Sanya Palli is a Digital Health Canada Member and a Business Analyst at the Department of Family Medicine, McMaster University.
Dr. Darren Larsen is the CMIO at OntarioMD, Vice Chair of Cancer Quality Council of Ontario and a family physician at Women’s College Hospital. He is also gregarious, has a cheerful, infectious personality and is one of the hardest working people I have met. He likes to quote the book “A Wrinkle in Time” as follows, “The shortest path from A to B is never a straight line.” As an emerging professional, I recently sat down to talk with Dr. Larsen about his advice for the new generation of leaders and his opinions on how to overcome professional failures, major changes that are not being addressed in health informatics (HI) and the inspiration that healthcare can draw from other industries. To read more about Dr. Larsen’s ideas for healthcare, visit darrenlarsen.com.
Advice to the New Generation of HI leaders
“The first thing is, you need to be patient. Things never happen at the pace you want them to happen. You need to show up, be involved and ask questions. What I see in the new generation of leaders is a lot of optimism, which is amazing. They don’t see the same barriers or boundaries that the previous generations did. The downside of this is there can be watering down of realism. It’s important to find mentors who can balance unbridled optimism or idealism and put it into context.
“But what I do see manifesting is, ‘If I can’t get this job, I’ll get yet another degree.’ This constant need to progress up that professional skill pyramid with more and more degrees does two things:
1) Keeps people protected from the really hard work of working and doesn’t let them develop experience;
2) We’re overtraining people to the point of them being obsolete before they even launch their career because they’re in such a tight niche that there are fewer jobs to choose from.
“Accept the fact that you’ve trained enough and you need to start working and get skills. The training that you get at work leads to wisdom, as it is grounded in practicality and real world outcomes, and is nothing compared to the training you will get when you’re at school.”
Overcoming Professional Failures with Optimism
“A recent example of failure in my life is the nearly three years of effort a few colleagues and I poured into an electronic medical records (EMR) data analytics strategy for the Ontario Medical Association (OMA) called Insights4Care. I truly believed that this would be an absolute game changer for our profession, at a time when physicians were feeling beleaguered due to their poor relationship with the government. This went really far, until it was cancelled in April.
“Reasons for failure: This project was defeated by bad luck and bad timing, launched at a point of time when our big audacious goal was simply not accessible. That was a failure, not necessarily because we did something wrong, but rather due to a series of unforeseen circumstances that none of us had any control over.
“On the other hand, optimism comes from the fact that even though a project we felt personally very close to didn’t happen, it was not because of people or the sponsors, but rather the period we were working in, where the world was not ready to consume it. Optimistic feelings come from the fact that it’s okay, and we’re okay. The product concept remains very strong, the ideas are still very important, conversations regarding governance happened, and in the end we advanced things. So on to the next thing.
“How do you maximize the best in everything, and learn from the stuff that doesn’t go right, and not predict the future from a point of pessimism? You start surrounding yourself with people who are positive, who are moving ahead, and who constantly see the world as full of opportunity, even when they are in hardship.”
Major Changes Health Informatics will Bring into Primary Care that are not Being Addressed
“Patients need access to their data. It’s their data, we house it. But we don’t own it. Patients own it. The reason they need access to it is because 99.99% of the time, they are looking after themselves and, as healthcare providers, we’re not there.
“The second piece is the use of aggregated data set as it’s being collected, and stewarding its use for good, not evil. Ultimately the patient should decide what their data could and should be used for. System level planning with public dollars needs accurate data to do that planning properly, so there must be rules to free data up so that we all benefit. The liberation and linking of data in our health IT systems is the next big wave, and along that comes analytics and decision support.
“The governance and policy issues around sharing are also a huge opportunity for emerging leaders, as currently, there’s a vacuum in governance and policy. A lot of the health IT folk stick purely to the informatics pieces because they are easy to comprehend. The really tough stuff comes with the rules of engagement. If we don’t get that right, all the data itself is irrelevant, since no one will be allowed to touch it, and that’s not helpful either.
“I also have views about patient-generated data. There’s going to be lots of it, but much of it is ‘normal’ so not clinically useful. Having wearable device-generated data available instantly at all times is not necessarily advancement, because then curating it becomes an absolute nightmare. My view on wearables and the mountain of potential patient-generated data is that we must create informatics systems that alert me when something is amiss. I just want to see the insights.”
Drawing Inspiration from Other Industries on Change Management Practices in Healthcare
“In our change management role at OntarioMD we have moved from always viewing our clients purely as accounts. When we were handing dollars to doctors, funding EMR purchases and selling the concept of EMR implementation, the company worked in this way. Every client was registered with us because we were funding their EMR procurements and we needed to account for that money. We built a culture around account management. But now we are completely changing that view to one of relationship management.
“The inspiration we get from other industries is largely from tourism and hotel management. For example, in the Ritz Carlton customer service view of the world, if you are a customer there and you have a problem, you report it to anybody. The person you report it owns that problem and they are responsible for ultimately seeing through its completion.
“When doctors come to OntarioMD and they say they have a problem, we can’t just say, ‘That’s an eHealth problem,’ or “That’s a government problem,” or ‘That’s an OMA problem.’ Instead we say, “We’ve heard you, we have your back, we’re here to help you. Let us carry through this process and advocate for you.’ We call ourselves trusted advisors, and it behooves us to act with trust built on solid relationships.
“We also have a lot to learn from the analytics side/enterprise view of the world from Big corporate America or Canada…The Walmarts of the world…companies which have very dominant market share and manage their data and the insights to get from that data with immediacy and an enterprise view of their work.
“We can also learn from professional sports. I find the dedication of Olympic athletes to be absolutely inspirational. They give up portions of their life, just like we do in medicine and healthcare, to become the best they can possibly be. I think we have a lot to learn from that degree of focus.
“And we have something to learn from the entertainment industry about how it engage people through social media. In healthcare we say, ‘We don’t understand the benefits of Twitter or Snapchat so we’re just not going to go there.’ And my point is, we have to go there. We have to meet people where they are. The bottom line is we can learn from every industry if we allow ourselves to listen and pay attention.”