Dr. Tamblyn’s research focuses on conducting observational and interventional studies in public health and health services delivery aimed at improving the safety and quality of health care. Her research program aims to identify modifiable determinants of adverse events and improved health outcomes. She develops and evaluates computer-enabled interventions to address these determinants (e.g. computerized decision-support, personal health record portals and self-management tools, automated surveillance systems.)
LAB LEAD
Robyn Tamblyn
Scientific Director Professor, Department of Medicine and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Faculty of Medicine
Dr. Robyn Tamblyn is a Professor in the Department of Medicine and the Department of Epidemiology, Biostatistics and Occupational Health at McGill University. She is a James McGill Chair, a Medical Scientist at the McGill University Health Center Research Institute, and the Scientific Director of the Clinical and Health Informatics Research Group at McGill University. Dr Tamblyn’s ground-breaking research on educational outcomes has elucidated important relationships between health professional training, licensure and practice that have subsequently guided credentialing policies. Her work on prescription drug use, its determinants, and computerized interventions to improve drug safety (MOXXI) has been recognized internationally. She leads a CIHR-funded team to investigate the use of e-health technologies to support integrated care for chronic disease, and co-leads a Canadian Foundation for Innovation Informatics Innovation Laboratory to create advanced technologies to monitor adverse events in populations and create new tools to improve the safety and effectiveness of health care. Her work is published in the Journal of the American Medical Association, the Annals of Internal Medicine, the British Medical Journal, Medical Care, and Health Services Research, among others. She has been awarded the CHSRF KT award for her research in improving the use of medication, the ACFAS Bombardier award for innovation in the development of a computerized drug management system and the John P. Hubbard Award by the NBME for her contribution to the assessment of professional competency and educational program development in medical education and delivery of healthcare. In January 2011, she became the Scientific Director of the Institute of Health Services and Policy Research at the Canadian Institutes of Health Research. Dr Tamblyn was appointed to the Order of Canada in December 2014 for her contributions to patient safety, notably through her research on physician training, health system monitoring and prescription drug management. In 2015 Dr. Tamblyn received an Outstanding Achievement Award from the Medical Council of Canada.
Nadyne Girard
Nadyne Girard is a senior data analyst at McGill University and at the Institute of Health Services and Policy Research at the Canadian Institutes of Health Research. Nadyne holds a BSc and a Masters in Economics from l’Université du Québec à Montréal. She has been working with Dr. Robyn Tamblyn since 1995 for the Clinical and Health Informatics Research Group, where she is involved in numerous projects as a data analyst and/or a project coordinator.
Nadyne Girard est analyste principale des données à l’Université McGill et à l’Institut de recherche sur les services et les politiques de santé (IRSC). Nadyne détient un Baccalauréat et une Maîtrise en économie de l’Université du Québec à Montréal. Elle travaille avec Robyn Tamblyn depuis 1995 pour le Groupe de recherche en informatique clinique et de la santé dans le cadre duquel elle participe à de nombreux projets en tant qu’analyste de données ou coordonnatrice de projet.
Manish Thakur
Holding a Master’s in Computer Application, Manish works as a software analyst and developer where he accumulated much experience and insight on software development planning and implementation. He is now the lead developer of the software department at MCHI.
Manish détient une maîtrise en application informatique. Il travaille en tant qu’analyste et développeur de logiciels, où il a accumulé beaucoup d’expérience et de savoir en matière de planification et de mise en œuvre de développement de logiciels. Il est maintenant le développeur lead du département de logiciel de MCHI.
Bettina Habib
Bettina Habib is a research assistant on Dr. Tamblyn’s team at the McGill Clinical and Health Informatics Research Group. She has a Masters of Science in Biology (Molecular Genetics) from the American University of Beirut and a Masters of Science in Public Health from McGill University. As part of Dr. Tamblyn’s team, she has contributed to research on electronic medication reconciliation, pharmacosurveillance, and multi-national antidepressant use, as well as participated in the design, development and testing of a mobile application intended to empower patients to better adhere to medications following hospital discharge. Prior to her work at McGill, Bettina coordinated a pilot trial at the Jewish General Hospital and contributed to research on smoking cessation therapies and clinical interventions for patients with cardiovascular disease. She was also part of a team that prepared a report published by the Canadian Foundation for Healthcare Improvement on the impact of the regionalization of Canadian health care systems on the Triple Aim of better health, better care, and better value.
