Getting out of the office
July 13, 2020
I recently had the pleasure and privilege to be the master of ceremonies at a GP training conference where 45 general practice doctors came together for nearly three days of presentations and workshops.
There was a mix of rural and urban GPs obviously looking to upskill and earn CME points along the way. I took some leave from my day job to do it as I enjoy that sort of thing and it got me out of the city for a few days. In other words, a win-win for all involved!
The unusual thing for me is that this was a completely non-digital conference. None of the presenters talked about the use of digital technologies. Probably the closest reference was to where to go on the internet for some specific clinical information and research.
So, what has this got to do with an article that should be about digital health technology?
Firstly, it was a refreshing change to be listening to such high quality clinical-level presentations. All of the attendees are clearly passionate about providing the best possible healthcare to their patients. The question and answer sessions were highly interactive, and everyone was totally engaged in the discussions. As an MC it’s always a challenge and fun to keep the sessions on track, while meeting the organiser’s requirement to stick to the time schedule.
Secondly, and most importantly, it made it very clear to me that we all become very focused on the things that interest us the most. Usually this revolves around our occupation and, in my case, the importance of digital technology to enable the delivery of healthcare. In fact, we get so focused on this that we convince ourselves that we know what everyone wants and that’s okay as long it’s about all things digital!
The doctors that I spent time with would put it another way – it’s about the delivery of healthcare and everything else has to be in place to help them do this the best way possible.
Technology is important but it’s not the most important thing about their daily lives. Patient care and having a sustainable business are critical to them with hardly any time left in their busy lives to consider all the information they’re bombarded with when it comes to how they can use digital to disrupt what they do (for the better, of course).
The clinicians reading this article will now be sighing with relief that I’ve finally figured this out so the point I’m making doesn’t necessarily apply to them anyway.
So, what is my point? An example could be about the use of technology to enable the provision of healthcare delivered in a virtual manner, i.e., a consult where the clinician and patient are not in the same room at the same time. The development of the virtual health model of care is rapidly gaining pace on a global scale and New Zealand is slipping further behind on this.
From a technology point of view, it’s an exciting thing to be involved in. The providers of digital solutions in this space are developing amazing software that’s almost only limited by their imagination. Linked to the likes of analytics, robotics, internet of things, interoperability and so on (the list is almost endless), we could be forgiven for thinking that clinicians will soon be a thing of the past. In fact, if we chuck genomics, bio-pharma and genetic engineering into the discussion then we could be convinced that there won’t be any patients in the future either!
However, when it comes to clinicians who deal with the lives of their patients every day, the things that might concern them in relation to virtual healthcare are far more basic, and the most important factors for them.
These include connectivity (how do I do a virtual consult when the internet is unstable), funding (how do I get paid when the current funding models encourage in-person consults), equity (my patient base can’t afford a mobile data plan), security (what happens with my patient’s records, and to me, if there’s a breach), trust (how much of this digital hype is real and how much is snake oil), sustainability (I’m struggling to run a profitable business now so how do I invest to stay ahead) and much more.
There’s clearly a gap, and in lots of cases this gap is very wide, and it’s my belief that the digital sector has got to firstly focus on what’s concerning the clinicians and the patients the most, especially in terms of the “here and now”. Only then will there be the ability to share the unimaginable magic of digital technology that we’re told is knocking on our doors right now.
For example, funding is a common denominator in many of these discussions. The digital sector says that their solutions will solve the funding problem – you don’t need more money, just use technology to do it differently.
The GPs would say they’re underfunded now and the way they’re funded is a discouragement to adopting different models of care. Why would they provide healthcare in a virtual manner if the funding model incentivises a 10-minute in-person consult?
We all say this is a no-brainer? It’s simple to solve by just changing the funding mechanisms but, if it was that simple, then why hasn’t it been done already? Clearly, leadership has a big part to play in this especially when it comes to political and bureaucratic resolve to either lead the way or get in the way. But we all have to take responsibility for this as it will take a joined-up, ‘collaboractive’ approach to develop joint solutions that make it as simple as possible to make the right decisions and put these into place.
On one hand, the digital sector needs to get closer to the day-to-day problems being experienced at the clinical coal face, be less evangelical about the promised land and actually demonstrate that they can “make real things happen in a pragmatic way”. On the other hand, the clinicians need to draw breath, take the time to consider the unimaginable and be prepared to share their problems in a way that engenders joint problem-solving.
Finally, there has to be the political and bureaucratic will to support this type of environment as the way things are done now are based on historic problems.
And, we all know that these are not the problems of today, or the future, so we need vision and leadership from everyone otherwise the opportunities that digital technology can provide will be sadly missed.
Scott Arrol is the CEO of New Zealand Health IT (NZHIT).