Stiller embodies the characteristics of physicianship,” Hearn said. “Dr. Stiller is an incredible inspiration and motivates me to approach my future role as a physician with more than just medical acumen.”

Along with his masters in health science in clinical engineering, Hearn completed a bachelor of science in engineering at the University of New Brunswick, where he earned the Lieutenant-Governor Silver Medal for highest academic standing before coming to Memorial.
 
During his time at Memorial, Hearn’s innovations in 3D-printing and virtual care have earned him two research awards. He also has publications, research grants, and a few conference abstracts and papers under his belt.
 
In addition, the New Brunswick native worked with medical students from across the country to advocate Members of Parliament for improved seniors’ care, led the compilation and presentation of research evidence that medical students used to lobby Members of the House of Assembly leading to the Government of Newfoundland and Labrador to lift the age restriction on insulin pump coverage in the province. Most recently, he co-founded an initiative to collect personal protective equipment items for frontline health care workers during the COVID-19 pandemic.
 
His experience at Memorial has helped shift his perception of medicine to one that holds paramount the entire patient experience, rather than just health outcomes. “I was incredibly honoured to have been chosen amongst such an impressive group of students at MUN. I am grateful for the opportunity to study at MUN, and I could not imagine attending medical school anywhere else!”