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Digital Health for The People

Last month, we announced an exciting new partnership between Global Public Affairs and Health Innovation Rx, led by Saurabh Popat. Health Innovation Rx is committed to helping digital health innovators better navigate, engage and accelerate digital health solutions to support the transformation of Canada’s health system. By joining forces with Canada’s premier Health & Life Sciences public affairs practice group, our partnership is well-equipped to support the digital health ecosystem for patients, providers and payers.

As we head into 2019, ask yourself a few questions. Have you taken stock of your personal health information (PHI) this year? Are you tracking your PHI via your smart phone, your wearable or online? Maybe you tried to access your personal health information from your doctor’s electronic medical record (EMR), digitally access your lab results or your electronic patient health record (EHR) data through a patient portal after a hospital visit or hospital stay or have a digital/mobile record of your discharge data/care plan when leaving the hospital to recover at home? When was the last time you booked an appointment with your primary care provider online or had an email or virtual exchange with them?

It’s likely that some of you may be able to answer some of these questions or at least you have contemplated one of these questions through your own lived health care experiences. You’ve tried, successfully or unsuccessfully, to access your data either at one point or along various points of your health care journey but in doing so the experience may not have been as frictionless as it should be. As Canadians, we want to access these important domains of data, but too often have to jump through too many hurdles. Why is it, that in a major developed nation, with incredible access to data across different industries, our own patient health information is so fragmented and can be so inaccessible? This is a critical problem… and yet also a major opportunity for rapid improvement.

Bringing tech to the health world

Our health care ecosystem is not as patient-centric as it could be. Patients and their families access health care along varying points of care or nodes across the patient care continuum. However, by doing so there is no guarantee that the appropriate health care information that is collected and tracked at these different nodes is somehow aggregated to provide the patient or their families with a clear or comprehensive picture of their health status and experiences.

Innovative digital health technologies and platforms are an incredibly accessible opportunity for us to harness in Canada. When gathered, relevant and aggregated health information and data points have the ability to support patient engagement and empower both patients and healthcare providers to find the best solution for optimal outcomes. The question then becomes… why is this not as prevalent or systematic today, and how can our public health system harness these digital technologies to accelerate patient access and better integrate patient information?

In 2016, Ed Clark, who was then the Premier’s Business Advisor, reviewed the province’s digital health assets. Clark provided advice as to what the Government should focus on to complete the “last mile” of activity by working to advance the important digital assets that had been developed, over several years with tools such as the drug health data repository (DHDR), e-notifications and hospital report manager (HRM), Ontario lab information system (OLIS), hospital information systems (HIS) renewal, e-Consult platform and the digital immunization repository. There is no doubt that these provincial “heavy” assets house rich and informative data about Ontarians that are the critical backbone elements of our health care ecosystem. The ability for us to quickly pivot towards enabling and promoting the adoption, integration and scale of “light” assets that are patient/consumer based, such as digital transformation for the people, can improve patient access to their PHI as well as patient engagement and empowerment. This pivot is critical now more than ever.

Canadians want health tech

How do we expect improvements in access, outcomes and sustainability of our health care ecosystem without the engagement and empowerment of patients to make decisions and follow their own health journey? Tools developed by Google, Apple, Amazon and Microsoft are already enabling patients to own and track their health journey. These tools also enable their providers and the system to be more accountable and attentive to patients’ medical histories and conditions to prevent downstream utilization and potentially unnecessary costs.

We also know that there is a risk in not embracing and integrating technology much more quickly, as digital health pioneer Will Falk explains:

“The slowness of policy makers to create appropriate pricing and regulatory environments threatens to undermine Canadian Medicare by creating or allowing the creation of a separate, digitally enabled, more desirable tier of care. It’s incumbent upon responsible policy makers to ensure they modernize our system at an appropriate pace – by not modernizing the system, they create the opportunity for two-tier medicine.”

Canadians have become far more tech-savvy than the government initially predicted. In fact, many Canadians, with an average of 6 interactions with the health system per year, already extensively embrace the applications of AI, virtual care and e-exchanges with their health care providers. We know that 7 in 10 Canadians are interested in taking advantage of virtual visits, and over 70% of Canadians want to access their medical records online. However, the current reality is that many of the digital solutions and options are not available nor have been enabled by governments for patients to access. Recent polls show that 10% or fewer Canadians have had a virtual visit/consultation with a health care provider and less than 20% of Canadian can even make an online appointment/booking with their providers. The possibility to change this situation is achievable with the right solutions.

The potential of digital health solutions

Provincial Governments, particularly Ontario, have the leverage and directive power as the single payor to establish the requirements and parameters to unleash the potential of digital health solutions. These solutions are already supporting patients across the province through digitally enabled house calls, online booking with providers, virtual care visits, and much more.

The challenge is to systematize these opportunities through a province-wide focus in an effort to ensure that these innovative digital solutions are equitably and appropriately available to all Ontarians and adequately reimbursed by the government so long as they drive value for patients and the health system in a sustainable manner. The Government can leverage other solutions such as blockchain and digital identity to improve the efficiency and access to data across our fragmented health care system in a more frictionless manner. As a recent Globe and Mail report pointed out, if the National Health Service (NHS) in the UK can direct their ecosystem to completely phase out the use of faxes by 2020, we can and should be able to achieve more digital health adoption and integration by 2020 as well.

The recent line-by-line review by the Ontario Government provided timely and targeted recommendations that can be leveraged in the short-term, including “better use of digital technology, data and analytics to enable a greater focus on Citizen-centered and Digital First approach to government services.”

The time is overdue for a more targeted consumer/patient-focused digital health by design approach.

By combining the power of government’s stewardship over the big data assets across the province with the focus on patient/user experience and agility of digital health innovators, we must work diligently in partnership with the government to accelerate progress on a comprehensive and forward- thinking approach to enabling a digital first paradigm for the people.

This article can also be viewed on LinkedIn.

Paurabh Popat

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