Gazing into the crystal ball: Predictions for Canadian healthcare IT

January 24, 2019 Dr. Chris Hobson

What can we expect to see happen in healthcare IT and the management of data this year? Based on the momentum we’re seeing, and the feedback we’re receiving in Canada and worldwide, here’s our outlook for 2019.

The growing importance of community care: Healthcare planners know that better healthcare in the community results in fewer hospital admissions. It also results in faster discharges from hospitals, with fewer patients staying in ALC beds. Slowly but surely, we’re seeing provincial governments increase their spending on nursing homes, home care and other forms of community care.

Consumer and patient-centric applications: Moving care to the community and becoming more patient-centric means a focus on enabling technologies like Remote Patient Monitoring, e-Referrals, and Medication Reconciliation. These systems help to connect caregivers and patients, and lead to higher-quality care. RPM also empowers patients to play a more active role in the management of their personal health, resulting in better outcomes.

A patient bill of digital rights: In the decision McInerney v. MacDonald, 1993, the Supreme Court of Canada made it clear that the information in a patient’s medical record belongs to that patient. Patients have a right to see the content of their record at any time and for any reason, subject to certain exceptions (e.g. if there is likelihood of harm to the patient). Nevertheless, it hasn’t been easy for patients to gain access to their records. As a result, in 2019, we’re likely to see a more cohesive lobby for an official patient bill of digital rights, and the continued growth of patient portals.

Enhancing technology’s value: Health organizations have found it challenging to realize the maximum value from their use of information technology. Some well recognized causes include the complexity of healthcare and of technology, and inadequate attention to fundamentals such as clinician-driven implementations and change management. Close alignment between the technology and the clinical/business direction in which the organization is growing and changing is also critical.

This situation will improve in 2019. There will be a more focused effort on solution adoption by physicians, nurse practitioners and other clinicians as they come to recognize tangible value from information technology. Organizations will rely on vendors to ensure the technology is designed with interoperability in its DNA to enable ease of use.

Managing medical devices: After extensive media coverage into the problems with medical devices this year, Canada’s health minister has vowed to strengthen oversight of certain devices such as pacemakers, implants and insulin pumps.

The rise of artificial intelligence: AI will move from hype to reality, helping clinicians identify patients for clinical trials or moving urgent cases to the top of radiology reading lists. As well, AI will become important parts of safety and security systems, automating the safe use of medical devices, software and hardware.

Shared services: We anticipate smaller provinces and health authorities will struggle with the costs and human resources needed to implement new systems, such as smart hospital software and hardware, and electronic systems to improve community care. They will likely move towards inter-provincial efforts. For example, the Atlantic provinces may make combined decisions about investments.

The shift from big data to actionable data: Providing the highest quality clinical care to patients with the support of IT can mean, in practice, that clinicians are having to spend ever more time looking for the specific data they need. The analogy of looking for the needle in a haystack is a good one here, and a solution that simply provides more hay is not of itself going to lead to better care. 2019 will therefore see a bigger focus on presenting meaningful data to clinicians, using analytics and predictive modeling to shift our thinking from ‘big data’ to ‘actionable data.’

Blockchain will become ‘PART’ of the solution: Blockchain will see an enhanced applicability in health technology, mainly because it meets the ‘PART’ criteria: Permanent, Auditable, Reliable and Transparent. This enables a key benefit from blockchain — the ability to ensure a reliable single source of truth. Blockchain allows for improved controls on data access by the right parties and is very attractive as a model for storing clinical data. However, there are some potential downsides, including how to re-engineer existing systems and the significant increase in the amount of raw computing power required.

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