That word again at #HIMSS21Europe

It was the word that highlighted discussions at last year’s virtual HIMSS Europe conference and trust was also the word heard again and again during the main presentations at this year’s #HIMSS21Europe meeting that has just concluded.

The big difference this year was that trust was used primarily in the context of encouraging COVID-19 vaccination to help end the pandemic and only secondarily with sharing of patient data.

This year’s HIMSS Europe meeting continued with the usual major topic areas showcasing advances in European countries and the UK with respect to digital health and virtual care. However, the keynote sessions focused to a greater degree on COVID-19 and the steps needed for Europe to adapt successfully to a post-pandemic era.

At last fall’s conference delegates and the health IT world in general were still basking in total transformation of health care delivery from in-person to a virtual basis because of the COVID-19 pandemic – a goal many had been working on fruitlessly for decades. Now as Dr. Ran Balicer, chief innovation officer at Clalit Health Services in Israel said on the conference’s first day “providing care at a distance is how you provide care”.  He added that the whole concept of telehealth has become some redundant as health systems have adapted to hybrid models of care delivery that combine in-person and virtual care.

Back to trust.

“The key to every vaccination program is trust,” said the World Health Organization’s Dr. Hans Kluge during the opening plenary session. This point was hammered home during a session of dealing with COVID-19 misinformation and fake news in which data was presented from surveys in several European countries indicating where trust in government was highest, people were also supportive of COVID-19 vaccines.

The importance of promoting digital trust in developing an inclusive society in the post-COVID-19 world was referenced during the main closing plenary session on global inequities by Dr. Ahmed ElSaaed, Focus Area Lead for Innovation Scaling at the United Nations Global Pulse Finland.

In the same session, Dr. Deborah Maufi, chief medical officer for Babymoon Care B.V. in The Netherlands, said trust was needed to build “key and targetted campaigns” aimed at specific communities to encourage vaccination.

Trust also surfaced in a sessions dealing with the use of patient data. Such trust is the key to sharing patient data for secondary use, said Seamus O’Neill, Chief Executive at the Northern Health Alliance in the UK.

People have been more trusting in sharing their personal health data during the COVID-19 pandemic, he said, because this was being done on an emergency basis to deal with an immediate, threat to personal health. However, he said, one should be wary in assuming people will continue to maintain the same high degree of trust over the longer term after the pandemic. “The volume of health-related data is increasing exponentially … and patients have to be convinced their data is being shared responsibly” said Dr. Rowland Illing, a radiologist and chief medical officer at Affidea in the UK, at the same session.

(Photo of Helsinki – where once again we are not meeting (but should have been) for HIMSS Europe because of COVID-19)

Better, but not there yet: Use of IT in primary care in Canada


When it comes to the use of information technology in primary care in Canada the best that can be said is that all the numbers have trended in the right direction since 2015.

Released by the Canadian Institutes of Health Information (CIHI) last week, the 2019 version of the Commonwealth Fund International Health Policy survey of 11 developed countries focused on primary care physicians and contains a wealth of data on the use of technology as well as on access and coordination of care.

At a time when Canadians and especially primary care physicians are engaged intense discussions about how to better use digital technology to improve care and better involve patients, what is most striking about some of the Commonwealth Fund findings is just how far many Canadian jurisdictions are from even having the basic tools to do this.

While the survey confirms the fact that overall Canadian primary care physicians have made huge gains in incorporating electronic medical records into their practices in the last decade (kudos to @Infoway and all the money put into enabling this in the 2000s), these gains are not evenly distributed. And when it comes to the use of health IT, Canada continues to lag behind other countries polled, in many instances badly.

While 86% of Canadian primary care physicians overall report using electronic medical records (EMRs), the 2019 survey shows only 1 in 4 (26%) are using EMRs in PEI while that percentage is 61% for primary care doctors in New Brunswick and Newfoundland.

Of course, the absence of an EMR makes any electronic engagement with patients or use of information technology to improve quality care a moot point.

As for providing patients with electronic access to their records or enabling electronic communication, Canada continues to also lag most other nations surveyed. Only 23% of Canadian primary care docs offered the option to ask medical questions via email or a secure website, and only 5% have the capacity to let patients see summaries of their medical record online.

These numbers fell far below the average among the other 11 Commonwealth Fund countries surveyed , which includes Australia, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the U.K. and the U.S.

