eHealth 2012 conference was held in Vancouver last week and was once again hosted by CIHI , COACH and Canada Health Infoway . This year’s theme was Innovating Health e-Care and included a Clinician only track as well as sessions certified for continuing education credit towards the CPHIMS-CA and The Canadian College of Health Leaders certifications.
The conference learning objectives were addressed by three district tracks:
Designing to connect care
Within each track sessions were led by industry expects and vendors with the majority of the presenters being health informatics professionals, clinicians and administrators from hospitals located across the country.
eHealth is primarily a learning, education and collaboration focused event and both the keynote and breakout sessions were very well attended. The conference facilities were well suited to the event and logistics ran smoothly throughout the week.
Delegate attendance was approximately 1,600 which is a increase over previous years. Sixteen countries were represented as well with sizeable representation from the US, Europe and notably Brazil making the conference a much more international experience than pervious years.
The keynote presentations were very suited to the conference theme. They each stressed simplicity and collaboration as the path to innovation and used the word “design” much more often than we would have heard “architect” in the past. This is a subtle yet important shift in thinking as design implies user i.e. both Clinician and patient experience as the key driver of innovation where architect implies complicated technical blueprints.
All of the speakers were frank and candid in their presentations as well as when answering questions from the audience. A reoccurring example of this was in addressing the frustration many Administrators and Clinicians have felt when policy issues and privacy has been perceived to stifle innovation. Overall the keynotes were presented in a much more conversational style this year that set the tone early for the conference and trickled down to the individual sessions as well.
A great example of an attendee who embraced the design trend, innovation and collaboration undercurrent in action was Cassie McDaniel from the Healthcare Human Factors team at UHN. She creatively documented the entire conference with “sketch notes” which she posted on her blog Day 1 , Day 2 , and Day 3 .
Dr. John Halamka Keynote notes
Dr. John Halamka, CIO, Beth Israel Deaconess Medical Center in Boston opened the conference Monday morning. He’s one of those people that seem to accomplish more before breakfast than most people do in a lifetime. He was an engaging speaker and stressed the importance of simplicity in design and necessity as the catalyst of innovation. His overall theme was that “the challenge is not technology, it’s trust” and this point touched on many aspects of healthcare from privacy to procurement. Some of the more interesting points he made included:
Every click makes a Doctor’s day an hour longer.
What is the ideal form factor? Let the user decide. There are over 1,000 iPads on the Beth Israel network. Doctors and nurses have purchased these devices themselves indicating their preference.
Technology must integrate into workflow not change it.
Care is team based. Technology must leverage the power of the care team.
Every time an organization undertakes a structured procurement, innovation is stiffled.
How to motivate a clinician? Pay them more, give them more free time or threaten them with public humiliation.
In Boston, a study with 12,000 patients were allowed access to all data in their patient records including clinician notes. There were concerns about patient access and safety. Nothing negative happened.
Healthcare information exchange needs to be frictionless
Richard Alvarez Keynote Notes
Richard Alvarez is the President and CEO of Canada Health Inforway and the former President and CEO of CIHI. He opened day two of the conference with a keynote tilted Resetting the Compass which largely referred to Infoway’s 2012-2013 Corporate Plan . The 2012-2013 Corporate Plan’s objectives build on Infoway’s investments to date and has a much greater focus placed on the benefits to consumers and clinicians than on technical architecture. This shift in priorities is what Alvarez refers to as resetting the compass. Some of the more interesting points he made included:
Three Myths need to be dispelled about Canada’s progress towards EMRs 1) we are behind everyone else, 2) there’s no value in EHRs 3) it’s taking too long. This last point he questioned with a very candid “compared to what?” which was well received by the audience.
We need to bring care closer to home to allow consumers to monitor their health and have virtual visits.
From the citizen perspective, the patient experience is THE priority
Canada is not about competing for patients, we’re about collaborating; we need aspects of interoperability. “Vendors take note”.
Privacy and Security has been used as a bit of a smokescreen. Let’s plan for it and not hide behind it.
We must challenge conventional wisdom to sustain the system
Structured procurement is a barrier to innovation – A great deal of frustration was evident on both the provider and vendor sides of the procurement process with providers being more outspoken on the topic than expected. Timelines to implement innovation, collaboration with the private sector and innovation provided by small companies without the financial and legal resources to reply to RFx procurements were mentioned as examples by many speakers.
mHealth – Mobile Health was both the sexy and practical topic on most attendees minds this year. Every presentation regardless of topic seemed to touch on mHealth as both an enabler for care teams and the bridge to consumer health models. Sessions led by UHN’s Healthcare Human Factors team demonstrating BANT , Cancer Care Ontario demonstrating their Library of mobile applications, the South West LHIN demonstrating eSHIFT and the Ottawa Hospitals use of iPad’s were not only among the best attended sessions but were also viewed as the most compelling solutions presented. BANT in particular drew a great deal of interest for it’s integration of mHealth, gamification and social media to dramatically increase adherence outcomes in adolescent patients managing Diabetes.
BYOD – Bring your own device was not on the official agenda anywhere, however it was a topic on everyone’s mind. Almost every session had a question related to the BYOD phenomenon and approaches varied from using Citrix to securely deliver apps to development and deployment of homegrown and vendor designed native apps. Other challenges discussed included privacy, security, network bandwidth (apparently iPads use considerably more of the network than traditional endpoints) as well as budgetary models for IT shops based on desktop fleet size.
Big Data – The entire conference was abuzz with talk of Big Data and it’s application and potential within Healthcare however the general level of conceptual understanding of what exactly “Big Data” means was overall not clear. IBM demonstrated Watson which while it was a great demo left many attendees feeling that Big Data solutions mean both big investment and big operating expense.
Design – User experience, workflow integration and small but impactfull innovations were more often presented than large big-bang style projects. The “Steve Jobs” effect on innovation in Healthcare was a topic of much discussion at the coffee stations between sessions.
Borrowing innovation from other sectors – The idea of collaborating with other verticals and industries to accelerate innovation was another reoccurring theme of interest. One of the stand out sessions was Cancer Care Ontario’s adoption of CRM and “sales practices” to enable their screening process. CCO demonstrated that early and targeted screening has produced positive population health outcomes in correctol and breast cancer and that they are looking to extend this model to other chronic decease management challenges such as kidney disease. Use of mobile devices, kiosks and digital signage for way-finding were another examples that were mentioned however with less detailed results presented.
Personalized Medicine – Genomics, personal care plans, consumer health, PHRs, Healthcare social media and the rise of Patient 2.0 as an active member of the care team were all top of mind. Any solution or technology that engaged and involved the patient or presented an opportunity for ownership of health to be shared with the patient was well received.
Analytics – Access to data continued to be the primary concern of both administrators and clinicians. This year however mobile played a much greater role in the analytics discussion than previous years and rather then scorecards and “measuring the system”, much of the discussion revolved around analytics as a means to “improve the system” or “improve individual health outcomes. Again, design for simplicity and effectiveness was stressed by most participants and speakers.
LEAN – Improving workflows, simplifying processes and reducing procedural waste were key themes throughout all tracks as well. Driving costs out of the system and improving effectiveness and efficiencies by leveraging LEAN methodologies continued to create discussions around innovation as well. Most of presenters spoke of a need to move to much more iterative cycles of innovation with a “persevere or pivot” and “fail early” attitude prevailing rather than the “big bang” style projects with extended timelines of the past which is very much in line with LEAN approaches. Most organizations represented at the conferenced seemed to have a LEAN initiative or project team in place.