Clinicians express views on the digital future at #HIMSS22

The majority (56%) of clinicians participating in a large, global survey believe that “the majority” of their clinical decisions in the future will be made with tools using artificial intelligence (AI)

However, in the poll of about 3000 physicians and nurses conducted in 111 countries (including Canada) by Ipsos for Elsevier Health,  the majority of respondents expressed concern that medical and nursing school training was not keeping up with the need to educate them properly with the knowledge and skills needed to use modern technologies.

Findings from The Clinician of the Future study were released during the Health Information and Management Systems Society (HIMSS) annual meeting here and discussed during a sponsored session by Dr. Ian Chuang, chief medical officer for Elsevier Health.

Meanwhile results from HIMSS own State of Healthcare survey conducted at the end of last year and including 359 physicians from five countries was also releasee and discussed at the meeting. That report confirmed clinicians feel digital transformation is well underway with 90% of respondents identifying ongoing digital initiatives within their own organizations.

Interestingly, while many health system leaders polled in the HIMSS survey had reservations about the pace of digital transformation within healthcare, 16% of US clinicians said they felt their organizations had completed the transformation process and about half felt the process was well underway.

According to U.S.-based clinicians, tools that do not fit into clinical workflows, lack of proper training and lack of clear communication within the health organization are impeding transformation efforts. However, UK clinicians identified lack of clear communication as the top barrier to digital transformation.

While 88% of clinicians in the HIMSS survey reported their digital skills have improved over the past year and 79% reported choosing to use digital health tools on their own initiative, respondents in the Elsevier survey were less confident of their skills in using new digital technologies.

Of those responding to the survey, 69% feel the widspread use of digital health technology will be a challenging burden on clinician responsibilities if clinicians are not appropriately supported. In addition, 83% felt training needs to be overhauled to keep pace with intro of new technologies. Dr. Chuang said there is a sense that it is not just new information that needs to be taught but rather a shift in the whole medical education paradigm. As one US clinician quoted in the report said: “There’s no time spent separately to learn technology. That education needs to be instilled into the system to ensure all doctors are educated.”

The survey also found that 69% of clinicians globally felt overwhelmed with the current volume of data they had to deal with. While 38% of the clinicians felt receiving training and education in order to remain current will be the top educational priority over the next decade, a similar percentage believe training in the effective use of digital health technologies to assist in the delivery of patient care remotely will be the second priority

Texting medical trainees: “You don’t hear pagers going off any more.”


Texting is the most common means used to communicate with residents and trainees, a small study of surgeons at a major Canadian teaching institution has shown.

While almost all of these surgeons reported using texting for patient related communications, the majority were not using encrypted devices and many were not aware if their hospital has a policy on texting.

The study from the University of Toronto, Women’s College Hospital and the University Health Network (UHN) is one of the first to shed some light on how a dominant means of communications in the modern world is being used in a medical setting.

The results were described by first author Mohammed Firdouse, a medical student, in a poster presentation at the recent Canadian Conference on Medical Education held in Montreal.

In the study, 98 general surgeons at UHN were asked to complete a 39-question online survey about their use of texting for patient-related communications and their awareness of regulations concerning the practice.

Approximately one third of those polled (33) responded to the survey.

More than 90% said they used texting for patient related communications and 60.7% said it was the most common way used to communicate with residents and trainees. However, only 14.3% of these staff surgeons said the used texting to communicate patient-related information with other staff.

The respondents identified speed and convenience as their main reasons for using texting.

Responses with respect to privacy and confidentiality with texting were more problematic.

Almost two-thirds of respondents (62.1%) said they did not have encrypted phones or did not know if their phones were secure while texting and 48.3% said they did not know if their hospital had a policy on texting. Even more respondents (72.4%) said they did not know if texting patient information is addressed in the Personal Health Information and Privacy Act.

These findings do not come as a surprise to Dr. Chris Simpson, past-president of the Canadian Medical Association and chief of cardiology at Queen’s University and Kingston General Hospital.

“You don’t hear pagers going off anymore,” he noted in an online interview.

“My sense – anecdotally, is that electronic communications (especially text) are commonplace between attending doctors and residents; between residents themselves, and less so between doctors and other health professionals.”

“Texting is fast, easy and accurate,” he said.

“Privacy is important but the horse is already out of the barn on this issue.”

