Guest Blog – South West LHIN Consumer eHealth Innovation Session

Richard Booth is a nurse and PhD candidate with a strong interest in the use of information in the delivery of healthcare services.  Richard has a particular interest in social media and is doing what he can to educate fellow clinicians on the power of social media.

Richard and I both attended the recent Consumer eHealth Innovation Session hosted by the SouthWest LHIN.  We both actively tweeted from the event and I asked Richard if he would write down this thoughts for a guest blog post.  The remainder of this post contains Richard’s observations on the event.

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On June 30th, 2011, I had the opportunity to attend the South West LHIN’s “Consumer eHealth Innovation Session” held at The University of Western Ontario. As described in Michael’s previous blog post, the event was billed to provide a venue for attendees to see how various eHealth tools were being used to support the LHIN’s eHealth strategic plan. On the agenda were a number of companies and organizations working with the SWLHIN, including Telus, Microsoft, thehealthline, Sensory Technologies, Sykes, Patientway, OTN, and CareLink.

Unfortunately, I was not able to arrive to the session until around 10:00am which meant I missed the introduction by Glenn and presentations given by both Telus and Microsoft. I’ll touch upon some of the points from each presentation I attended and outline what I thought to be salient:

  • thehealthline.ca was presented by Brian Ashby. This online portal to health information in the SWLHIN looks to be a fantastic resource – similarly, the document “Help yourself through hard times” is a booklet that organizes all the key community and social resources that may be required by individuals and their families during “hard times”. What I think makes this document invaluable is that each organization/agency listed in the booklet has a descriptor of the services offered and hours of operation. This document is freely available on the thehealthline.ca website.
  • Sensory Technologies spoke about their eShift 2.0 model for homecare. In a nutshell, in an eShift delivery model, nurses work remotely and act as a delegator and knowledge broker of healthcare. Personal Support Workers (PSWs) with extra training deliver the health services to the client, in the client’s home. The PSWs and nurses are connected by way of an iPhone, and if the nurse deems further care is required, a higher skilled assessment can be authorized and delivered to the client. I believe my tweet related to this presentation summarized my feelings regarding this care delivery shift: “eShift 2.0 is a delivery model I need to examine more closely. Like it or not, this typology of care delivery is the future #swlhin.” I will be curious to see how regulators like the College of Nurses of Ontario respond to the remote monitoring of patients by nurses and unregulated healthcare providers, like that outlined in the eShift 2.0 model.
  • Sykes presented next, introducing a self-management care model – CareCoach and teletriage. The presenters also listed various other services offered by Sykes, including chronic disease management, tobacco cessation services, and health education services.
  • PatientWay had an engaging presentation outlining their kiosk and way finding solutions that are currently used in a number of healthcare organizations around Ontario. Their concise and succinct presentation outlined how the use of their systems had significantly reduced costs for organizations, and at times, facilitated an increase in engagement by consumers. Jay from PatientWay described to me that by engaging consumers in a meaningful and productive fashion during their healthcare interaction(s), you can sometimes reduce the anxiety and stress of the situation. I guess the old mantra of ‘an active mind is a healthy one’ rings true in this instance. By engaging consumers during their various ‘wait times’ (i.e., waiting for registration or information taking), you can potentially increase efficiency and engagement consumer in the health process.
  • Laurie from Ontario Telemedicine Network (OTN) presented next, outlining the results of their pilot research examining the effectiveness of remote monitoring technologies to support the healthcare of consumers suffering from chronic illness at home. Nurses at a family health team would remotely ‘check’ the results of their assigned clients in the community and decisions regarding care were made appropriately. At the end of the four month study, Laurie stated that many of the clients wanted to keep the remote monitoring technology as they had found value in its use. Yet again, another call to engage consumers in a meaningful fashion and move away from purely paternalistic approaches of health delivery.
  • Finally, CareLink provided an interesting presentation on their suite of remote monitoring technology. The range of monitoring technologies offered by CareLink to ‘wire’ a house was extremely impressive. If/Than programming could be directly fed into the smart house to enable prompts to be pushed to caregivers in the circle of care (e.g., if Grandma doesn’t open the fridge and/or her pill bottles by 0900, a message is sent to caregivers prompting of the situation). Video cameras and other sorts of surveillance systems were also offered by CareLink as a means of being able to view in real time, a loved one living at home. In other words, CareLink modifies the current suite of home security technology for use within a health/individual monitoring context. What was not touched upon in the presentation were the potential ethical and privacy issues related to this type of invasive surveillance. Although I can see the functionality of this technology for some cognitively compromised populations, it does raise some important issues regarding autonomy and dignity.

