“This kind of agentic AI [artificial intelligence] is the next big thing,” says Associate Professor Vijay Mago, director of the DaTALab at �첥��Ƶ and Chair of the School of Health Policy & Management, Faculty of Health.

“Right now, a clinician reviews test results such as CT scans, gathers the patient’s medical history, and uses that information to make a diagnosis or decide on treatment. In the future, AI agents will be capable of performing many of these tasks – analyzing data, integrating medical information, and supporting or even making clinical decisions. We’re heading toward a much more advanced stage of health-care intelligence.”

It is the stuff of science fiction and York researchers are on the cutting edge of helping to make it happen in a safe and ethical way. As Mago points out, LLMs are becoming increasingly sophisticated, and the emergence of agentic AI – systems capable of autonomous reasoning and decision making in health care – appears to be imminent.

As a type of LLM, these agentic AI models involve several agents working together to accomplish complex tasks, memorize and collect data, plan, reason and learn.

Mago is part of a project developing an AI-powered doctor’s assistant for patients with chest pain to enhance diagnostic support in First Nations communities in northern Ontario, as well as other rural areas.

“AI models are becoming more intelligent every day.”

If a patient presents with chest pain, a doctor would ask all sorts of questions, including medical history and symptoms, but Mago says the AI assistant could say: “‘Hey, doctor or nurse practitioner, you missed asking this question,’ or recommend care approaches or suggest an ambulance be called.” The ultimate goal is to improve diagnostic accuracy, patient outcomes and safety.

“For rural emergency departments, where there is limited access to critical care, these AI-based approaches can help alleviate a lot of pressure,” says Mago, a member of Connected Minds and the Centre for AI & Society at York.

The model, once complete, still needs to undergo testing in a clinical setting, but down the line these types of AI models could help manage and diagnose any number of ailments, including strokes or diabetes.

“There are some very exciting things happening right now in the field and a rush to leverage the potential of these systems to improve health care, which would eventually include treatment options and predicting disease progression and outcome,” says Mago, whose health related research has garnered some $3.5 million in funding, including from the Natural Sciences and Engineering Research Council of Canada, the Social Sciences and Humanities Research Council and the Public Health Agency of Canada (PHAC).

With such a surge in interest, Mago acknowledges, comes the necessity to ensure AI is unbiased, ethical and adding benefit, rather than harm, to patients.

“AI models are becoming more intelligent every day. The goal is to figure out how to infuse them with emotional intelligence and cognition, and to make sure they are safe,” says York Research Chair in Safe AI for Health Equity, Elham Dolatabadi, who recently received funding through the Canada Foundation for Innovation’s John R. Evans Leaders Fund to start the Health Equity and AI Lab (HEAL).

Over the next five years, she will be part of a team building a human-AI complementary system that combines human brain power with cognitively robust and emotionally intelligent AI for use in health care and mental health.

She agrees agentic AI holds the promise of being a game changer for improved health care, which is why much of her current focus is on creating toolkits and pipelines to evaluate these systems before being deployed. These multi-agent models are more complicated to assess than non-agentic generative AI models where it is easier to see if the outputs align with expectations.

When dealing with several agents in a model, if one is biased, perhaps toward a certain demographic, it could throw off the accuracy and safety of the output, the diagnosis or prognosis.

“Hackers are another issue. They can attack one of the agents in the group or infuse a faulty agent into the system, which may corrupt how the system thinks, or push it into hallucinating. That’s something many will find surprising, but AI not only lies; it hallucinates,” she says. In both cases, the model outputs something that looks factual, but is not.

“Hallucination is very complicated to understand, but we are working on a dynamic pipeline for hallucination evaluation, as well as pipelines for AI agentic models in mental health, acute care and outpatient care. These are across different dimensions, clinical values, behavioural values or cognition, and emotional intelligence, so they align with human values,” says Dolatabadi of York’s Faculty of Health and a faculty affiliate of the Vector Institute.

There can be different agentic systems for each health-care application. What will work for mental health care will not work for acute care. “We also need to ensure the output is not something AI made up because it didn’t know the answer.”

Gender, ethnicity, race and skin colour can all affect accuracy. Anyone who falls outside of the average parameters is not always served well.