We are also falling short when it comes to connectivity between physicians: The survey showed only 25% of Canadian family doctors used EMRs to exchange clinical summaries and 36% to exchange laboratory results with other physicians (Commonwealth Fund averages: 63% and 65%, respectively).

So, some good stats when looks at 2015 numbers provided for comparison, but many miles to go.

(Illustration: Cover of Future Practice magazine published by the Canadian Medical Association, May 2011)





#Ehealth2016 – inquiring minds want to know


ehealth_ambassadors_badge_300x300Canada’s premier conference on health information technology – #ehealth2016 – is now less than a month away.

That means it’s a good time to start to contemplate some of the big questions facing the health IT community in Canada and wondering whether this mega-meeting hosted in Vancouver.\, courtesy of COACH, Infoway and CIHI will provide any answers to these questions.

At its worst, this annual meeting can be an annoying combination of sometimes irrelevant keynote speakers and simultaneous sessions that do not live up to their titles/abstracts. But over the past decade e-health (however one chooses to write the name – hyphen, no hyphen, capital on ‘e’ or no capital on ‘e’ etc.) has become THE meeting for those interested in health IT to network, hear leaders in the field and gain insights into really interesting work going on at local/regional and provincial/territorial levels.

As an observer, I would suggest a few interesting questions this conference may help to provide answers for:

  • With the death or evolution of the big dinosaur programs for funding physician EMRs (POSP, PITO etc.) what is being done to continue to involve and engage physicians in improving how they use electronic records to improve care?
  • What is Infoway planning on doing with its new infusion of funding courtesy of the last federal budget?
  • Is patient engagement a thing in Canada in health IT and if so what does it mean?
  • Is the vendor space for EMRs and EHRs going to continue to consolidate ?
  • And that interoperability issue – is anything substantive happening to better connect physicians and hospitals.
  • Big data. (enough said).
  • Are hospitals and practitioners adapting to the mobile revolution in health?
  • Are these the correct questions to be asking? At HIMSS this year there was a big shift towards discussing digital connectivity beyond the electronic record and major discussions about data security in health. Should Canada be having those discussions too.

Inquiring minds want to know.


A Canadian in Vegas (#HIMSS16)

HIMSS16 SMA Badge [8339409]

For many years I have joined hundreds of my fellow Canadians in making the annual pilgrimage to #HIMSS16 to soak up the hyperbole and find out what is on the minds of those who spend their time fixated on health information technology.

Canada may have its own quaint health care system which seems to manage to provide essential medical care to all at no point-of-care cost. But trends sweeping our neighbour to the South often impact the Canadian system and this is especially true when it comes to the world of electronic medical records, digital care, patient engagement, and what have you.

Previously I have attended as a journalist for the publication Future Practice, striving to find new amusing ways to work in prayer references when talking about HIMSS while providing a 3-4 page feature summary of the entire conference for Canadian physicians.

This year – along with two fellow Canadians, Colin Hung and Glenn Lanteigne – I have had the honour of being selected as one of the 20 social media ambassadors for the meeting. Our mission is to use social media to comment on HIMSS16 pre-, during and post-meeting as well as to engage each other and other delegates in provocative ways to promote discussion and debate on key issues at the meeting.

I want to take this opportunity to talk to other Canadian delegates and find out why they are in Vegas and what they hope to bring back that will be relevant to their work within the Canadian system. I also want to try and find the one or two sessions that usually focus specifically on Canadian innovation and have been chosen as educational sessions

Also, I already know I want to try and get a better handle on this whole ‘death of meaningful use’ situation. We in Canada – while not always using the exact language and without any government funding infrastructure attached to the concept – are starting to talk about meaningful use more and more. So, suddenly announcing the demise of the concept needs some looking into especially since many US commentators also seem unclear about whether meaningful use is quite dead yet or not.

Patient engagement is the other area in which I want to see what is new and intriguing. The Canadian system also talks a good game when it comes to patient engagement but it turns out many physicians are not keen on sharing all or even some patient data with their patients. Patient portals are still in their infancy and very, very few Canadian physicians can use email to communication with patients. Having been tied to the small but effective patient advocacy community in Canada I want to see just how things are evolving in the US and where better to do this than HIMSS.

HIMSS is always fun and informative and HIMSS in Vegas extra so. So, let’s get on with it.