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Digital Health 2019

Canadian Health Care Needs a Data-Driven Strategy

Close-up of doctor using a mobile phone
Close-up of doctor using a mobile phone

Jim Shave

President – Canada Operations, Cerner

Health care in Canada may be ripe to undergo a seismic shift toward a data-driven culture with easier access.

Canada’s health care system represents 11.3% of the country’s gross domestic product (GDP). It’s created a lot of data that has been difficult to access for both doctors and patients. A survey by Telus Health in 2017 found that two-thirds of physicians and specialists in the country still used fax to communicate with one another. In some instances, two departments in the same hospital have no electronic means of sharing data.

Government regulations have been slow to adapt to digital alternatives, and with a growing infrastructure throughout health care, shifting to a data-driven culture is a key step forward, says Jim Shave, president at Cerner Canada.

“When talking about the health care system this way, it really is more than just an acute care hospital or home health agency, or long-term care organization,” says Shave. “All of those points are data contributors, as well as social determinants of health, so we have access to a lot of other data sources that we could take advantage of to drive better strategy around system integration and coordination.”

The challenge, Shave adds, is in getting everyone on board across the spectrum. Decades-long processes and siloed organizations have preserved a status quo that he believes would be hard to move. For that reason, he advocates that both grassroots and leadership from the top need to endorse a system-wide data-driven approach to spur such change.

Both grassroots and leadership from the top need to endorse a system-wide data-driven approach to spur such change.

Common cause

For Shave, that sort of change would span fully across the continuum to go beyond hospitals. It would also include patients all the way through primary care, specialty care, acute care, and over to community and home health.

“In Ontario, it’s somewhat different than other provinces, where you have health authorities and system-wide structures,” he says. “We look to government as a top-down agency, but the system already has leaders who want to be accountable and responsible and see a better way to provide care more economically.”

It’s those leaders willing to effect change that Shave wants to work with. For its part, the 

Ontario government announced a health care reform in March that would allow local hospitals, clinics, home-care agencies and family doctors, among other facilities, to link together as one group, sharing patient information and funding under their care. 

Security and privacy

It’s unclear how smoothly such a restructuring effort would turn out, though data security and patient privacy have remained stumbling blocks for lawmakers to push digital health initiatives, he adds.

“Architecture matters, and what we do in terms of our ability to create a data structure with availability goes a long way to supporting the privacy and security issues,” he says. “Legislation still has to catch up to present-day technology. We don’t have any ownership of data, we are custodians of data, so we’re bound to prohibit any kind of secondary use.”

He refers to the British National Health Service (NHS) as a good example of a large public health care system applying a big data platform with analytics for improved monitoring. It’s part of an effort for U.K. lawmakers to make the NHS “the most cutting-edge system in the world,” by including, among other things, a mobile app for booking appointments and medical records.

“The data that people look for, it’s not just about analytics, it’s about understanding that data and making it actionable,” he says. “It’s about delivering intelligence and a learning system that can go and support care at any given intersection of the system. That’s why we want to help coach through that kind of adoption.”

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