The Innovative Ideas Workshop occurred after lunch – we were tasked with answering three brief questions related to how the technologies/ideas presented over the morning could be used to assist healthcare of individuals. The 30 minute task led to some interesting (and at times divided) discussions in the small breakout groups. This eventually fed into a large group feedback session led by Glenn who asked all groups to report their findings. In sum, these were the salient ideas I captured and tweeted during the discussion:

  • LTC patients, and repatriating to the home is ‘doable’, but should be looked at closer as it is currently a difficult and cumbersome process
  • We need to examine the 5 percent of the population who are the highest users of the health system. Engage and utilize eHealth in these areas appropriately improve care and reduce inefficiency.
  • Need to refocus on the consumer; vendors need to work together to achieve this.
  • Homecare is “imminently important”
  • Business drivers from healthcare are currently missing – we need to use the data that the government currently has to help build a better business case
  • Accountability – need more discussion on this topic, from all angles, including patients, clinicians, consumers, vendors, government, etc.

Upon closing, Glenn stated that he hopes to hold another event in six months time. The unfortunate lack of tweeting from the event was a bit of a surprise – the smartphone penetration in the room was 100% (we did a show of hands). At future events, I hope participants utilize twitter in a bit more functional and consistent manner. Similarly, I believe future events would benefit from having ‘consumer groups’ in attendance. There were a number of specific consumer groups mentioned and highlighted during the workshop (e.g., homecare, ALS, diabetes, mental health, long-term care, etc.). It would be interesting (and probably dynamic) to have these stakeholder groups present during the presentations and discussion. Finally, I was disappointed at the number of clinicians in attendance. At one point during the morning, a show of hands was requested for “practicing clinicians”. I counted only five or six out of the audience of well over 50. Although the reasons for the lack of clinician attendance is probably extremely multidimensional (e.g., workload, scheduling, potential lack of interest, etc.), it does warrant further reflection.

Overall, I was extremely impressed with the workshop. This was the first event that I’ve been to with eHealth vendors which felt collaborative, rather than competitive. Equally, it was one of the few instances where talk of ‘technology’ generally took a backseat to the ‘client’ and ‘health’. Normally at eHealth events, the discussion is extremely techno-medical-centric. This Consumer eHealth Innovation Session was a breath of fresh-air.

Richard Booth, RN, MScN

2 responses to “Guest Blog – South West LHIN Consumer eHealth Innovation Session

  1. As I was reading this post, I was asking myself how many clinicians were present (and what about patient attendance?) I’m not surprised that clinician attendance would be low. LHIN are not structurally set up to significantly involve clinicians. My thoughts are that having clinicians involved in e-health innovation is crucial. We’re talking about extending patient care using technology and clinicians are the patient care experts. Having mostly vendors, bureaucrats, and end deliverers of care participating in this conversation is going to end in a short circuit. Money will get spent (or not) and without proper input of those most trained to manage patient care (and study it’s results), it has a very high likelihood of being wasted.

  2. Without pretending to speak for Glenn, I believe that Glenn would welcome greater clinician participation in these sessions. Any suggestions on how we can encourage more clinicians to participate?

    Mike

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