Keith Denny - Academia.edu (original) (raw)

Papers by Keith Denny

Research paper thumbnail of OUP accepted manuscript

Public Health Ethics, 2020

Since 1984, the idea of health equity has proliferated throughout public health discourse with li... more Since 1984, the idea of health equity has proliferated throughout public health discourse with little mainstream critique for its variability and distance from its original articulation signifying social transformation and a commitment to social justice. In the years since health equity’s emergence and proliferation, it has taken on a seemingly endless range of invocations and deployments, but it most often translates into proactive and apolitical discourse and practice. In Margaret Whitehead’s influential characterization (1991), achieving health equity requires determining what is inequitable by examining and judging the causes of inequalities in the context of what is going on in the rest of society. However, it also remains unclear how or if public health actors examine and judge the causes of health inequality. In this article, we take the concept of health equity itself as an object of study and consider the ways in which its widespread deployment has entailed a considerable e...

Research paper thumbnail of The Role of Performance Data and Information in Driving and Supporting Health System Innovation

A Canadian Healthcare Innovation Agenda

Research paper thumbnail of Informed consumers, regulated subjects: Public health and the rise and fall of the interventionist state

Research paper thumbnail of An international survey examining the impact of the COVID-19 pandemic on telehealth use among mental health professionals

Journal of Psychiatric Research, 2022

Background COVID-19 has profoundly affected the work of mental health professionals with many tra... more Background COVID-19 has profoundly affected the work of mental health professionals with many transitioning to telehealth to comply with public health measures. This large international study examined the impact of the pandemic on mental health clinicians’ telehealth use. Methods This survey study was conducted with mental health professionals, primarily psychiatrists and psychologists, registered with WHO's Global Clinical Practice Network (GCPN). 1206 clinicians from 100 countries completed the telehealth section of the online survey in one of six languages between June 4 and July 7, 2020. Participants were asked about their use, training (i.e., aspects of telehealth addressed), perceptions, and concerns. Outcomes Since the pandemic onset, 1092 (90.5%) clinicians reported to have started or increased their telehealth services. Telephone and videoconferencing were the most common modalities. 592 (49.1%) participants indicated that they had not received any training. Clinicians with no training or that only addressed a single aspect of telehealth practice were more likely to perceive their services as somewhat ineffective than those with training that addressed two or more aspects. Most clinicians indicated positive perceptions of effectiveness and patient satisfaction. Quality of care compared to in-person services and technical issues were the most common concerns. Findings varied by WHO region, country income level, and profession. Interpretation Findings suggest a global practice change with providers perceiving telehealth as a viable option for mental health care. Increasing local training opportunities and efforts to address clinical and technological concerns is important for meeting ongoing demands.

Research paper thumbnail of Living in Interesting Times: An Update from the Canadian Healthcare Association

Introduction “May you live in interesting times”. So goes the ancient proverb, and these are cert... more Introduction “May you live in interesting times”. So goes the ancient proverb, and these are certainly interesting times for the Canadian health systems, and thus the Canadian Healthcare Association (CHA). The last year has brought a great deal of change and unanticipated developments. Within a few short months, widely held expectations have been largely turned on their head and an entirely new dynamic has emerged in the politics of Canadian healthcare.

Research paper thumbnail of Commentary – From Mixtapes to Playlists: Evolving Options for Capturing Diagnoses in Canadian Physicians’ Data

Healthcare Policy | Politiques de Santé

Research paper thumbnail of From Performance Measurement to Performance Management

Research paper thumbnail of Diagnostic coding of routinely collected data

Canadian Medical Association Journal

Research paper thumbnail of La santé et le développement de l’enfant dans la perspective de leurs déterminants sociaux

Canadian Journal of Public Health

Research paper thumbnail of Les indicateurs socioéconomiques régionaux : des outils de recherche, de politiques et de planification axés sur les disparités d’état sanitaire

