Posted on May 23, 2017 by Bobby Gheorghiu
Between March 19 and 23, I had the privilege of attending the eTELEMED 2017 Conference in Nice, France. It all began with an invitation to sit on the conference’s Editorial Board with the opportunity to shape the content and agenda of this year’s conference. Through this collaboration, I was nominated to Chair a special track with the freedom to select the topic of the track and invite contributors to submit research papers or presentations. I saw this as a great opportunity to showcase Infoway’s work on the international stage, not just through our perspective, but also through that of our stakeholders.
As such, the DIGIHEALTH@CA stream was created to demonstrate how Infoway and its partners have nurtured the growth of digital health across the country through the establishment of governance and funding structures, development of pan-Canadian standards, and investment in digital health infrastructure, adoption, change management and research/evaluation.
On the first day of the conference, the tone was set emphatically when our CEO, Michael Green, delivered the keynote speech, titled “Digital Health in Canada: Transforming Health Care Through Innovation.” Michael followed up his presentation by participating in a discussion panel on “Citizen-centric Digital Services” alongside presenters from Sweden, Norway, the Netherlands, and Japan. In addition to the diverse backgrounds of the presenters, as well as the audience, it was remarkable to note the diversity of professional backgrounds present.
eTELEMED was itself a stream as part of a larger conference titled Digital World 2017 and the keynote and panel were delivered to the entire audience. As a result, it was refreshing to observe the breadth of questions and discussion topics originating from backgrounds as diverse as computer science, industrial design, social services, and public service.
On the third day of the conference, there were two sessions meant to support Michael’s vision as outlined in the keynote and demonstrate our achievements as an organization as well as those of some of our key partners. The first session took a macro-level look at the enablers for the development and spread of digital health in Canada; the progress achieved to date; and the possibilities to build and innovate on this established infrastructure.
Don Sweete, CEO of SNOMED International, discussed the importance of technology and terminology standards in facilitating the interoperability of digital health systems with a focus on the role of standards in facilitating the spread and scale of digital health in Canada. I followed that up with a description of how benefits generated from investments in digital health are key towards demonstrating accountability to funders as well as to encouraging widespread adoption by clinicians and other health care professionals. It also described the research paper written by Simon Hagens and myself on the cumulative benefits calculation that has demonstrated over $16 billion in benefits accrued to clinicians, patients, and the health care system since 2007. Lastly, Tracy Johnson of the Canadian Institute for Health Information (CIHI) described the role of health data beyond the point of care, such as in health system use and health analytics along with the enablers needed to maximize its value and usability.
The second part of the DIGITALHEALTH@CA stream focused on the front lines of care and highlighted some innovative approaches for engaging patients and clinicians through digital health. I had the pleasure to present on behalf of Sanaz Riahi and Wendy Odell of Ontario Shores Centre for Mental Health Sciences. This presentation included an overview of the strategies that the organization has employed to foster patient adoption and ongoing engagement. This included a summary of the launch of an Electronic Medical Record (EMR)-integrated patient portal; implementation of a mobile (mHealth) experience for patients to manage their care with actionable interventions through a secure mobile cloud technology platform; and the piloting of a virtual clinic which will utilize e-therapy to maximize access and utilization of evidence -informed virtual treatments.
Next up, Dr. Kendall Ho, a practicing emergency specialist, and lead of Digital Emergency Medicine at the University of British Columbia, provided examples of care delivered closer to home through telehomecare or the remote monitoring of patients living with heart failure or chronic obstructive pulmonary disease (COPD). His research further examined the use of information technologies to accelerate the incorporation of the latest health evidence into routine practice.
Lastly, I presented a poster developed by our own Maria Sauco, introducing Infoway’s Change Management Framework, and the results of a pan-Canadian change management survey that provides insights into how change management is currently conducted across the country; the use of change management best practices and resources; and top enablers and barriers to change when implementing digital health technology projects.
I wrapped up my marathon presentation day by participating in a discussion panel titled “Addressing Knowledge/Learning in a Smart World” with researchers from Germany, the Netherlands, and Norway. I decided to focus my presentation on the results of our consumer research over the past three years, which collected Canadians’ views on their adoption of digital health and its perceived value. This stimulated a lengthy and entertaining discussion among panelists and the audience, greatly complemented by the participation of Dr. Ho, who provided very cogent and thoughtful arguments from a clinical viewpoint.
Overall, I think that Canada came across as a well-established leader in digital health especially through Infoway’s multi-jurisdictional, co-investment approach; adoption and use supported by gated funding; pan-Canadian standards and a common architectural blueprint; benefits evaluation studies; knowledge transfer and sharing; and the thoughtful and strategic approach to engaging and working with key stakeholders. This is in contrast to some of the international comparisons, such as the Commonwealth Fund and the Organisation for Economic Co-operation and Development (OECD) studies that over the years, have painted Canada as lagging behind most developed countries. This is particularly the case in areas such as sharing clinical information by clinicians, and electronic access to clinicians and clinical data by patients. Serendipitously, this more positive perception was reinforced emphatically at dinnertime, after the presentations had concluded, when Michael announced to our Canadian contingent that Infoway had received a $300 million vote of confidence from the federal government. It was an exclamation point on a unique experience in which I am very grateful to have played a part.
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Bobby works with stakeholders in academia, private and public sectors to develop and monitor performance targets for initiatives such as PrescribeIT®, Canada’s national e-prescribing service, to ensure widespread adoption of technology and to demonstrate tangible benefits of investments in digital health. He holds an MHSc in Health Policy, Management, and Evaluation from the University of Toronto.