Canadian Journal of Nursing Informatics


This article was written on 21 Dec 2020, and is filled under Volume 15 2020, Volume 15 No 4.

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Off-label Software

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Software Column

by Allen McLean, RN, MN, MSc, PhD(c)

Allen is currently a PhD Candidate in Health Sciences at the University of Saskatchewan (Saskatoon) in the Computational Epidemiology and Public Health Informatics Lab. His research interests include the development of computer modeling and simulation software for addressing health systems challenges, chronic diseases and health inequities at the population level, as well as mobile technologies applied in long-term care facilities. Allen previously attended the University of Victoria earning an MN and MSc (Health Information Science) in a unique dual degree program for Nursing Informatics professionals. Allen has over 20 years’ experience in healthcare as an ultrasound technologist, clinical educator, team leader and community health RN.

Citation: McLean, A. (2020). Off-label Software. Software Column. Canadian Journal of Nursing Informatics, 15(4).

Off-label software


When most of us hear the term off-label, we think about this term in the context of a drug used to treat a condition for which it was not originally designed to treat and has not been officially approved. But broadly speaking, we can think of the term off-label as something that was designed for some specific functionality then later used for some other useful purpose. Many examples can be seen throughout history; Coca-Cola started out as a cure for morphine addiction, Bubble Wrap was originally marketed as wallpaper, the Slinky was meant to stabilize naval equipment on rough seas, and both Viagra and Rogaine were originally intended as medications to lower blood pressure. Repurposed might be a more accurate word to describe the evolution of some of these products, but semantics aside, this article will describe the use of an existing software application, a bit of out-of-the-box thinking, resulting in a novel and promising off-label use of that software. In the interest of full disclosure, this article is based on a recently published paper I co-authored (McLean et al, 2020).

Writing a successful grant or other funding applications is a requirement for continued employment, promotion, and tenure among nursing faculty and researchers. Writing successful applications is a challenging task, with often uncertain results. We proposed using simulation software to tackle this problem. To our knowledge, this approach had not been previously described. For those interested, I wrote a more in-depth article on dynamic simulation modelling for the CJNI in 2016 (McLean, 2016). Briefly, dynamic simulation models are computer models that are simplified representations of the real world. Used successfully in engineering, ecology, defence, and business since the 1950’s, these models enable decision-makers and researchers to map complex problems by bringing together a variety of evidence sources such as research, expert knowledge, practice experience, and data. The resulting models are used as a ‘what-if’ tool that can simulate various practice or policy scenarios to see which is likely to have the most effect. This modelling allows us to test a range of possible solutions in a low-risk and robust way before implementing them in the real world.

In our recent paper (McLean et al, 2020), we  presented a thought experiment hypothesizing that by first conducting a research study in a virtual space (using simulation software), nurse researchers could refine their study design, test various assumptions, conduct experiments, and better determine which elements, variables, and parameters are necessary to answer their research question. Simulation modelling is a learning tool, and the modelling process helps nurse researchers gain additional insights that can be applied in their real-world research, and used to strengthen funding applications. While as yet unproven, we believe this is a promising strategy for improving success rates with funding applications. I encourage all of you to think about possible off-label uses for the software you routinely use, and then share your discoveries widely!


McLean A. Dynamic Simulation Modeling. Canadian Journal of Nursing Informatics, 11(4).

McLean A, McDonald W, Goodridge D. (2020). Simulation Modeling as a Novel and Promising Strategy for Improving Success Rates with Research Funding Applications: A Constructive Thought Experiment JMIR Nursing, 3(1), e18983 DOI: 10.2196/18983

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