Canadian Journal of Public Health

Research paper thumbnail of Canadian Approaches to Optimizing Quality of Administrative Data for Health System Use, Research, and Linkage

International Journal of Population Data Science

Theme: Data and Linkage QualityObjectives: To define health data quality from clinical, data scie... more Theme: Data and Linkage QualityObjectives: To define health data quality from clinical, data science, and health system perspectives To describe some of the international best practices related to quality and how they are being applied to Canada’s administrative health data. To compare methods for health data quality assessment and improvement in Canada (automated logical checks, chart quality indicators, reabstraction studies, coding manager perspectives) To highlight how data linkage can be used to provide new insights into the quality of original data sources To highlight current international initiatives for improving coded data quality including results from current ICD-11 field trials Dr. Keith Denny: Director of Clinical Data Standards and Quality, Canadian Insititute for Health Information (CIHI), Adjunct Research Professor, Carleton University, Ottawa, ON. He provides leadership for CIHI’s information quality initiatives and for the development and application of clinical c...

Research paper thumbnail of The Borderland of Imbecility: Medicine, Society and the Fabrication of the Feeble Mind in Late Victorian and Edwardian England by Mark Jackson

Research paper thumbnail of Towards a Model of Stewardship and Accountability in Support of Innovation and “Good” Failure

Research paper thumbnail of The resilient child, human development and the “postdemocracy”

BioSocieties, 2015

Resilience is the popular term for a capacity to ‘bounce back’ from adversity. It is also a scien... more Resilience is the popular term for a capacity to ‘bounce back’ from adversity. It is also a scientific concept informing an influential bio-psychological approach to contemporary inequality. This article recalls the origins of the term in developmental psychopathology and suggests that the project of cultivating resilient selves is an aspect of the broader depoliticization characterizing “postdemocracies” today. The scientific object of resilience is produced through the study of the interplay of risky and protective variables in the individual life course. Resilience is present when developmental resources in and around the self help to combat threats to ‘adaptation.’ The project of resilience is to know how to cultivate individual robustness in the face of immutable threats, including poverty, grasped as a developmental risk factor. In this way of knowing the world, structured inequality is seen to be relatively unchangeable compared to the powers of resilience. Resilience has been taken up by neoliberal governments as the model of evidence-based ‘actionable knowledge’ for population interventions. But its influence extends further, to institutions of global governance, where resilience’s central object of inquiry and intervention̞̞̞̞--the child--has been projected onto humanity as a whole. The appeal of resilience as a practical and optimistic science is undeniable but we suggest that it is time to take account of its implications for political contestation. Resilience provides positive psychology’s contribution to the narrowing of justice- and equity-seeking projects in the current moment, reducing their horizons to the care for ‘human capital’ under conditions of socio-economic precarity. Advance online publication in Biosocieties: http://www.palgrave-journals.com/biosoc/journal/vaop/ncurrent/abs/biosoc201524a.html

Research paper thumbnail of Mental Health: Population Perspectives

Canadian Journal of Community Mental Health, 2013

Research paper thumbnail of Transformation through Clinical and Social Integration: Meeting the Needs of High Users of Healthcare

HealthcarePapers, 2014

A minority of patients consume the bulk of health services and/or the costs of care. This group p... more A minority of patients consume the bulk of health services and/or the costs of care. This group provides a focus for a number of concerns related to health system sustainability, the appropriateness and effectiveness of care and the proportion of government program spending made up by health expenditures. This introduction offers five observations. First, if Ontario's Health Links are to meet the needs of high users, local autonomy may have to be balanced with more consistent frameworks. Second, there is a need for creative approaches to evaluation, specifically in the area of rapid cycle evaluation. Third, genuine innovation will require clear role specifications in governance relationships and bold approaches to accountability that build in space for learning from "good" failure. Fourth, successful interventions will encompass social care services and broader social determinants as well as clinical factors and, fifth, we will need an approach to stewardship that faci...

