Notes from Driving the Future of Digital Health virtual conference, November 2, 2022 by Aaina Aggarwal, George Brown College, Health Informatics
Keynote speaker Dr. Alika Lafontaine (Canadian Medical Association), believes that virtual care is the future of care. He provided an overview of the current state of affairs, challenges that we face in the implementation of virtual care, the opportunities that it creates and how digital health can evolve to embrace opportunities and call to action.
Overview of the current state of affairs
Virtual care is now more than phone and video consult. All the data that is generated through virtual care can also be used for analysis to improve the healthcare services to provide the best possible care to the patients. Virtual care has changed since 2014, as there has been tremendous growth in this industry. However, the growth has slowed down or stagnated in 2021. As of now, patients have the option to choose the care that they would like to receive. Moreover, virtual care is not uniform across all types of care like ambulatory, community or in-patient care.
As per the latest Canada Health Infoway study, the major reasons why patients prefer virtual care over in-person care are:
- Shorter wait times
- Cost savings
- Virtual care is more appropriate for the kind of care I need
- Virtual care was recommended by my physician for the current condition
Challenges we face
Dr. Lafontaine also talked about some of the barriers that we are currently facing to implement virtual care. These barriers are:
- Lack of interoperability
- Patient information is siloed
- Data flows jurisdiction not the patient journey
- Persistent friction in clinical workflows
- Direct competition with Click-and-mortar model of care
- Increased fragmentation as more and more entities create their own virtual care solution
Opportunities and how digital health can evolve to embrace o pportunities
Dr. Lafontaine discussed the scope of asynchronous telemedicine, which is also known as ‘store and forward’ approach, where the patient records the video and submits it to the physician. The video has information about the chief complaint, symptoms, and medical history etc. This provides flexibility and efficiency to the healthcare provider.
Artificial Intelligence integration is the next big step in the world of telemedicine. Data analysis and collaboration, ability to remotely monitor the patient and intelligent diagnoses are some of the most common uses of AI in telehealth. AI helps in assisting doctors in diagnosing, treating patients and also helps in reducing the professional burnout and improving the whole patient experience.
The major driving force of virtual care adoption is developing every day. The primary reason for virtual care adoption is the front-line burnout. As virtual care provides the flexibility to the physicians and thus helps in decreasing the burnout. The second major reason is the worsening access to care, the long wait time and the shortage of nurses and physicians. By providing virtual care we can tackle these critical issues that cripple our healthcare system.
Call to action
The question that we should ask is: are we able to provide the quality of care to the patients? Dr. Lafontaine considers that still there are a lot of variables that needs to be figured out. He says that the government needs to be deliberate and should make virtual care more cost effective. He suggests the we need health information framework for the digital age and also considers that we should scale up the virtual care. The main area where the virtual care model falls is the elaborative history taking and giving physical exams. The physicians should be able to provide the best possible medical advice to the patient by connecting with the patient. This will in turn help in providing the best quality care to the patients.
PATIENT PERSPECTIVE ON DIGITAL HEALTH INNOVATION
Presented by: Dr. Durhane Wong-Rieger
Digital health is the driving force behind putting health care in the hands of patients. It improves access to care, efficiency and provides convenience while also helps empowering patients for self-care. Due to the boost in virtual care there is a lot of digital information that we can use for analysis. cost and regulatory requirements are some of the barriers in accepting the new technology.
Genetic counselling can be used to determine and provide care for the conditions that can be tracked through genetic testing.
She talked about the Hub and spoke model, that how virtual care could be the answer to all the problems that we are facing today. She also said that we need to enhance the capability to access virtual care and the access should be equitable for all individuals.
HOW CAN DIGITAL HEALTH INNOVATION ADDRESS THE SOCIAL DETERMINANTS OF HEALTH IN CANADA?
Presented by: Dr. Alika Lafontaine, Dr. Durhane Wong-Rieger, Dr. Keith Thompson, Dr. Veronica McKinney
The most important question that we have now, is virtual care giving us equitable access? As connectivity and accessibility are the most important factors for providing the best possible virtual care to patients. The panellist discussed that we often focus on convenience but what matters most is actually solving the problem for which the patient sought the medical advice. More and more physicians now-a-days believe that the way they are practising is not ideal. The key difference is who can provide the care and who can provide the best care to the ones in need. We have to look at the workflow and have to perform some necessary restructuring.
One of the key factors that is being followed in the province of Saskatchewan is the use of similar technology across all the areas. This helps in improving the interoperability and also decreases the time spent on learning varied technologies.
It was brought forward in the session that some of the patients don’t really feel that we are actually living in the post covid. The actual truth is that we might never be post covid. Physicians should retrospect themselves with some questions like how can we bring the care close to home or if we are able to solve the problem that the patients were facing and finally how was the experience for the patient to access the virtual care and are we meeting the needs of the patients.
The medico-legal perspective of virtual care needs to be looked upon. The legal implication of telemedicine and telehealth can be regarding confusion or mistake deciphering electronically the problem the patient should be treated for. Therefore, Digital health literacy is paramount in today’s digital world.
In perspective of virtual care for Mental Health, patients as well as the care giver are very much engaged in solving the problem. Antibiotics was the most common drug prescribed before pandemic however, antidepressant and antianxiety is the most common drug that is being prescribed post pandemic.
Our panellist ended the session with some questions that should be answered and some points that we need to bear in mind to drive the future of digital care in healthcare.
- How to get virtual care to people at low cost or no cost.
- Fragmentation- patient should have a seamless experience doesn’t matter who provides it
- People who are paying are the one that needs the care
- We are spending a lot of money but are we spending the money in the right place
- Everyone should have the accessibility to the best technology for providing care
- Privatization is not going to make anything better
- Patient information should not be siloed
- Interoperability is of utmost importance
- Breaking the negative thinking and providing cognitive thinking
- Supporting the positives in our community and accepting the negatives