Too Little or Too Much Health Technology?

The Future Has Started - ZsooltBlog post by Colin Hung

Our next #hcldr tweetchat – Tuesday June 7th – coincides with Canada’s eHealth conference in Vancouver (#eHealth2016). It is an annual gathering of HealthIT professionals, government policy makers, healthcare leaders and consultants.

For the first time I’ll be attending #eHealth2016 as an attendee – no booth to man this time. This will be my opportunity to sit in on the sessions and really dig deep into what’s happening in Canadian healthcare. I gave myself a mission for the conference: I’m on the hunt for HealthIT innovation. I plan to search high and low for people and organizations who are truly doing something that isn’t just a variant of something already in place. I’m looking for the bright lights on the Canadian healthcare horizon.

On Tuesday June 7th I’ll be hosting #hcldr live from #eHealth2016…provided I can find a good wifi connection. I *might* even host from the social media hub they have set up.

In honor of #eHealth2016 I thought we could discuss HealthIT on #hcldr this week. Specifically I would LOVE to hear from the #hcldr community about where HealthIT should focus its attention – what specific challenges in healthcare we should tackle.

Should the focus be on providing patients access to their electronic health record? Protecting health data from piracy? Building the capability to share data seamless within the healthcare ecosystem? Incorporating patient-generated-data into #EHRs ? Telehealth? All of the above?

Please join in our #hcldr tweetchat on Tuesday June 7th at 8:30pm ET (5:30pm PT, for your local time click here) when we will be discussing:

  • T1 How has #HealthIT or healthcare technology impacted your care or you personally?
  • T2 Do you think healthcare organizations are investing the right amount in #HealthIT? Too much? Too little?
  • T3 What aspect of healthcare should receive LESS investment from HealthIT and why?
  • T4 What aspect of healthcare deserves MORE investment from HealthIT and why?

In 2001, the Canadian Senate Standing Committee on Social Affairs, Science and Technology commissioned a report about the role of government in Healthcare. Chapter 9 of that report focused on healthcare technology. Fifteen years ago the Committee had this to say:

It is generally agreed that health care technology constitutes an important component of health care delivery in industrialized countries. Health care technology can improve the speed and accuracy of diagnosis, cure disease, lengthen survival, alleviate pain, facilitate rehabilitation and maintain patient independence. However, many issues were raised before the Committee about the availability, assessment and cost of both new and existing health care technologies in Canada. Witnesses stressed that these issues need to be addressed if Canadians are to derive the maximum benefits health care technology can provide, while still maintaining an affordable health care system.

If you didn’t know the date of the report you could be forgiven if you thought it was commissioned in 2016.

Healthcare technology is advancing at a breakneck pace [dark pun intended]. Every day new software applications and health devices are introduced to the market. There is a general feeling that if you don’t invest in the latest technology you’ll be left behind. It’s true for individuals (who hasn’t yearned for the latest cellphone?) and it’s true for institutions. The Report highlighted this issue:

The Committee was told that the shortage of new technology and the use of outdated equipment impede accurate diagnoses and limit the quality of treatment that can be provided. This situation, which can have a negative impact on the health of patients, also raises concerns about the legal liability of health care providers.

Yikes! Can you imagine being legally obligated to adopt a certain technology? Oh wait, that’s almost the case in the US with the Meaningful Use incentive-turned-penalty program [yes I’m being a little cynical].

As a believer in #HealthIT I certainly support the need to invest in technology, but even I question whether the current pace of adoption is sustainable. Are we simply chasing the proverbial pot of gold at the end of the rainbow?

In a MedCity News post earlier this year, Dr Kevin Fickenscher – president and CEO of American Medical Informatics Association and former chief medical officer at WebMD – commented on how too much focus on technology could be harmful.

One of the things that has been a problem in healthcare is that we tend to spend too much time talking about the technology and not enough time talking about the people and the process,” he explained. “So my personal bias is that while technology is important […] if we don’t deal with the people and process, we will not solve these other issues; we won’t have good change management, and we won’t have good implementation, which is where the value gets created from large data.”

This sentiment was echoed by Dr. Arnold Relman, the former editor of the New England Journal of Medicine, who was hospitalized after breaking his neck in a fall. During his treatment, Relman took note of how much time doctors were focusing on technology vs their patients. Below is an excerpt from a National Post story on Relman’s experience:

“Attention to the masses of data generated by laboratory and imaging studies has shifted [doctors’] focus away from the patient,” Relman notes. “Doctors now spend more time with their computers than at the bedside.”