Research paper thumbnail of Area-based socio-economic measures as tools for health disparities research, policy and planning

Canadian journal of public health = Revue canadienne de santé publique, Jan 5, 2012

Research paper thumbnail of Evidence-based medicine and medical authority

The Journal of medical humanities, 1999

Over the last five years evidence-based medicine (EBM) has been promoted in mainstream medical li... more Over the last five years evidence-based medicine (EBM) has been promoted in mainstream medical literature in Canada, the United States, and the United Kingdom as a new paradigm in medical education and practice. "Traditional," "unsystematic" and "intuitive" methods, based on individual clinical experience, are eschewed in favour of an approach which stresses the need for greater scientific rigour. This scientific

Research paper thumbnail of Supplement 3: Taking a Social Determinants Perspective on Children's Health and Development || Avant-propos

Research paper thumbnail of Enhancing capacity for risk factor surveillance at the regional/local level: a follow-up review of the findings of the Canadian Think Tank Forum after 4 years

Archives of Public Health, 2014

Background: National health surveys are sometimes used to provide estimates on risk factors for p... more Background: National health surveys are sometimes used to provide estimates on risk factors for policy and program development at the regional/local level. However, as regional/local needs may differ from national ones, an important question is how to also enhance capacity for risk factor surveillance regionally/locally. Methods: A Think Tank Forum was convened in Canada to discuss the needs, characteristics, coordination, tools and next steps to build capacity for regional/local risk factor surveillance. A series of follow up activities to review the relevant issues pertaining to needs, characteristics and capacity of risk factor surveillance were conducted. Results: Results confirmed the need for a regional/local risk factor surveillance system that is flexible, timely, of good quality, having a communication plan, and responsive to local needs. It is important to conduct an environmental scan and a gap analysis, to develop a common vision, to build central and local coordination and leadership, to build on existing tools and resources, and to use innovation. Conclusions: Findings of the Think Tank Forum are important for building surveillance capacity at the local/county level, both in Canada and globally. This paper provides a follow-up review of the findings based on progress over the last 4 years.

Research paper thumbnail of OUP accepted manuscript

Public Health Ethics, 2020

Since 1984, the idea of health equity has proliferated throughout public health discourse with li... more Since 1984, the idea of health equity has proliferated throughout public health discourse with little mainstream critique for its variability and distance from its original articulation signifying social transformation and a commitment to social justice. In the years since health equity’s emergence and proliferation, it has taken on a seemingly endless range of invocations and deployments, but it most often translates into proactive and apolitical discourse and practice. In Margaret Whitehead’s influential characterization (1991), achieving health equity requires determining what is inequitable by examining and judging the causes of inequalities in the context of what is going on in the rest of society. However, it also remains unclear how or if public health actors examine and judge the causes of health inequality. In this article, we take the concept of health equity itself as an object of study and consider the ways in which its widespread deployment has entailed a considerable e...

Research paper thumbnail of The Role of Performance Data and Information in Driving and Supporting Health System Innovation

A Canadian Healthcare Innovation Agenda

Research paper thumbnail of Informed consumers, regulated subjects: Public health and the rise and fall of the interventionist state

Research paper thumbnail of An international survey examining the impact of the COVID-19 pandemic on telehealth use among mental health professionals

