Cardiovascular Network of Canada enhances its digital health platform VIRTUES, optimizing the delivery of cardiac care to patients in all regions across Canada • Cardiovascular Network of Canada — CANet
Cardiovascular Network of Canada enhances its digital health platform VIRTUES, optimizing the delivery of cardiac care to patients in all regions across Canada

Cardiovascular Network of Canada enhances its digital health platform VIRTUES, optimizing the delivery of cardiac care to patients in all regions across Canada

Eighteen inches.

Dr. Kenneth Gin vividly recalls that number.

“I recently attended a conference talk given by a General Physician (GP), who had brought a stack of papers with him on stage and measured it – 18 inches,” says Dr. Gin, Professor of Medicine and Head of Cardiology Division at Vancouver General Hospital. ” That was the stack of papers just from the last two years that he was expected to read up to stay current as a GP.”

The growth of medical information currently outpaces doctors’ abilities to keep up with it. Patients, too, are living longer – encouraging news but also challenging, as they accrue more chronic medical conditions, which tend to interact with one another, but so do their treatments.

“We are treating very complicated medical cases that require advanced knowledge that we can barely keep up with,” says Dr. Pavel Antiperovitch, Medical Development Lead for VIRTUES and an early career cardiologist at the London Health Science Centre.

To help alleviate these specific problems, the Cardiovascular Network of Canada (CANet) has evolved its proven-successful digital health platform, VIRTUES.

“With recent enhancements incorporated into VIRTUES, we have a platform designed to provide patients with the most relevant medical information, facilitate access to effective care options and connect them with clinicians who understand their medical and personal care requirements,” explains CANet’s Scientific Director, and CEO, Dr. Anthony Tang.

Patients begin their journey in VIRTUES by completing their medical profile related to their condition. They can access, review and share this critical information belonging to them at any time.

Compliant with all Canadian healthcare privacy laws, including the Personal Health Information Protection Act (PHIPA), the platform is not owned by hospitals, businesses, insurance companies, or physicians; it is in the hands of the patients who use it.

Canadian Clinical Practice Guidelines-Driven

Customized proprietary algorithms developed by CANet’s team are at the heart of VIRTUES.

Unlike traditional generic guideline recommendations accessed through various tools and apps found online, VIRTUES algorithms analyze a patient’s medical history, labs, and medications activating appropriately identified CareSets. These CareSets are guidelines-driven, accurate and provide standardized treatment recommendations tailored to their unique conditions.

CANet has a strong partnership with the Canadian Cardiovascular Society (CCS) and works extensively with CCS members who develop cardiac care guidelines.

“These guidelines take a lot of work and are very well done,” Dr. Tang says. But keeping up with these guidelines and implementing them consistently has become more complex with the constant expansion of medical knowledge.

Now, with the latest version of VIRTUES, implementation of guidelines recommendations are now individualized to the specific needs of the patients such that the clinicians and the patients have the individualized recommendation at their fingertips.

Patients can view their recommendations within the VIRTUES platform and share them with their healthcare provider of choice. Their healthcare provider will receive a copy of recommended treatment options, including the relevant information and references supporting the recommendations. The patient and healthcare provider can choose the best treatment option together. A combination of educational materials, medication infographics, and informative videos about managing their condition are provided directly in VIRTUES for the patient.

“We are a long way from implementing VIRTUES as part of standard medical practice,” Dr. Tang clarifies, adding that the coming years will consist of rigorous platform testing across Canada.

The hope is to demonstrate that using the platform results in better health outcomes for patients and increases access to quality of care and quality of life, reduces the cost to the healthcare system, and improves the efficiency of medical professionals.

Optimizing Cardiac Care Delivery for all Canadians

Currently in use for remote monitoring and support for patients with Cardiac Implantable Electronic Devices (CIED), VIRTUES’ has also proven successful during the pandemic utilizing the platform to provide symptom tracking for COVID-19-positive patients and integral support to healthcare professionals.