“That’s the risk,” says York Associate Professor of the School of Public Policy & Administration, Faculty of Liberal Arts & Professional Studies. He is cross-appointed to York’s Osgoode Hall Law School where he graduated with a PhD. “Different subpopulations are not always captured as well with AI models. The question becomes, as a doctor do you still deploy the model if you know that it’s going to catch 80 per cent of European diseases and 10 per cent of sub-Saharan African diseases?” It’s a question Dolatabadi ponders often as she develops evaluation tools, suggesting the doctor needs to be aware of any limitations so they can make adjustments.

Despite the current shortcomings, Stedman too holds out great hope in the power of AI for the future of health care, specifically in how AI can help better leverage genome sequencing. As someone who lives with a rare genetic condition, he is a prime example of a person whose health data might not yet be captured by larger AI models, as is his daughter who inherited the same gene mutation.

It took 32 years of searching before he finally had a diagnosis and learned the name of his rare disease, which allowed him to access appropriate medicine. Stedman says that getting a diagnosis felt, at the time, like winning a lottery.

There are more than 8,000 known rare diseases that affect one in 12 Canadians, but only about five per cent of them have an effective therapy, with even fewer having access to available therapy. Stedman really is among the lucky.

In his vision of the future, he says, AI plays an outsized role in health-care systems. With its ability to speed up genomic data interpretation, unpack clues to rare disease diagnoses and generally help in the understanding of each individual’s needs better, he believes that getting AI right will be non-negotiable in moving toward the ideal of having personalized health-care systems.

“If you look at the power of genomics in the context of its ability to improve care, it comes from unlocking the data through genomics sequencing. If we can do that with big data analytics and in an everyday clinical setting, we can change health care,” he says. “The challenge is all the legal stuff, which is where my unique hat comes in.”

Stedman brings a particular set of skills, knowledge and experience as a patient to the realm of AI and health. He is on the executive of the Centre for AI & Society and Connected Minds at York and the Chair of the advisory board for the Canadian Institutes of Health Research’s (CIHR) Institute of Genetics.

“The potential of AI is bigger than people imagine.”

Ensuring rare disease health-care data and genome sequencing data is available across the country is a big part of the equation. That was the impetus for the (PCGL), funded by the CIHR and Genome Canada’s Canadian Precision Health Initiative, with the goal to sequence 100,000 genomes and deposit them in the PCGL. “We’ve done a lot of infrastructure work behind the scenes to build a secure, privacy-protected, properly governed repository,” says Stedman, a member of the PCGL leadership team.

He is confident the repository will lead to more equitable precision health and result in faster rare disease diagnoses. “AI, genetics, precision therapy, it all fits under the umbrella of – how do we build a personalized health-care system where data analytics has an actual bedside impact. When you walk into the ER or your family doctor’s office and data analytics has some impact on you getting quicker, better, more accurate care, people will understand the value of the infrastructure,” he says.

He was also instrumental in the creation of the Canadian Rare Disease Network, which got its start in 2023 with funding from One Child Every Child, a Canada First Research Excellence Fund grant hosted by the University of Calgary. It helps connect the country’s rare disease scientists and clinicians with patient expertise to advance care and research.

“I believe the rare disease patient’s experience will teach us how to create a personalized health-care system. If you build a system that treats every individual as an individual, you’ll create a system that cares for more. I think we’re going to find we’re all rare, even if we don’t call ourselves rare disease patients,” he says. “The potential of AI is bigger than people imagine.”

It is already exploding into so many aspects of the healthcare field, even if patients are unaware, adds Mago. In addition to his work on LLM-based doctor assistants, he is partnering with the Northern Ontario Academic Medicine Association to use LLMs for text simplification for things like medical summaries in highly technical research articles.

It is another way AI is removing geographical boundaries to medical knowledge, he says. “It’s making research a lot more understandable and accessible, not only to lay people, but also to medical practitioners.” The continuing challenge is ensuring the summaries are ethical and sensitive, including to Indigenous and Black communities. With an ill family member in India, Mago knows first-hand the value of these sorts of AI-assisted summaries to bridge the gap not only between layperson knowledge and medical jargon, but also between different countries.