Consequently, Relman and many other physicians believe that some physicians are losing all the old skills that used to be critical to making a quick and accurate diagnosis. These skills tend to be part of the physical exam, the part of an appointment that sees a doctor using touch, sight and all the other senses to learn about what’s ailing the patient — flashing lights into the pupils, watching the way a patient walks, pushing and tapping on the abdomen and listening to the chest with a stethoscope. Skills the legendary physician William Osler called “inspection, palpation, percussion and auscultation.”

Of course it’s not all doom and gloom. There are many positives about healthcare technology. You don’t have to look any further than our own #hcldr community. James Legan MD @jimmie_vanagon uses a large format screen so that his patients can see what he is doing in the EHR. He uses the technology to engage his patients not push them away. There’s also Rasu Shrestha MD @RasuShrestha, Chief Innovation Officer at UPMC, who is constantly pushing partners like Microsoft, GE and Google to develop technologies that enhance physician experience as well as patient outcomes.

How do you feel about Health IT?

References

“The problem with big data in health? Too much focus on technology instead of people/process”, Deanna Pogorelc, Medcity News, 7 May 2013, http://medcitynews.com/2013/05/the-problem-with-big-data-in-health-too-much-focus-on-technology-instead-of-peopleprocess/, accessed 5 June 2016

“Digitally numb: Doctors are losing hands-on diagnosis skills by relying too much on technology”, Dr James Aw, National Post, June 10 2014, http://news.nationalpost.com/health/digitally-numb-doctors-are-losing-hands-on-diagnosis-skills-by-relying-too-much-on-technology, accessed 5 June 2016

“Healthcare IT — An Investment Choice For The Future”, Kay Koplovitz, Forbes, 4 February 2014, http://www.forbes.com/sites/kaykoplovitz/2014/02/04/healthcare-it-an-investment-choice-for-the-future/#49700ffa79ae, accessed 5 June 2016

“Investors: Dumb Money For Digital Health Will Vanish As Quickly As It Came In”, Christina Farr, Fast Company, 2 March 2016, http://www.fastcompany.com/3057341/investors-dumb-money-for-digital-health-will-vanish-as-quickly-as-it-came-in, accessed 5 June 2016

“We’re at an inflection point: Why Ontario health tech startups may finally be able to find financing at home”, Mary Teresa Bitti, Financial Post, 29 May 2015, http://business.financialpost.com/entrepreneur/fp-startups/were-at-an-inflection-point-ontario-health-tech-startups-may-finally-find-prescription-for-financing-at-home?__lsa=7244-a722, accessed 5 June 2016

“The Health of Canadians – The Federal Role, Interim Report Vol 4”, Senate Standing Committee on Social Affairs, Science and Technology, September 2001, http://www.parl.gc.ca/content/sen/committee/371/soci/rep/repintsep01part4-e.htm, accessed 5 June 2016

“Why the UK needs increased investment in healthcare tech”, Becky Slack, New Statesman, 10 December 2015, http://www.newstatesman.com/politics/health/2015/12/why-uk-needs-increased-investment-healthcare-tech, accessed 5 June 2016

“Why Innovation in Health Care Is So Hard”, Regina E Herzlinger, Harvard Business Review, May 2006, https://hbr.org/2006/05/why-innovation-in-health-care-is-so-hard, accessed 5 June 2016

“5 Reasons Why Canada Could Be a Hotbed for EHR Innovation”, Colin Hung, EMRandHippaa, 4 June 2016, http://www.emrandhipaa.com/colin/2016/06/04/5-reasons-why-canada-could-be-a-hotbed-for-ehr-innovation/, accessed 5 June 2016

“Interoperability Will Define Health IT Vendors in 2016”, Dr Saif Abed, HIT Consultant, 5 January 2016, http://hitconsultant.net/2016/01/05/2016-will-be-the-year-we-move-on-from-the-hype-around-apps-and-digital-health/, accessed 5 June 2016

Image Credit

The Future Has Started – Zsoolt https://flic.kr/p/p8NFnr

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One comment

  1. While I agree with Dr. Kevin Fickenscher partially about making sure we need to focus on the people and the process, I disagree with us spending too much time focusing on technology. To me, technology is an answer for the people and the process. If we can come together on this stance, a lot more progress could be made!

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