Journal of Psychiatric Research, 2022

Background COVID-19 has profoundly affected the work of mental health professionals with many tra... more Background COVID-19 has profoundly affected the work of mental health professionals with many transitioning to telehealth to comply with public health measures. This large international study examined the impact of the pandemic on mental health clinicians’ telehealth use. Methods This survey study was conducted with mental health professionals, primarily psychiatrists and psychologists, registered with WHO's Global Clinical Practice Network (GCPN). 1206 clinicians from 100 countries completed the telehealth section of the online survey in one of six languages between June 4 and July 7, 2020. Participants were asked about their use, training (i.e., aspects of telehealth addressed), perceptions, and concerns. Outcomes Since the pandemic onset, 1092 (90.5%) clinicians reported to have started or increased their telehealth services. Telephone and videoconferencing were the most common modalities. 592 (49.1%) participants indicated that they had not received any training. Clinicians with no training or that only addressed a single aspect of telehealth practice were more likely to perceive their services as somewhat ineffective than those with training that addressed two or more aspects. Most clinicians indicated positive perceptions of effectiveness and patient satisfaction. Quality of care compared to in-person services and technical issues were the most common concerns. Findings varied by WHO region, country income level, and profession. Interpretation Findings suggest a global practice change with providers perceiving telehealth as a viable option for mental health care. Increasing local training opportunities and efforts to address clinical and technological concerns is important for meeting ongoing demands.

Research paper thumbnail of Living in Interesting Times: An Update from the Canadian Healthcare Association

Introduction “May you live in interesting times”. So goes the ancient proverb, and these are cert... more Introduction “May you live in interesting times”. So goes the ancient proverb, and these are certainly interesting times for the Canadian health systems, and thus the Canadian Healthcare Association (CHA). The last year has brought a great deal of change and unanticipated developments. Within a few short months, widely held expectations have been largely turned on their head and an entirely new dynamic has emerged in the politics of Canadian healthcare.

Research paper thumbnail of Commentary – From Mixtapes to Playlists: Evolving Options for Capturing Diagnoses in Canadian Physicians’ Data

Healthcare Policy | Politiques de Santé

Research paper thumbnail of From Performance Measurement to Performance Management

Research paper thumbnail of Diagnostic coding of routinely collected data

Canadian Medical Association Journal

Research paper thumbnail of La santé et le développement de l’enfant dans la perspective de leurs déterminants sociaux

Canadian Journal of Public Health

Research paper thumbnail of Les indicateurs socioéconomiques régionaux : des outils de recherche, de politiques et de planification axés sur les disparités d’état sanitaire

Canadian Journal of Public Health

Research paper thumbnail of Canadian Approaches to Optimizing Quality of Administrative Data for Health System Use, Research, and Linkage

International Journal of Population Data Science

Theme: Data and Linkage QualityObjectives: To define health data quality from clinical, data scie... more Theme: Data and Linkage QualityObjectives: To define health data quality from clinical, data science, and health system perspectives To describe some of the international best practices related to quality and how they are being applied to Canada’s administrative health data. To compare methods for health data quality assessment and improvement in Canada (automated logical checks, chart quality indicators, reabstraction studies, coding manager perspectives) To highlight how data linkage can be used to provide new insights into the quality of original data sources To highlight current international initiatives for improving coded data quality including results from current ICD-11 field trials Dr. Keith Denny: Director of Clinical Data Standards and Quality, Canadian Insititute for Health Information (CIHI), Adjunct Research Professor, Carleton University, Ottawa, ON. He provides leadership for CIHI’s information quality initiatives and for the development and application of clinical c...

Research paper thumbnail of The Borderland of Imbecility: Medicine, Society and the Fabrication of the Feeble Mind in Late Victorian and Edwardian England by Mark Jackson

Research paper thumbnail of Towards a Model of Stewardship and Accountability in Support of Innovation and “Good” Failure

Research paper thumbnail of The resilient child, human development and the “postdemocracy”