Bettina Habib est assistante de recherche au sein de l’équipe du Dr Tamblyn du Groupe de recherche en informatique clinique et en santé de l’Université McGill. Elle est titulaire d’une maîtrise en biologie (génétique moléculaire) de l’Université américaine de Beyrouth et d’une maîtrise en sciences de la santé publique de l’Université McGill. En tant que membre de l’équipe du Dr Tamblyn, elle a contribué à la recherche sur le bilan comparatif des médicaments, la pharmacosurveillance et l’utilisation multinationale d’antidépresseurs. Elle a également participé à la conception, au développement et à la mise à l’essai d’une application mobile destinée à permettre aux patients de mieux respecter médicaments après la sortie de l’hôpital. Avant de travailler à l’Université McGill, Bettina a coordonné un essai pilote à l’Hôpital général juif et a contribué à la recherche sur les thérapies pour cesser de fumer et les interventions cliniques auprès des patients atteints de maladie cardiovasculaire. Elle faisait également partie d’une équipe qui a préparé un rapport publié par la Fondation canadienne pour l’amélioration des services de santé sur l’impact de la régionalisation des systèmes de santé canadiens sur le triple objectif d’une meilleure santé, de meilleurs soins et d’un meilleur rapport qualité-prix.
Physician, graduate of the University of Buenos Aires. Médecin, diplômé de l'Université de Buenos Aires.
Santiago Marquez Fosser
Physician, graduate of the University of Buenos Aires. Specialist in Health Informatics from the Italian Hospital of Buenos Aires, where he is also finishing the Master in Health Informatics. He currently serves as Post Doctoral Fellow at McGill Clinical & Health Informatics research group, Montreal, Canada.
Médecin, diplômé de l’Université de Buenos Aires. Spécialiste en informatique de la santé de l’hôpital italien de Buenos Aires, où il termine également sa maîtrise en informatique de la santé. Il est actuellement boursier postdoctoral du groupe de recherche en informatique clinique et en santé de l’Université McGill, à Montréal, au Canada.
Siyana Kurteva
Siyana Kurteva is doctoral candidate in Epidemiology at McGill University under the direct supervision of Dr. Robyn Tamblyn. Previously, Siyana completed her undergraduate training in pharmacology from McGill and worked as one of the interviewers for the RightRx Project before enrolling as a master student in Epidemiology. She is currently involved in pharmacoepidemiolgy research focusing on opioid prescribing practices and opioid-related safety issues. Her thesis work is supported by the Rossy Cancer Network, CIHR-Drug Safety and Effectiveness Training Program and the Burke Fellowship Award.
Siyana Kurteva est candidate au doctorat en épidémiologie à l’Université McGill sous la supervision directe de la Dre Robyn Tamblyn. Auparavant, Siyana avait terminé sa formation de premier cycle en pharmacologie à l’Université McGill et avait travaillé comme intervieweuse pour le projet RightRx avant de s’inscrire comme étudiante à la maîtrise en épidémiologie. Elle est actuellement impliquée dans la recherche en pharmacoépidémiologie en se concentrant sur les pratiques de prescription des opioïdes et les questions de sécurité liées aux opioïdes. Son travail de thèse est soutenu par le réseau de cancérologie Rossy, le programme de formation sur l’innocuité et l’efficacité des médicaments des IRSC et la bourse de recherche Burke.
Fiona Chan
Fiona Chan is a doctoral candidate in Epidemiology at McGill University under the supervision of Dr. Robyn Tamblyn. Fiona received her B.Sc in Pharmaceutical Sciences and her M.Sc in Population and Public Health from the University of British Columbia. She is a practicing pharmacist with extensive experience in community and long-term care settings. Her work focuses on innovative community pharmacy services, pharmaceutical policy, and health service utilization. Specifically, she is interested in utilizing technology to support community pharmacists and patients to manage and optimize medication use and in doing so, reduce drug-related adverse events and preventable deterioration in health status.
