The Strangely Technophobic Nature of Healthcare Records
“The future is already here — it’s just not very evenly distributed”
- William Gibson
The acclaimed writer William Gibson has always had his eye on the future. While he said that famous quote in the early 90’s, it’s rings even truer today. That’s the curse of the futurist, always an eye on what is to come, rather than what is. At Focus21, we’re focused on the present, on getting the future that has already arrived distributed to everyone’s doorstep.
Today, we’ll be specifically looking at health sciences, data driven solutions, and the venn diagram middle ground where they should meet.
It’s not hard to picture a doctor’s visit where your health data is available in a seamless stream, where qualified doctors and nurses have instant, privileged access to the information they need to diagnose you correctly. You want to be sure the doctors know all the information, that they’re not overlooking anything. This is your health, after all.
However, it’s not just an issue for personal health. Anonymized patient records can paint the pathology portrait of whole populations. Identifying which treatments work on who, what illnesses are spreading where; everything you’d need to avoid an epidemic or other bio-medical catastrophe.
At its core, whether for whole populations or an individual, diagnosis is about applying data to pre-existing models. A doctor trains for a lifetime to gain the knowledge necessary to assess and cross-reference your own symptoms to understand your pathology. It’s an application of data analysis, and frankly, for most day-to-day medical issues, a well maintained algorithmic database could likely handle a lot of the systemic busy work of diagnosing.
So why aren’t we seeing more of it? After all, we still endure a doctor shortage here in Canada, and this kind of technology could help alleviate an overburdened system.
It’s not as though the tech doesn’t exist, IBM’s Watson AI already made quite the splash in the medical community back in 2012. This flagship platform was able to process thousands of medical research papers, providing insightful diagnoses in seconds. Watson is a complex showpiece, but the same technological principles could be applied much more simply and functionally.
So if the tech isn’t the problem, then what is? For Canada at least, the biggest hurdle is a lack of uniformity among medical data. Despite the federal health care system, there is little standardization between the provincial medical establishments. While citizens are free to move as they will between provinces, their health data is not.
In many towns, physicians still primarily access their patient’s data through fax machines. Yes, fax machines, those aging relics of the 1980’s. This mass of faxes often requires a full time staff member just to sort through them all. Often times this is held up as a privacy precaution, but faxing is far from secure. Sure, you can’t hack into a fax, but human error can prove just as effective.
Just ask Lisa Belanger of Bedford N.S., who was receiving confidential medical faxes from across the country for over a decade. Operator of a local spa, Belanger had tried for years to end this barrage of patient information intended for a local clinic. Only after a decade of protests and complaints did the government finally get around to fixing the faxing error. Privacy issues are indeed a major concern, but not utilizing modern data management technology stems from archaic legalities not keeping up with modern encryption technology.
The roadblocks to implementing a comprehensive national data solution are rooted in sociology, not technology. There have been plenty of efforts in the past, E-Health initiatives on the federal and provincial level have often been complete boondoggles. Billions of dollars spent with little to show.
These were not undertaken by small players, these were failed projects created by tech giants. IBM and Siemens, as examples, were recruited to bring the Canadian health sector into the digital age, yet they produced nothing but disappointment and public deficits.
Political issues between provinces certainly made things difficult, but the biggest issues came from within, from the very practitioner for whom the system was being designed. When asked what they wanted out of such a system, they tended to answer “everything and the kitchen sink”.
It’s hard to envision everything you might need out of a system, to conjure from thin air your own perfect digital assistance framework. After all, that’s not a doctor’s job, and they’ve already spent most of their lives focused on their vocation.
This is where you need UX and data science experts. You wouldn’t ask a carpenter to build an engine, why would you ask a doctor to build a data management system? While practitioner input is obviously invaluable, the problem needs to be put to someone who understands the golden rule — design with purpose. Don’t include every feature you can think of; think of your purpose, and design from there.
This is the cure to project bloat, to scale creep in the Canadian health industry. Make clear your system’s purpose, then design accordingly. Universal standards would need to be put in place, from the ground up. Only when this foundation is in place, with privacy concerns properly addressed, could such a system move forward.
It is the one element consistently lacking in Canada’s various attempts to consolidate their health data, and until it is addressed, we are likely to continue seeing records faxed across the country. The future can’t get evenly distributed soon enough.
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