Catching up to the Present — How to bring Canada’s Healthcare System into the 21st Century
Healthcare has been something of a hot button issue over the last year. While just about everyone can find issues within our healthcare system, no one wants to pay for it. Sidestepping political and moral arguments for a moment, the issue of how to bring the benefits of modern healthcare technology is a fascinating one. Part of what makes it interesting is the range of issues. Aging populations increase costs and require a different approach to treatment plans. New medications and procedures emerge faster than doctors can learn about them. Economic instability caused by automation can make it difficult to convince populations to commit to new expenses. Time and time again, we hear the same refrain: There just isn’t enough money in the budget. Fair enough. There are limits on national budgets, there are ceilings on tax revenues. That’s being realistic. However, to just assume “There isn’t any other option” is a dangerous falsehood.
There are plenty of options, and as ever, solutions lie in the data.
Take the problem of medical adherence — when patients don’t follow their treatment plans and create a cascade of costly problems. Wasted money filling extra prescriptions and extended hospital stays are obvious issues, but they’re just the beginning of the cascade. For example: If patients don’t finish their course of antibiotics, they can create antibiotic resistant bacteria, opening the door to life threatening infections. All serious problems, all addressable in part by everyday technology.
How many of these problems are already being addressed by simple apps and programs? Need to track your dietary intake? Apps like myfitnesspal or fitbit already possess that kind of functionality. Managing multiple medications can be dealt with using the same idea as any number of productivity management apps. None of these ideas are new, they’re solutions already tested and ready in the world around us.
We often look at America’s healthcare issues from a place of detached condescension. We shouldn’t. Canada’s health sector lags behind our economic peers embarrassingly in applying technology. We’re not even talking about innovation, we’re talking the simple application of information technology that’s an integral part of our daily lives.
The biggest hurdle is the most obvious, that for a digital system you need digital records to work off of, and that represents a major snag for Canada.
What Canada needs is an agile methodology when it comes to health care. However, the extensive bureaucracy of Canadian governments is rather allergic to anything that would require that kind of innovation.
This issue was nicely summarized by a paper from the C.D. Howe Institute, aptly named “In The Paradox of Productivity, Technology, and Innovation in Canadian Healthcare”. “With healthcare now accounting for well over a tenth of GDP, the efficiency with which healthcare resources are used has a significant impact on overall productivity, and issues relating to new technology and innovation in healthcare have been attracting increasing attention,” state the authors.
“There is evidence to suggest that a substantial share of our healthcare resources are wasted, being used for tests and interventions of no or little value,” they add.
If the problem is widely understood, then what of the solutions? The researchers effectively identify a series of changes that wouldn’t sound out of place in the private sector. Provinces should be encouraged to experiment with new models of distribution and payment to encourage the adoption of new technology and techniques. Patients should be empowered by digital access to their own records in order to help them make informed health decisions.
“It will be incumbent on national and provincial health technology assessment bodies, in the context of a more rapid pace of technological growth, to find ways to become more nimble,” states the report. Modern business, the tech sector in particular, has long since made a specialty of introducing flexibility into rigid companies. Perhaps then it would be wise for the government to turn its attention to its own private sector for inspiration. A more nimble bureaucracy — that would be a clever innovation indeed.
For those readers involved in either the public or private end of the medical world, we encourage you to share any ideas you might have in implementing a nimble healthcare bureaucracy. It’s a process with a truly staggering number of moving parts and perspectives, yet there is no problem whose solution does not benefit from a bit of discussion and debate. Just as it is in creating a digital solution, we have to understand the problem first before we can solve it.
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