Cancer Care Ontario & Vice President (2018–19), Digital Health Canada Board
Newfoundland and Labrador Centre for Health Information & Sec. Treasurer (2018–19), Digital Health Canada Board
We asked digital health professionals Angela Copeland and Gillian Sweeney for their perspective on the Canadian digital health landscape and the opportunities presented by digital health innovations.
Mediaplanet: What potential do digital health innovations have to increase patient access, improve quality, and reduce costs?
Gillian Sweeney (GS): Virtual care has the greatest opportunity to improve health care by allowing patients to interact with providers through virtual visits using computers, smartphones, and monitoring devices. Virtual care facilitates secure communications between health care providers. Ultimately, it increases access for patients to health care providers and services, and allows health care providers to deliver care in a more efficient manner.
Angela Copeland (AC): For years, increasing patient access, improving quality, and reducing costs have been fundamental goals for the majority of health care providers. In my 20-plus years in this field, there has never been a shortage of technology innovations with the potential to accelerate the achievements of these goals. Nor has there been a lack of interest in investment in these technologies.
Why have we seen so little impact on achieving these common goals? The answer is simple — technical solutions were independently developed and often designed to solve isolated health care pain points. Although this provided temporary relief, it did not necessarily have a broader organizational impact, nor did it benefit the patient themselves.
I recently attended a site visit of Humber River Hospital (HRH) in Toronto, recognized as North America’s first fully digital hospital. HRH has been able to demonstrate significant performance improvements by combining data real-time and applying predictive analytics to continuously interpret how effectively patients are moving through the hospital.
This cohesive approach to people, process, data, and technology working in unison is the breakthrough innovation that will change the future of health care.
This cohesive approach to people, process, data, and technology working in unison is the breakthrough innovation that will change the future of health care.Angela Copeland
How would you compare the uptake of digital health solutions in Canada to the rest of the world?
GS: Canada has made great progress in the last two decades with the implementation of digital health solutions such as electronic health records and telemedicine, which has been utilized since the 1970s here in Newfoundland and Labrador, when the late Dr. Maxwell House started to use telephone technology to interact with patients in remote regions of the province. However, compared to our counterparts in Europe, for example, Canada is lagging and needs to increase access to patient-centric digital solutions and services.
AC: It is no surprise that the United States continues to be the global leader in health technology development. However, Canada, the UK, China, and India are also making investments in digital health, as they realize the potential contribution to sustainable economic growth. There has never been more potential for fast uptake of digital solutions, because of the shift to consumer driven health care and the fact that most of the world’s population now has access to a mobile phone and signal.
Texts are being used to educate people and provide them with best-practice health information; test results can be quickly transmitted; specialists and patients can be connected even in remote areas; and anyone can maintain a personal health record wherever they go.
What are the main challenges and barriers preventing the uptake of these technologies in Canada?
GS: Health care delivery is complex and there is still work to be done to improve clinician adoption of these new technologies. Key to addressing that is research to demonstrate the benefits and improved outcomes. There are also some regulatory barriers that need to be addressed given the digital shift, and a digital divide that we need to address so that patients, regardless of social and cultural inequalities, have equal access to these new methods of health care delivery.
For example, there remain differences in broadband access between urban and rural communities. We need to ensure that patients have access to digital health technologies regardless of their socioeconomic status.
AC: Healthcare delivery is the accountability of individual provincial and territorial governments. Without a unified, pan-Canadian direction, this inadvertently creates silos with disparate practices, inefficient use of resources and duplication. As we evolve to a borderless world connected through data and technology, such a complex environment is not ideal to promote uptake of digital health solutions which rely on embracing the notions of data sharing, supplier diversity, and enabling a gateway to an integrated network of best of breed solutions.
Health care is also traditionally a risk-adverse industry that has been hesitant to invest in technologies until they are mature and/or adopted by peer organizations. This is heightened by the fact that there are limited dollars to invest in technology so there is also the fear of making the wrong investment decision.
Finally, the amount of time, resources, and governance required to implement are significant, so investments are considered to be long-term solutions. If there is a resistance to use, inadequate training and no resources to support continued meaningful use, you could have the best digital health solution possible but experience no impact in the delivery of care or, even worse, actually increase risk to the organization and the patient.
However, with barriers come opportunities and Canada has never been known to shy away from a challenge so I am optimistic. Canada is on the shortlist of global artificial intelligence (AI) leaders and this is something to be proud of. This would have never happened if not for a passionate group of collaborative individuals, the backing of tech hubs by both academia and industry and the aid of government funding.
What do Canadians need to know about digital health, and what can we do to ensure we have access to these 21st century technologies?
GS: Digital health is an enabler that can transform the delivery of health care services. Patients have a tremendous opportunity to drive digital health in our country given the current adoption of digital solutions in our everyday life. Research shows that a patient who is more informed and engaged in their health care has better outcomes. To increase access to these solutions, patients need to be partners in this digital health journey in Canada and talk to their health care provider and policy makers and provide input to the vendor community.
AC: The first major step for Canadians (if you haven’t already) is to transition from a passive patient to an active advocate for your own health care. Research has indicated that when you become your own health advocate, there is significant improvement in your experience and outcomes. Start accessing current digital health technologies as enablers for managing and gaining insights into your health and wellness. Some strategies on how you can be more active in a digital age include:
- Track your exercise using a wearable and log your food choices in an app
- Subscribe to a personal health record app and/or use a portal offered by your healthcare provider
- Report electronically on your symptoms, outcomes and experiences
- Receive best practice health information via text or email and join on-line collaboration communities for knowledge sharing
- Try new services offered by your healthcare provider such as remote health monitoring devices or e-visits
- Participate in patient/client advisory groups to inform the design and adoption of digital health solutions
- And most importantly, gain an understanding of what your data is telling you, have a conversation with your healthcare provider and if required take action to live life to the fullest.