Fiona Chan est candidate au doctorat en épidémiologie à l’Université McGill sous la supervision du Dr Robyn Tamblyn. Fiona a obtenu son baccalauréat en sciences pharmaceutiques et sa maîtrise en santé publique et populations de l’Université de la Colombie-Britannique. Elle est pharmacienne et possède une vaste expérience en milieu communautaire et en soins de longue durée. Son travail se concentre sur les services de pharmacie communautaire innovants, la politique pharmaceutique et l’utilisation des services de santé. Plus précisément, elle souhaite utiliser la technologie pour aider les pharmaciens communautaires et les patients à gérer et à optimiser l’utilisation des médicaments et, ce faisant, à réduire les événements indésirables liés aux médicaments et la détérioration évitable de l’état de santé.
Jeanne Vachon
Jeanne Elizabeth Vachon is a Junior Research Assistant on Dr. Tamblyn’s team at the McGill Clinical and Health Informatics Research Group. Working mainly on-site with patients and personnel of the Montreal General and MUHC hospitals. She holds a Bachelor’s degree in Fine Arts majoring in Film Studies from Concordia University.
Jeanne Elizabeth Vachon est adjointe de recherche subalterne au sein de l’équipe du Dr.Tamblyn du Groupe de recherche en informatique de la santé de l’Université McGill. Travaillant principalement sur place avec les patients et le personnel de l’Hôpital général de Montréal et du CUSM. Elle détient un baccalauréat en beaux-arts avec majeure en études cinématographiques de l’Université Concordia.
Projects
Smart About Meds
Empowering Patients to Better Manage their Medications: The ‘Smart About Meds’ (SAM) Mobile Application
Over 3 million hospitalizations and 17 million emergency department visits occur each year in Canada, a significant proportion of which are medication-related and preventable. Studies have shown that many such events are the result of prescribing or dispensing errors, incomplete drug information, and the underuse or overuse of medications. In fact, our previous study showed that 55% of patients discharged from hospital did not adhere to at least one of the changes made to their medication regimen at discharge, which subsequently increased their risk of adverse events. Analyses of patient interview data suggest that unclear communication with patients about medication changes may be driving non-adherence, as might difficulties in managing complex drug regimen information and dosing schedules. To address this apparent need for patient support mechanisms that reduce medication non-adherence, we developed the SAM mobile application, which is aimed at improving medication management following hospital discharge. The app provides patients and their caregivers with a continuously updated medication list, pill images, drug information, medication reviews by other patients, a side effect checker, alerts if they do not follow planned therapy, and the ability to connect with hospital pharmacists when needed. We plan to conduct a pilot study to assess the usability of the app and, at a later stage, a larger clinical trial to evaluate its effectiveness in improving adherence and reducing the occurrence of adverse events.
Funded By: Économie et l’Innovation Québec
Medication Reconciliation: The RightRx Trial
Effective implementation of medication reconciliation is essential to reduce preventable adverse drug events occurring at the transitions between community and hospital care. More efficient and reliable methods of obtaining the community drug list are critical to improve hospital staff adherence to the medication reconciliation process and reduce unintended discrepancies in community and hospital medication at discharge. Community-based pharmacy records could be used, particularly if the hospital treatment team could automatically retrieve these records. Adherence to medication reconciliation at discharge will likely be improved by providing an automated order entry process that facilitates re-ordering of hospital and community-based medications at discharge. Moreover, the effectiveness of an electronic medication reconciliation module in reducing adverse drug events may be augmented by interventions to improve the successful transmission of treatment discontinuation and change orders to community-based pharmacists and physicians.
Funded by: Canada Foundation for Innovation, Canadian Institutes for Health Research
In Collaboration with: MUHC-RU and MSSS Quebec
Reducing Injuries from Medication-Related Falls by Generating Targeted Computerized Alerts for High Risk Patients within an Electronic Prescribing System
Drug-related illness is the sixth leading cause of mortality. Preventable adverse drug events in ambulatory practice are estimated to occur in 2% to 3% of patients treated per year, of which 58% are related to prescribing errors. Older adults are at higher risk of adverse events and medication-related fall injuries are the most common problem. Approximately 10% to 39% of falls are attributable to the inappropriate use of psychotropic drugs and are potentially preventable. The purpose of this research is to reduce medication-related fall injuries by using computerized electronic prescribing and drug management systems to identify high risk patients and provide physicians with patient-specific recommendations for modifying psychotropic medication use to reduce this risk. We will develop and test a “smart-alert” system for modifying high risk psychotropic drug use among high risk patients within the MOXXI system to determine if the smart-alert system reduces the rate of inappropriate psychotropic drug prescriptions and fall-related injuries.