He is also in the second stage of a project that monitors substance-related issues in real time using an LLM-based surveillance system to analyze social media, mainstream news items, including images and videos, and hospital reports across the country. As part of a larger team, the work could result in earlier intervention and more targeted healthcare action. It has already expanded into a multi-institutional collaboration with the Canadian Centre on Substance Use and Addiction and the Urban Data Centre at the University of Toronto, funded by PHAC Enhanced Surveillance for Chronic Disease Program.

“This is the time for us to embrace AI, especially in the medical domain because there is the promise of huge benefits,” says Mago, who is excited about the opening of York’s new School of Medicine saying it will help further accelerate research outputs.

He also believes Canada should design and develop its own AI technology and software rather than use technologies made elsewhere that are then customized for Canadians. It’s a matter of AI sovereignty, he says.

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Professor Lora Appel is producing 360-degree experiences that simulate environments that make people anxious, then leveraging VR to immerse them in those situations in a controlled way, allowing the person to confront and overcome their fears in a safe space.

The scene could be a party, a busy shopping mall, a bus or the subway where someone with epilepsy might worry they will lose control if they have a seizure. It could be a podium in a packed lecture hall where an anxious student is expected to present a paper.

“If something causes anxiety in an individual, exposing them to this scenario gradually allows them to habituate and get used to it so that they can manage their emotions and deal with the situation,” says Appel of York’s School of Health Policy & Management, Faculty of Health.

“More and more, we’re considering health to be the ability to manage with your current situation. You might have cancer or you might be bipolar, but if you are able to manage your condition well, you can describe yourself as healthy – that’s the best-case scenario.”

With her team at York’s PrescribingVRx lab, Appel piloted a VR exposure therapy program for people with epilepsy and completed a randomized controlled trial at Toronto Western Hospital. The same platform is now being provided to people with dementia, including Alzheimer’s disease, experiencing anxiety, apathy and aggression. For older adults with mental health issues, Appel is leading a University Health Network team to create soothing or engaging experiences patients can access through VR to improve their well-being.

The benefits for VR therapy are substantial and their potential applications enormous, says Appel.

VR can also be a valuable addition to clinical therapy and serve as a drug-free alternative treatment. It has the potential to be self-administered, a game changer in a health-care environment where people with mental health issues can wait months or years to see a therapist. VR can recreate anxiety-producing worlds for people with post-traumatic stress disorder that would be unsafe for them to return to. For example, rescue missions led by firefighters and first responders, and conflict zones experienced by soldiers.

If the anxiety can be controlled, says Appel, a world of new possibilities opens up for people who often avoid situations that are fear-inducing for them. Otherwise, they can become isolated from life, sometimes missing out on job and life experiences that would be rewarding.

Appel says artificial intelligence (AI) has the potential to combine with VR to generate customized exposure therapy.

“As AI advances and VR headsets become more affordable, I can imagine a world where the technology would create customized videos for people to upload from their personal library, put on their headsets and use them for self-therapy,” says Appel.

York’s anxiety research is supported by Beneva, a Canadian mutual insurance company focused on anxiety prevention.

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Among those leading the way in this is Boateng, a quantitative sociologist and epidemiologist who was recently appointed Canada Research Chair (CRC) in Global Health and Humanitarianism. 

One of Boateng’s latest research projects is related to his CRC appointment, which aims to measure and quantify different forms of resource insecurity, including food, water, energy and housing, as well as to advance our understanding of the overall health effects of environmental contaminants, both in the Global South and in Canada. This work exemplifies, he said, the importance of having international partners and collaboration.  

“Partnerships are key and without them, global health research isn’t possible,” he said. “�첥��Ƶ’s partnerships in the Global South greatly expand the scope of my research and allow me to reach populations and communities that would not be accessible otherwise.”  

Boateng’s project looks to collect physiological, ecological, and demographic data from informal settlements in sub-Saharan Africa and Latin America.  

Using high-cost field equipment, the researchers will assess the quality of the air and water samples (stored, drinking and groundwater) found in and around the settlements.  

The data will be used to validate scales, like the Household Water Insecurity Experiences Scale, co-developed by Boateng for use by public health practitioners, non-governmental organizations, government officials, and development agencies to monitor and assess progress on targets set out in the United Nations Sustainable Development Goals around achieving equitable access to safe and affordable drinking water, as well as adequate and equitable sanitation and hygiene. 

