From notes written by Annie-Kim Nguyen (University of Waterloo); Aaina Aggarwal (George Brown College); Diego Duran-Arteaga (George Brown College); Mia Trillanes (Alberta Health Services); Tiffany Oei (Public Health Ontario; Alana Esty (CHEO); Ahmad Haroon Syed (Johnson Shoyama Graduate School of Public Policy, University of Regina); and Mobeen Lalani (University of Toronto)
The CHIEF Executive Forum Fall Symposium took place on Thursday, September 22, 2022. 65 digital health and healthcare delivery leaders gathered in Toronto to to collaborate, exchange best practices, and share their expertise in setting the agenda for the effective use of information and technology to improve health and healthcare in Canada.
Concurrent 1. Cybersecurity lessons from the financial sector—partnerships to improve resiliency
Robert Michel, Chris Suknunden, Scott McMillan
What can we from the healthcare system learn from the financial industry and how can we collaborate enhance resiliency to cybersecurity threats?A more coordinated approach to cybersecurity threats within the healthcare industry is needed.
Canadian Financial Resiliency Group (CFRG) was formed in 2019 in response to a focus on coordination with a goal of better resiliency and recovery from cyber crises. The Office of the Superintendent of Financial Institutions (OSFI) takes a proactive approach (instead of having to react to cybersecurity incidents). Works with with CFRG to help contribute to test playbooks when a cybersecurity incident occurs. Coordination between players is very important, as is documenting info and key information sharing areas.
CFRG sets the mandate, membership structure, develops the playbook (how do we operate, defines scope of potential incidents, escalation threshold, what is the activation threshold? document information we are willing to share even during a crisis). OFSI regulates mandates; develops policy, and creates guidelines and frameworks around what is expected from a cybersecurity and risk perspective from the financial industry. OFSI Is a provincial regulator, provides recommendations and then organizations implement based on their own processes. OFSI also provides incident management, capturing expectations regarding documentation and reporting (banks are required to report incidents within 24h, data collected helps identify fields of improvement). With this information OFSI can look at trends which are a result of an incident and highlight areas that organizations need to improve on in the future.
Proactive leadership from the Bank of Canada helped to set this up after the 2008 financial crises—the next crisis is around the corner. Having regulatory oversight helps a lot, and education and awareness are would go a long way toward convincing hospitals because the risk is important.
- Look for cyber talent across industries, academic partnerships
- Rogers outage incident led to realization of over-dependence on one telecommunication company, showed importance of cross-sector collaboration
- Regulatory oversight helps bring everyone together
- The amount of data that health industry has it should be regulated to prevent any cyber security breach.
- Not everything needs to be by the play book, innovation is the key for cybersecurity.
- Implement mandatory 24-hour incident reporting
- Use data trends for knowledge management
Concurrent 2. Addressing healthcare human resource issues
The current healthcare human resources issues are urgent and critical, but we are not really dealing with it that way. The pandemic changed everything, with many heath professionals getting sick and health professional working outside of their area of expertise. Organizations were nimble about leveraging silver linings such as virtual care, changing to team-based care (inter-professional team working 24/7, new novel roles), and taking an integrated approach and staff community agencies.
Examples: in Nova Scotia: department of health and the health authority started working together and developed a coordinated heath decision team that speak with one voice and achieved a major upgrade to digital infrastructure. It is possible to pivot to new ways of working quickly. Virtual care needs to keep rolling out more fully with secured messaging. Need to reduce admin burden (reduce hours in filling out forms for physicians to access information).
We need to increase efficiency by removing the small barriers for health professionals and introducing new models of primary care. This requires integrated thinking among multiple healthcare providers and stakeholders. Need to fix the fact that we have no alignment in the system; need clear roles and responsibilities across the whole system.
For employee mental health, we need a physician framework for wellness and support resources and a focus on equity, diversity, and inclusion (tackle systemic racism to attract top talent from around the world). Create psychologically safe workplaces (we are not paying enough attention to culture).
The problems need to be clearly defined with consistent messaging from all stakeholders and a sense of consensus.
- Lack of planning, data, and knowledge of where we are going with recruitment
- Need more granular data on what health professionals are actually doing
- How to facilitate through policy and funding models to distribute health professionals in the right areas
- Need more accountability of services
- Feeling of support; challenge for rural areas when less people covering for each other
- Co-designing care with patients and embracing team decisions
- Need to break down organizational silos
- Look at workloads and quality of care
- Technology adoption: make clinicians’ lives easier with real time information that only shows the most relevant information
- Change management in bringing people on board (training)
- Being away of unintended consequences with technology; measure reality and improve
- Unions: need to be clear between roles and responsibilities; need to be involved right at the beginning
- Need to have co-creation with multiple health partners
- Need healthy respect of both management and union
- Need lots of effort in engagement and time, which end with faster solution and implementation
- Relationship-building to create trust