Innovation in eHealth – Any Steve Jobs Out There? Don Newsham

Don Newsham, Associate Editor, is the CEO of COACH: Canada’s Health Informatics Association in Toronto, Ontario.

What innovation action are you undertaking? How are you making a difference for your eHealth community? Are you applying your expertise, creativity and enthusiasm in innovative ways? Oh and have you read Steve Job’s book?The health informatics (HI) community is continuously seeking innovators – contributors to better information for better health – and people who know how to pick up, revitalize and remake a seemingly stalled initiative. We have a responsibility to tackle innovation with all our expertise, energy and enthusiasm. We also have a responsibility to do it well, with integrity, true leadership and effective processes, regardless of whether we succeed or fail. I am always excited about the successes and results of so much of the eHealth work across all our country. And sometimes I’m dismayed by the projects that are seemingly ‘off-the-rails’. What are some secrets to eHealth successes and what causes other activity to become stuck? What needs to be done to deliver on innovative, visionary and needed initiatives? Do we have the capacity, credentials and creativity needed in our HI community? I certainly believe so, but what is it that really needs doing? And doing right!Based on projects that I have observed or participated in and on various leading presentations from the past month there are several actions to support innovation in eHealth, innovation in technology, innovation in project and change management, innovation wherever you are working. 1. Simplify. My Newsham’s Notes blog of April 23 (www.coachorg.com/en/aboutcoach/ceoblog.asp,) identifies several actions to embrace, if we are to better succeed and indeed better innovate.• Bridge the conceptually elegant

_____ (pick your word here – standard, architecture, system development, deployment plan) to a simplified, scalable, action-oriented, good-to-start implementation (which requires a strong understanding of business need).

• Improve our various processes (conference registration, patient lists, integrated care plans) to meet data needs quickly and simply, using

technology that we all use day to day on our PDAs.

• Simplify the health are human-technology interface equal to that of the “i” entertainment world.

• Use the best of project management that supports implementation and accountability without being a complex paper burden.

• Embrace the axiom “less is more” (less steps, less extraneous data, less intrusion).

2. Be ‘patient first’• Whatever initiative or project, it is

only the patient story that makes it real, different, truly valuable and adoptable.

• A positive, valued patient experience and result is good for healthcare, good economically and in so many other ways.

• Our innovation mission could be – alleviate pain, restore health, extend life (words from a Conference Board of Canada André Picard speech).

3. Innovate the how, as much as the what.• Most great ideas or lengthy

recommendations on what needs to be done have been reported … frequently and forever (exaggeration acknowledged). We know what to do.

• Innovation in scaled implementation, enabled transformation, permanent change and coordinated care is truly required.

• Innovation can be practical. It’s often the little everyday changed actions that will make a difference (Checklists, anyone? Pay for results, anyone?)

• It’s how the person or patient receives and understands their care, their services, their electronic health data that’s important, more than the cool technology or system functions or medical instrumentation.

4. Focus innovation where people live.• We live at home and in the

community. We live near doctors’ offices, community clinics, pharmacies and other family members.

• Home telehealth, mobile health,

virtual health, PDA access to my doctor are where innovation can strongly take hold.

• Provide health system navigation where and when people need it.

• This innovative focus must be and is being founded upon a platform of “e” records (EMRs, EHRs, EPRs) that are going mainstream now.

5. Focus innovation on patient safety.The impact, need and urgency of promoting and supporting all aspects of patient safety have not disappeared, regardless of the passing of time since the IOM and Baker and Norton studies. Innovative means to enhance patient safety are needed, whether implementing systems that enable safer care (medication management, e-prescribing, CPOE or other needed systems) or adopting safe practices, standards and guidelines in the development, implementation and operation of eHealth systems. (See Neil Gardner/ Elizabeth Keller eHealth Safety article elsewhere in this issue.)6. And lastly, ‘big data’ needs attention.• Structured, natural language,

heuristic algorithms – we need the very best of data analytic capability and capacity, easily available and usable.

• There will always be more information to be managed, too many frameworks to consider and a large set of data standards to adopt and use. Back to point #1, simplify please.

• Innovation to answer what is beyond ‘google for health data’ is needed.

Numerous other creative ideas abound from the many HI professionals across this country. There are creative and talented leaders in COACH, Canada Health Infoway, the jurisdictions, Canadian Institute for Health Information (CIHI), eHealth and telehealth agencies, physician EMR organizations, product vendors and consultant companies, academic institutions and countless other organizations. While we might all aspire to be the Steve Jobs of eHealth, I do hope there are many innovators out there contributing vision, energy and insight for eHealth innovation – with or without the black turtleneck.

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