This is particularly important in sub-Saharan Africa, where flooding due to climate change is a considerable health risk and bacterial infections like dysentery and waterborne illnesses like cholera are widespread.  

The scales would help researchers and health-care professionals to assign a score to the environmental contaminants found in settlement households, which enables them to determine if water, for example, is safe for consumption without the need for further testing.  

For local governments, this would streamline water, air, and housing quality assessments and provide valuable information to inform health-care policy and decision-making.  

“Our project will also produce the necessary data for comparative studies, so that this evidence can be used in other contexts, including in some Indigenous communities in Canada that face similar resource insecurity challenges,” said Boateng.  

The project is slated to start this summer with 300 households in Accra, Ghana, alongside Boateng’s partners from his alma mater, the University of Ghana, and the University of Cape Coast, before moving onto research sites in Nigeria, Kenya and Malawi, and subsequently to Colombia and Mexico.  

Last month, Boateng was also part of a York delegation that visited Ghana, Nigeria and Kenya. The Africa trip helped the University engage with prospective students and explore partnership opportunities with local universities and research institutions.  

For Boateng, studying global health helps bridge the inequality divide.   

“It’s important to identify the sources of health disparities and the structural determinants of health, so that proper interventions can be put in place,” he said.  

“Global health research, when applied, can not only enhance the quality of life for the world’s most vulnerable populations – women, children and seniors – but it also has life-saving potential for people worldwide. It’s teamwork at its best.”  

Learn more about .

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They could dispatch the police or an integrated unit of both police and mental health professionals. But instead, the operator sends a robot.

This scenario may sound like science fiction, but it’s the kind of futuristic thinking that has researchers at �첥��Ƶ considering all angles when it comes to artificial intelligence (AI) and crisis response.

Building more empathetic bots through interdisciplinary research

In a paper published in Applied Sciences earlier this year, psychology PhD candidate Kathryn Pierce and her co-authors explore the potential role robots could play in crisis de-escalation, as well as the capabilities engineers would need to program them to be effective.

The visionary paper is part of a larger project at the Lassonde School of Engineering that involves early-stage research to design and test robots to assist in security and police force tasks. The York engineers asked the psychology researchers to provide their social scientific lens to their forward-thinking work on humanizing machines.

“De-escalation is not a well-researched topic and very little literature exists about what de-escalation really looks like moment by moment,” says Pierce, who is supervised by Dr. Debra Pepler, a renowned psychologist and Distinguished Research Professor in the Faculty of Health. “This makes it difficult to determine what kinds of behavioural changes are necessary in both responders and the person in crisis to lead to a more positive outcome.”

No hard and fast rules for de-escalation, for both humans and robots

With limited academic understanding of what really happens in human-to-human interactions during a crisis response, let alone robot-to-human, training a robot to calm a person down poses an incredibly tall task.

Despite the challenge, Pierce and her co-authors were able to develop a preliminary model outlining the functions a robot should theoretically be able to perform for effective de-escalation. These functions are made up of verbal and non-verbal communication strategies that engineers would need to be mindful of when building a robot for such a task.

Some of these strategies include a robot’s gaze – the way a machine and human look at one another – the speed in which they approach (slow and predictable), and the sound and tone of their voice (empathetic and warm).

But, as the researchers point out, ultimately, robots cannot be “programmed in a fixed, algorithmic, rule-based manner” because there are no fixed rules for how people calm each other.

“Even if there were algorithms governing human-to-human de-escalation, whether those would translate into an effective robot-to-human de-escalation is an empirical question,” they write.

It is also difficult to determine whether people will react to robots emulating human behaviour the same way they would if it was an actual person.

Advances in AI could add new layer of complication to the future of crisis response

In recent years, the use and discussion of non-police crisis response services have garnered growing attention in various cities across North America, and elsewhere in the world.

Advocates for replacing traditional law enforcement with social workers, nurses or mental health workers – or at least the integration of these professionals with police units – argue that this leads to better outcomes.

published earlier this year showed that police responding to people in mental distress use less force if accompanied by a health-care provider. found that community responses were more effective for crime prevention and cost savings.