With the release of the enhanced VIRTUES platform, an ongoing pilot trial involving 1400 patients across 15 clinical sites throughout Canada aims to determine the effectiveness and patient satisfaction of CareSets for patients with various cardiac conditions like Atrial Fibrillation (AF).

AF is the most common cardiac disturbance contributing to cardiovascular morbidity and mortality. Studies estimate a 250% increase in AF prevalence by 2050.

Dr. Allan C. Skanes, who focuses on AF management, is hopeful that VIRTUES will help widen the geographic scale of treatment across Canada. “Many of the drugs we use for AF management are unfamiliar to most family doctors and internal medicine specialists,” says Dr. Skanes, Professor of Medicine at Schulich Medicine and Dentistry and Director of Electrophysiology Laboratory, London Health Sciences Centre, and echoes the myriad questions medical care specialists face – How do we provide the best guidance on managing AF related rhythm disturbances? How do we choose what drugs to give, and how to monitor and manage patients?

One critical advantage of VIRTUES, he notes, will be its ability to optimize the delivery of cardiac care guidelines and guideline-directed therapy to the broader medical community more consistently.

Once validated, how does VIRTUES get integrated into the national healthcare system?

“Does it become one component of Canada’s evolving electronic health record-keeping landscape, or does it become the dominant digital health platform, with all sorts of medical and lifestyle information feeding into it?” wonders Dr. Michael D. Hill, Senior Medical Director, Cardiovascular Health & Stroke Strategic Clinical Networks TM, Alberta Health Services. With the constant expansion of medical knowledge and data collection, one will need more resources and a larger pool of experts who can collect, analyze, and communicate this information in an accessible way; he points out.

“This opens up opportunities for medical students to receive training in digital health,” speculates Dr. Antiperovitch. According to him, the training would help doctors gain knowledge of programming and interface software in a way that would help them communicate medical knowledge to software designers.

The collaboration, as demonstrated by CANet’s VIRTUES team, will be vital in creating and keeping algorithms up-to-date to generate the most effective and current patient-specific treatment guidelines.

“VIRTUES is an extremely ambitious project with a huge amount of background work.” Dr. Gin says.

Knowing this, CANet remains steady and committed to transforming the nation’s healthcare system, driving quality and affordable care for better cardiovascular health outcomes. Dr. Tang is hopeful that the Federal government remains committed as well.

“Our strength is our network, with its vast collective expertise of healthcare professionals, academia, government, industry, not-for-profit, and patient partners across Canada,” he says.

Patient engagement, Dr. Tang notes, is often an afterthought in profit-driven digital health platforms, where patients are involved only at the end of the development process. He emphasizes VIRTUES has been a patient-controlled digital health platform since the first line of code was written, placing it in a league of its own.

“VIRTUES is a big and ambitious project, made possible by the generous and selfless voluntary contributions of highly skilled and highly qualified professionals, striving to put the patient at the centre of it all. We will continue to move forward.”


VIRTUES is a holistic, comprehensive digital health approach that provides equity of care to meet the needs of all patients, regardless of geographical, cultural, or systemic barriers.

Addressing the critical needs of patients, VIRTUES provides secured digital health tools to access efficient and quality care in all regions across Canada for improved quality of life and better health outcomes.

With patient information collected in VIRTUES, patients receive personalized CareSets for their medical conditions. Patients may receive different CareSets (modules) in VIRTUES based on their current health conditions and needs.

A CareSet is a package of Guidelines-Driven Recommendations and Educational Resources that address relevant health conditions tailored to a patient’s needs.


  • Antithrombotic Management (Blood Thinning)
  • Post Myocardial Infarction Care (Heart Attack)
  • Rate & Rhythm Management for Atrial Fibrillation
  • Lipid Management (Cholesterol)
  • Hypertension Management (Blood Pressure)
  • Physical Activity
  • Healthy Eating

  • Blood Sugar Management (Diabetes)
  • Smoking Cessation
  • Alcohol Reduction
  • Heart Failure Management
  • COVID-19
  • Cardiac Implantable Electronic Devices (CIED)


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