A recent report on Canada's healthcare system shows that there is a big and growing disconnect between patients and our healthcare system. The Ivey Business School's International Centre for Health Innovation has shown that patients are now the primary force behind the uptake of healthcare innovation. As Canadians embrace and adopt the latest technologies to manage their healthcare, they have created a parallel health system and our healthcare providers and governments are empowered to continuously ensure that patients receive the best treatment possible.
The report noted two main drivers for this change: unprecedented access to health information from the internet, and a "number of recent advances in science which have generated extraordinary new ways to treat disease, manage risk of illness and more effectively achieve outcomes for patients." The result is more informed and increasingly assertive patients who are bringing their own values and ideas when they meet their health practitioner and who expect a two-way conversation. There is also a grassroots demand for the customization of healthcare where medical decisions, practices, and treatments are being tailored to the individual patient.
The report entitled It's All About Me: the Personalization of Health Systems makes for sobering reading about our healthcare system's adaptation to this new reality. It calls on governments, healthcare professionals and providers to draw inspiration from other industries, such as insurance and banking, which provide a wide variety of services and tools to empower their customers. Indeed the authors equate our current healthcare system to the single-teller banking system of the 1980s.
I was surprised to learn from the report that there are over 97,000 mobile health applications currently available across the globe. Last year, there was a 134% growth in Americans viewing health content on their mobile devices. However, the authors note that this innovation is not being captured or leveraged by the system. This is because the formalized healthcare services are operated in parallel and exclusive to this new patient generated system.
The risk is a dislocation between the patient and the health system which may impact health outcomes. An example of this is the fact that as many as half of the patients being prescribed a medication are still not taking it as advised by their medical practitioner. Interestingly, it was found that although 19% of patients are using a smartphone health app, the study's authors could not find any scientific papers published before the end of 2012 that evaluate the effectiveness of such smartphone health apps. What a fantastic opportunity this offers! There is a significant exchange of information with important potential significances that are not currently being measured or evaluated. Just imagine the intellectual capital we could gather.
Why are our health systems struggling to keep pace as innovators? Firstly, we must acknowledge that it is difficult for all organizations to adopt innovation as it usually comes with a high price tag, and what looks like a sure thing can sometimes be quickly overtaken by another technology.
The public sector is even more challenging. There is intense public scrutiny about the cost, the decision-making process and the pace and quality of implementation for any new technology. One need only look at some of the difficulties provincial governments have had implementing electronic patient records. These difficulties are not isolated to Canada, as can be seen from the experience with such records in Britain.
Governments know that innovation must be an important factor in their procurement processes. They are consistently reminded by business, patient and research groups about the important role they play in purchasing the most innovative technologies. However, more often than not, caution rules and the end result is that decisions with respect to health technology innovation are primarily evaluated on cost-containment without reference to the benefits that innovation can provide. Innovation is often ignored or devalued whether it is consulting services, information technology, defence kits or in a case I know all too well --medicines, vaccines and diagnostic tools.
Our federal, provincial and territorial governments are working hard to introduce and adopt innovation into our healthcare systems, but it is difficult to tie it all together and implementing proven solutions remains a challenge. On March 25, 2014, the Conference Board of Canada's Dr. Gabriela Prada hosted a webinar to review the results of a survey of healthcare executives gauging the degree to which their innovation priorities are actually put into practice. There was a strong appreciation for innovation, but many participants feel their own organizations are not taking the necessary steps to ensure innovation is at the forefront.
To this end, Rx&D is expanding its medication management and smartphone app to include Blackberry and Android platforms in May 2014. This app, currently available for iPhone/iPad users can keep a record of prescription and non-prescription medicines, vaccines, vitamins, herbal supplements, etc. It can also record clinical outcomes such as blood pressure and cholesterol, set dose reminders and share information with clinicians via email.
These are not easy issues and it will take time to reconcile them. However, one fact seems clear: the delivery of healthcare is undergoing an unprecedented transformation. The traditional model of top down solutions in healthcare delivery must adapt to this new reality, and empowered patients will have a greater voice and a greater role in its design and its delivery.
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