BioSocieties, 2015

Resilience is the popular term for a capacity to ‘bounce back’ from adversity. It is also a scien... more Resilience is the popular term for a capacity to ‘bounce back’ from adversity. It is also a scientific concept informing an influential bio-psychological approach to contemporary inequality. This article recalls the origins of the term in developmental psychopathology and suggests that the project of cultivating resilient selves is an aspect of the broader depoliticization characterizing “postdemocracies” today. The scientific object of resilience is produced through the study of the interplay of risky and protective variables in the individual life course. Resilience is present when developmental resources in and around the self help to combat threats to ‘adaptation.’ The project of resilience is to know how to cultivate individual robustness in the face of immutable threats, including poverty, grasped as a developmental risk factor. In this way of knowing the world, structured inequality is seen to be relatively unchangeable compared to the powers of resilience. Resilience has been taken up by neoliberal governments as the model of evidence-based ‘actionable knowledge’ for population interventions. But its influence extends further, to institutions of global governance, where resilience’s central object of inquiry and intervention̞̞̞̞--the child--has been projected onto humanity as a whole. The appeal of resilience as a practical and optimistic science is undeniable but we suggest that it is time to take account of its implications for political contestation. Resilience provides positive psychology’s contribution to the narrowing of justice- and equity-seeking projects in the current moment, reducing their horizons to the care for ‘human capital’ under conditions of socio-economic precarity. Advance online publication in Biosocieties: http://www.palgrave-journals.com/biosoc/journal/vaop/ncurrent/abs/biosoc201524a.html

Research paper thumbnail of Mental Health: Population Perspectives

Canadian Journal of Community Mental Health, 2013

Research paper thumbnail of Transformation through Clinical and Social Integration: Meeting the Needs of High Users of Healthcare

HealthcarePapers, 2014

A minority of patients consume the bulk of health services and/or the costs of care. This group p... more A minority of patients consume the bulk of health services and/or the costs of care. This group provides a focus for a number of concerns related to health system sustainability, the appropriateness and effectiveness of care and the proportion of government program spending made up by health expenditures. This introduction offers five observations. First, if Ontario's Health Links are to meet the needs of high users, local autonomy may have to be balanced with more consistent frameworks. Second, there is a need for creative approaches to evaluation, specifically in the area of rapid cycle evaluation. Third, genuine innovation will require clear role specifications in governance relationships and bold approaches to accountability that build in space for learning from "good" failure. Fourth, successful interventions will encompass social care services and broader social determinants as well as clinical factors and, fifth, we will need an approach to stewardship that faci...

Research paper thumbnail of Area-based socio-economic measures as tools for health disparities research, policy and planning

Canadian journal of public health = Revue canadienne de santé publique, Jan 5, 2012

Research paper thumbnail of Evidence-based medicine and medical authority

The Journal of medical humanities, 1999

Over the last five years evidence-based medicine (EBM) has been promoted in mainstream medical li... more Over the last five years evidence-based medicine (EBM) has been promoted in mainstream medical literature in Canada, the United States, and the United Kingdom as a new paradigm in medical education and practice. "Traditional," "unsystematic" and "intuitive" methods, based on individual clinical experience, are eschewed in favour of an approach which stresses the need for greater scientific rigour. This scientific

Research paper thumbnail of Supplement 3: Taking a Social Determinants Perspective on Children's Health and Development || Avant-propos

Research paper thumbnail of Enhancing capacity for risk factor surveillance at the regional/local level: a follow-up review of the findings of the Canadian Think Tank Forum after 4 years

Archives of Public Health, 2014

Background: National health surveys are sometimes used to provide estimates on risk factors for p... more Background: National health surveys are sometimes used to provide estimates on risk factors for policy and program development at the regional/local level. However, as regional/local needs may differ from national ones, an important question is how to also enhance capacity for risk factor surveillance regionally/locally. Methods: A Think Tank Forum was convened in Canada to discuss the needs, characteristics, coordination, tools and next steps to build capacity for regional/local risk factor surveillance. A series of follow up activities to review the relevant issues pertaining to needs, characteristics and capacity of risk factor surveillance were conducted. Results: Results confirmed the need for a regional/local risk factor surveillance system that is flexible, timely, of good quality, having a communication plan, and responsive to local needs. It is important to conduct an environmental scan and a gap analysis, to develop a common vision, to build central and local coordination and leadership, to build on existing tools and resources, and to use innovation. Conclusions: Findings of the Think Tank Forum are important for building surveillance capacity at the local/county level, both in Canada and globally. This paper provides a follow-up review of the findings based on progress over the last 4 years.