I recently attended the annual Canadian eHealth conference, held this year for the first time at the new Ottawa Convention Centre. One of the themes that emerged during the conference, at least for me, was the role of the individual in their health and healthcare and the extent to which information and related technologies might change this role. Many speakers and participants spoke about the emergence of the Healthcare Consumer and some even suggested that their behaviour will shape future healthcare services. While I think that consumerism has a role to play in healthcare, I also believe that the traditional roles of patient and physician are not going to disappear anytime soon – nor should they.
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Several weeks ago I was invited to speak to a Masters of Health Informatics class at the University of Toronto along with two health IT thought leaders who I admire and respect. Richard Booth, of the two instructors for the class, asked me and the other two invited guests to offer our thoughts on several topics including our advice to the students as they pondered their career options. I offered the following advice:
Learn from other industries. While healthcare, like other industries, has unique characteristics, it also shares many similarities. Since many other industries are further advanced in their use of information technology and in managing the digital information that they collect, they offer many lessons that can be applied to healthcare. I encouraged the students to seek out these lessons and figure out how they might be applied to the delivery of healthcare services.
To make my advice more concrete, I cited The Ottawa Hospital as an example of an organization that is actively seeking best practice examples from other industries. For starters, The Ottawa Hospital’s CIO, Dale Potter, was hired specifically for his experience in other industries. In turn, Dale has engaged organizations outside the health sector and created learning opportunities for his staff. One such organization is Nav Canada, the agency responsible for air traffic control in Canada. According to Dale, Nav Canada’s focus on moving people safely through the skies is similar in many ways to ensuring optimal patient flow through a hospital.
Listen and Observe. Mark Douglas, co-founder of this blog and my frequent sounding board, likes to remind me that God gave us two ears and one mouth and that we should use them in that ratio. Effective IT professionals in any industry are the ones that learn the business in which they work and figure out how to make IT useful to the organization and the people that work there. I encouraged the class to take the time to listen to and observe the people delivering healthcare services and to work with them to figure how IT can make the most impact in their day to day activities.
Technology Drives Strategy. My final piece of advice was, admittedly and quite purposefully, intended to buck what I see as a commonly accepted practice in healthcare IT. I have heard numerous presentations over the past year make that the case that business strategy and objectives should drive IT plans and architecture. While I don’t argue that the merit of this seemly prevailing viewpoint, I think that it ignores the often disruptive nature of continued technology evolution.
Technology can and does drive business strategy. Hence, I believe that one of the important roles of the healthcare IT professional is understand the possible impact of technology evolution on business strategy and to help the organization understand how it can take advantage of technology developments. IT will drive business strategy as much as business objectives will drive IT strategy, whether an organization likes it or not.
Despite attempts by some to portray physicians as luddites unwilling to use IT in the practice of medicine, a recent survey by QuantiaMD offers some hard data to refute this belief. QuanitaMD is an online physician-to-physician learning collaborative where, according to the company, 1 in 6 U.S. physicians engage, share, and learn from experts and each other.
According to the recently conducted QuantiaMD survey, more than 80% of physicians responding to the survey indicated that they own a mobile device that is capable of downloading applications (including but not limited to smartphones and tablets). This level of adoption is higher than the general population and demonstrates, in my view, a clear physician willingness to use technology when it fits into their workflow (which is highly mobile). Interesting findings from the survey include:
- 44% of physicians who do not yet have a mobile device intend to purchase one in 2011.
- 30% of physicians surveyed indicated that they use a tablet device. Interestingly, 2/3’s of these tablet users employ their tablet in a clinical setting.
- Despite claims that younger doctors are more apt to embrace new technologies than older physicians, the QuanitaMD study shows that interest in tablets holds steady across years of practice and is, according to the survey report, “as high for physicians with 30 years or more of practice as it is for those with 10 years or less”.
- Approximately 2/3’s of survey respondent state they are likely to select an Apple product. 60% of smartphone users indicate that they have an iPhone while nearly all tablet users have an iPad.
How do physician want to use their mobile? According to the QuanitaMD survey, their top interest is access to EMR data. Other desired uses devices for “peer to peer activities” include receiving treatment protocols alerts, and sharing and discussing cases with other physicians. Desired activities that involve patients include e-prescribing, sharing patient education materials, and receiving alerts when patients need follow-up treatment.
A close to home example of how mobile technology can be used for patient care is the Ottawa Hospital’s massive rollout of iPads and other Apple mobile devices. According to recent articles and anecdotal feedback from sources at the Ottawa Hospitals, the clinical community is enthusiastically embracing these new devices.
After months of what seemed to be nothing but negative articles about eHealth, I was pleased to read Vito Pilieci’s article this past Sunday. In his front page story, Vito highlighted the recent accomplishments of The Ottawa Hospital’s IT team led by their “new” CIO, Dale Potter. Several aspects of this story are worth noting:
- It is one of the first major eHealth stories in quite some time that has focused on the positive benefits that can be derived by applying IT to health care processes.
- The projects mentioned in the article are all local to the hospital and were not, to the best of my knowledge, part of a larger provincial or Infoway funded project. As I have argued in past blog posts, health care is a complex ecosystem with each organization having its own agenda and priorities. The projects highlighted in the Ottawa Citizen clearly show that in addition to provincial projects such as a diabetes registry there are also a myriad of smaller yet equally important regional and local opportunities to apply IT.
- Dale Potter brings fresh insights and different perspectives acquired through his work in other industries. While I don’t want to appear to say that all good ideas come from outside the health system, I do believe that there are lessons learned in other industries that can be applied to the health sector and we should find ways to transfer this knowledge.
A couple of weeks ago I had a chance to spend a little time chatting with Dale Potter and heard additional stories about how his fresh thinking is finding new opportunities to apply IT to the delivery of health services. I was particularly struck by the story behind the iPad initiative described in the Ottawa Citizen story. Seems that Mr. Potter, in getting to know his “clients”, noted that many physicians were using iPhones. He realized that their enthusiasm for this device presented a unique opportunity to garner physician engagement and quickly embarked on an ambitious program to put clinical information in their hands. I was struck by both his desire to understand what his “clients” need and his passion for getting on with a good idea.