One of the life lessons that I have tried to teach my kids is the value of learning from your mistakes. I frequently remind my daughter of Thomas Edison’s famous quote when, after numerous failures in developing an electric light bulb, he was asked if he was ready to quit. Edison replied
“I have not failed. I’ve just found 10,000 ways that won’t work.”
Another quote that I have shared with her and even printed a copy to hang above her desk is from Winston Churchill
“Courage is going from failure to failure without losing enthusiasm.”
More recently, I was struck by President Barak Obama’s view on failure:
“Making your mark on the world is hard. If it were easy, everybody would do it. But it’s not. It takes patience, it takes commitment, and it comes with plenty of failure along the way. The real test is not whether you avoid this failure, because you won’t. it’s whether you let it harden or shame you into inaction, or whether you learn from it; whether you choose to persevere.”
I was reminded of my many discussions with my children about failure and mistakes when I read the federal Auditor General’s report on Canada Health Infoway. Although I wholeheartedly support and endorse Canada Health Infoway, I have long felt that they don’t share failures or anything less than positive news. Given the number of investments that they are making it is not reasonable to assume that they will all be roaring successes and, given the statistics on IT projects across all industries, we can expect a number of failures and only partial successes. How are we communicating these lessons learned from these failures? In this current era of eHealth “scandals” no sane person would want to risk media attention by admitting that IT project for which they were responsible had failed. Too bad. If we want to get the best return on our investments I think that we need to openly share all lessons learned and to admit, without fear of recrimination, when something goes wrong so that other can benefit. Failure is indeed an acceptable option provided that we learn from it. Otherwise, we have squandered our investment and have not generated any value for the money spent.
As the U.S. moves aggressively to drive the adoption of healthcare IT, the Agency for Healthcare Research and Quality commissioned a project to explore whether consumers felt that they should have “a role in determining how health IT is designed and used”. The final report of this project can be found at:
Through a series of focus groups across the United States, consumers expressed the following views:
- “… participants were optimistic that health IT would benefit health care quality. They thought that computers may add efficiency to health care and reduce medical errors, such as those associated with illegible handwriting.”
- “…some participants were concerned that health IT might make providers more impersonal, devoting more attention to the computer screen and less to the patient.”
- “Privacy and security were the main concerns of a large majority of the participants. A substantial proportion felt that health care consumers owned their data and needed a role in ensuring that those data were secure and used only in ways that they authorized. The participants were concerned that hackers or other individuals might gain inappropriate access to patient data. They were also concerned that their data might be shared with persons who want to use the data for their own purposes, rather than to provide care.”
- “The participants did tend to support the idea that health care consumers should be asked for their consent before their medical data are stored electronically. Many participants felt that consumers should be able to elect to leave their data in paper format. The participants tended to feel that each individual provider should ask each patient for permission to store the patient’s data electronically and to share the data with other providers. Patients should be able grant permission to one provider but deny it to others, in the opinion of many in the focus groups. In this way, the participants felt that health IT restrictions should be set individually for each consumer, rather than by general rules applied to all consumers.”
- “The participants were divided on the issue of how electronically stored data could be used for medical research and for market research by pharmaceutical companies.”
- “…there was a great deal of disagreement about the role of government. Some felt that government should not concern itself with health IT at all, saying that market forces should guide those decisions. Others thought that elected officials and government agencies would protect the interests of health care consumers.”
Supporting a key theme that I have been harping on for the past few months, “… public education about health IT is needed. The education might address how health IT will affect the experiences of all health care consumers. It might also show the public how patients and consumers can have an influence on how health IT is designed, implemented and/or used.” I think that such education is part of larger eHealth leadership issue, one that we (in Canada) are not addressing in the current climate of eHealth spending concerns. While we are getting better at engaging the clinical community, we still have a long way to go in engaging a critical important constituency … the people to whom care is provided!
I will keep this post short and too the point…is it me or is the very title of this article called “Unlike in eHealth scandal, no payoff for lottery executive” implying that very term “eHealth” is now the gold standard for a Canadian scandal?
It appears the media coverage of the eHealth Ontario scandal has peaked…for now. There will no doubt be some serious short term changes (Alan Hudson stays or goes, the eHealth strategy is amended, etc) coming down the pipe. My concern is the spillover effects of the scandal on the larger eHealth agenda throughout Canada. I now live in BC and I’m starting to see stories trying to link prominent eHealth people to the the scandal in Ontario. Some of the worst case scenarios that keep running through my head include:
- The politicians and public lose interest in eHealth, and they develop a tin ear to the benefits of investing;
- Funding starts getting cut of to various national and other provincial eHealth agencies;
- The majority of the senior experienced eHealth leaders get sick of it all and either jump or are pushed out of the industry. Some may see this as a good thing, but we’d lose a huge amount of domain expertise just when we need it most;
- The brightest new entrants into the market see limited opportunity in the market and instead go to work in some other industry;
- etc, etc
I’m sure that Mike will read this post and say “step away from the edge of the cliff Mark and be rational”. I hope he is right and that it is just a case of me making tinfoil hats. I really do try and see the forest for the trees on this stuff, and realize that I may have blatent self-interest (ie my current career path) in seeing the eHealth agenda moved forward. Irregardless of my own self-interest, I keep seeing the crisis in healthcare spending coming to fruition in the near future. We cannot continue to see healthcare spending increase at the current rates, otherwise we will have to raise taxes significantly and triage services. Try and explain to the baby boomers that “sorry we simply can’t help you right now”, and see how they react.
As I have always stated, eHealth is NOT the silver bullet that will solve this problem, but it sure can help improve the overall efficiency of the system. Adding additional paper-based doctors and nurses to the system is an arithmetic solution to a logarithmic problem.