Funded By: Canadian Institutes for Health Research
Providing Comparative Out-of-Pocket Cost Information for Prescription Drugs through an Integrated Physician Electronic Prescribing System: A Proof of Concept with Anti-hypertensive Drugs
The potential benefits of new drug treatments and increased medication utilization rates have not been fully realized, even though the proportion of health costs due to drug expenditures continues to rise on a yearly basis. This has created a need to investigate new methods to maximize the benefits of existing and new drug treatments while minimizing costs. This research will build on initiatives to implement electronic prescribing and integrated drug management systems to improve patient safety. The study will assess a) whether access to detailed comparative information on patient out-of-pocket cost for drugs of equivalent effectiveness at the time of prescribing will improve the cost-effectiveness of drugs prescribed for uncomplicated hypertension and b) determine the impact on patient adherence with the anti-hypertensive therapy. The results will help to assess the degree to which evidence-based decision-support systems that provide physicians with information on out-of-pocket payments from patients can be integrated into electronic prescribing and integrated drug management systems and produce improvements in cost-effective prescribing.
Funded By: Canadian Institutes for Health Research
The Medical Office for the Twenty First Century (MOXXI)
The MOXXI project is a computerized system to manage medications and electronically write prescriptions. The goal of the research project is to study the impact of these new technologies on quality of care delivered and on patient outcomes.
Optimal management of prescription medications is an increasingly complex challenge. In order to ensure the best and safe treatment of their patients, physicians and pharmacists must keep their knowledge about medications and their use up-to-date. Today there are:
- More than 33,000 drug interactions
- More than 6,500 prescription drugs that are counter-indicated in the presence of certain illnesses
- More than 3,500 prescription drugs that can cause allergic reactions. The goals of the project are to determine whether the MOXXI system can prevent undesirable drug-induced effects by testing
- An electronic prescription module, including therapeutic intent, in order to reduce errors in the prescription, transcription, and delivery of medications.
- A therapeutic advisor, to rapidly detect drug interactions and ineffective treatments.
- A module for the follow-up of drug treatment adherence.
Funded By: Canada Foundation for Innovation
Information Systems-enabled Outreach Program for Adverse Drug Events: The ISTOP-ADE Trial
Medications are an effective intervention for managing and preventing health problems but their benefit can be undermined by non-adherence or adverse drug events (ADEs). As these issues are interconnected, efforts to improve non-adherence should also include reduction of ADEs. We have developed the ISTOP-ADE system (Information Systems-enabled Outreach for Preventing Adverse Drug Events) which enables timely monitoring of patients for ADEs and couples it with an intervention to manage ADEs. The objectives of this study are to determine whether the ISTOP-ADE system, compared to routine care, will reduce a) the probability of discontinuing of prognosis-altering medications, b) the probability of a patient experiencing a severe ADE, c) the proportion of patients experiencing ADEs, preventable ADEs, and ameliorable ADEs, and d) health services utilization.
Funded By: Canadian Institutes for Health Research
International Pharmacosurveillance using Electronic Health Records and Health Information Technologies
While there are considerable benefits from modern drug therapy, the frequent occurrence of adverse drug-related events and the uncertainty about effects of drugs after they enter the market have highlighted fundamental shortcomings in the ability to actively monitor drugs after their approval. Electronic health records, computerized prescribing and automated patient follow-up systems are health information technologies that provide an unprecedented opportunity to develop an active surveillance system that will monitor and provide patients and physicians with real-time feedback on the comparative safety and effectiveness of new drugs. Conducting active surveillance on a collaborative international scale will provide more rapid information about drug safety and effectiveness from users around the world, as well as permit more personalized risk/benefit analysis for subgroups where drugs may have a different risk/benefit profile. The purpose of this project is to develop state-of-the-art methods of i) monitoring, and ii) analyzing the comparative risk and benefit of new drug therapies, in real-time, through an international prospective surveillance system, and iii) communicating this information to clinicians to inform treatment decision-making at the point-of-care.
Funded By: Canadian Institutes for Health Research
Former Members
Jenna Wong
Ania Syrowatka
Daniala Weir
Lina Petrella
Jessica Nadigel
Nancy Winslade
Aude Motulsky
Melissa Bustillo
Sarah Elsayed