Introducing robots into the mix would add to the complexity of crisis response services design and reforms. And it could lead to a whole host of issues for engineers, social scientists and governments to grapple with in the future.

The here and now

For the time being, Pierce and her co-authors see a machine’s greatest potential in video recording. Robots would accompany human responders on calls to film the interaction. The footage could then be reviewed for responders to reflect on what went well and what to improve upon.

Researchers could also use this data to train robots to de-escalate situations more like their human counterparts.

Another use for AI surveillance the researchers theorize could be to have robots trained to identify individuals in public who are exhibiting warning signs of agitation, allowing for police or mental health professionals to intervene before a crisis point is ever reached.

While a world in which a 911 operator dispatches an autonomous robot to a crisis call may be too hard to conceive, Pierce and her co-authors do see a more immediate, realistic line of inquiry for this emerging area of research.

“I think what’s most practical would be to have engineers direct their focus on how robots can ultimately assist in de-escalation, rather than aiming for them to act independently,” says Pierce. “It’s a testament to the power and sophistication of the human mind that our emotions are hard to replicate. What our paper ultimately shows, or reaffirms, is that modern machines are still no match for human intricacies.”

The paper, “,” was co-authored by Pierce and Pepler, along with Michael Jenkin, a professor of electrical engineering and computer science in the Lassonde School of Engineering, and Stephanie Craig, an assistant professor of psychology at the University of Guelph.

The work was funded by the Canadian Innovation for Defence Excellence & Security Innovation Networks.

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That interest has taken her as far afield as Uganda - where, for her PhD work - she evaluated how martial arts could impact the lives of self-identified women and girls for the better.

“Since then, I've always been focused on unpacking and teasing apart how gender-based violence can be addressed, reduced and prevented through interventions that are part of the ‘sport for development and peace’ umbrella,” says Hayhurst.

       
Today, that work includes a principal investigator role with the Wheels of Change project, funded by the Social Sciences and Humanities Research Council of Canada (SSHRC), which studies how access to bicycles can help address poverty, gender equity and sustainability for self-identified girls and women in Nicaragua, Uganda, and Canada, using a trauma-informed approach. It’s work that began in 2016, now funded through to 2026. 

Hayhurst argues mobility may play a significant role in gender-based violence prevention, and points to bicycling in Nicaragua to help explain why.

“If you can't move, if you can't escape, if you can't access employment opportunities and education, those are the structural factors that the bicycle can help solve.” 

“The young women in Nicaragua were able to go to school during the pandemic because they had bicycles and could avoid virus exposure on public transit. They were also able to sell goods on their bikes and to access health services that they otherwise wouldn’t have.”

Over the next three years, Hayhurst - who is also a York Research Chair in Sport, Gender and Development and Digital Participatory Research - is hoping to gain more insight into how to address some of the social issues that affect the study participants. 

“In rural Uganda, there are a lot of stigmas and myths around young women ridingbicycles – particularly in more remote communities. So they often don’t want to be seen riding them.” 

“At the same time, they want to be visible for safety reasons. There’s a paradox, and we think trauma- and violence-informed approaches to cycling and bicycle-focused development programs can possibly help address some of these issues.”

Some of those approaches include training staff on the health effects of trauma and violence, creating emotionally and physical safe spaces and peer support for program participants, fostering choice for participants to pick their own physical activities, and building on participants’ strengths, rather than deficit thinking. 

These are some of the key principles of trauma-and violence-informed physical activity, a concept Hayhurst is further investigating with self-identified women in communities throughout Toronto, Ottawa, and Vancouver for a project about preventing and addressing family violence. Hayhurst is co-principal investigator, alongside principal investigator Francine Darroch at Carleton University, with funds from the Public Health Agency of Canada.

As a mother of four active young kids, Hayhurst says she’s also hopeful her work will help contribute to the current national discourse about youth sports, like hockey. 

“With all that's happening right now in the Canadian context around safe sport, I'm certainly questioning a lot of the purported benefits and thinking a bit more critically around what can be done to make it safer,” she says. “I do feel like there are sports, like Ultimate Frisbee, dragon boating or pickleball, that have tried to move deliberately away from a neo-liberal, competitive, individualistic model.”

“There's hope in using a trauma and violence-informed approach in sports development that is more community-focused and inclusive.”

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