“It will always be the responsibility of health care providers to safeguard the privacy of patient information that they have in their possession – this is true. But I am not convinced that texting info poses any greater risk to privacy that currently endorsed communication practices like faxing.”

“The challenge is for us all to find ways to enhance our ability to use electronic technologies in as low risk a way as possible – to establish a best practices culture that minimizes risk of privacy breaches. The answer can’t be and shouldn’t be an outright ban on texting,” said Dr. Simpson

Dr. Matthew Bromwich is an Ottawa pediatric otolaryngology surgeon and founder of Clearwater Clinical Limited and he has a keen interest in the development of mobile apps and the implications for patient privacy.

In an interview, he said, texting now has “100% penetration” in the health care sector and is an invaluable tool due to its convenience.

However, he expressed concerns that hospitals are still paying for pagers for staff that they do not use rather than tackling the issue of making their networks secure for mobile phone use and texting.

Bromwich said while clinicians and trainees can protect patient confidentiality by taking some care in how they frame texts, it would be far better for hospitals to address the issue especially as texting is particularly prone to illegal access.


Mind the gap: social media and #meded


Two small but intriguing Canadian research studies have documented the wide gap between teachers and students and educator users and non-users in their perceived value of social media as learning tools in medical and health education.

The studies were presented at this year’s annual meeting of the Canadian Conference on Medical Association (#CCME16) and the research involved two leading physicians in the social media and digital health world in Canada, the University of Ottawa (uOttawa)’s Dr. Aliraza Jalali and the University of British Columbia (UBC)’s Dr. Kendall Ho.

The uOttawa study conducted by medical education researcher Dr. Safaa El Bialy with Jalali evaluated feedback from 72 medical professors and 63 second-year medical students on their use of popular social networking sites (Twitter, Facebook etc.).

The UBC study presented by second-year medical student Karan DSouza evaluated feedback from 270 health educators at 8 global institutions on their attitudes towards the use of social media in teaching.

The uOttawa study found the medical students were about three times more likely to use the social networking sites for medical education than the professors (67% vs. 23%).

While 94% of students said they felt the sites facilitated learning, only one third of the professors said they used such sites in their teaching practices.

Despite established social media platforms being more than a decade old, El Bialy and Jalali noted “some of the educators did not even know about social media use for educational purposes” and many expressed concerns that such sites were distractions and promoted time wasting.

Just as the uOttawa study documented the gap between medical students and professors, so the UBC study showed sharp differences in perspectives between educators who use social media in the classroom and those who do not, in a variety of countries.

That study documented that health educators globally have concerns about the lack of guidance and support for using social media for educational purposes and also the lack of evidence showing the value of such tools. Even among those using social media in teaching, only 11% said they had received training in using social media for teaching.

DSouza and Ho also echoed the uOttawa study in their introduction when they noted “students have already adopted social media informally to share information and supplement their lecture-based learning.”

They also documented that adoption of social media is not consistent within faculties, even at the same institution.

Both research teams provided suggestions on how the use of social media in the classroom could be encouraged and facilitated.

(Artwork by @Aga_ta_ta on display at CCME16)


An open letter to medical educators (#ccme14)

Please teach medical students about the value of using social media in health care and medicine
That’s my plea delivered in what I hope is a timely manner to delegates currently attending the annual Canadian Conference on Medical Education (CCME) here in Ottawa.
It’s a message I feel badly needs to be delivered in the face of statistics and anecdotal evidence suggesting practising doctors still do not appreciate the value of Twitter, LinkedIn, YouTube, and other social media tools for improving their own professional lives and the care they are delivering.
It is clear that if physicians are going to learn the value of social media tools and platforms they need to be taught about it in medical school. Despite the ubiquitious use of social media by young people, most entering medical school have little understanding of how social media tools can improve their learning experiences and their future professional lives.
If examples are needed of just how social media tools can be incorporated into the curriculum one needed look no further than the CCME meeting itself where panelists at a pre-conference symposium delivered a crash course in just how social media can be used effectively to improve the learning experience in medical school
The panelists:
* Dr. Alireza Jalali (@ARJalali), professor of anatomy at the University of Ottawa and social media lead for the Royal College of Physicians and Surgeons of Canada
* Dr. Ann Marie Cunningham (@AMCunningham), GP and clinical lecturer at Cardiff University, UK and acknowledged expert in using new media in medical education
* Natalie Lafferty (@NLafferty), lecturer at the University of Dundee, UK
* Dr. Neil Mehta (@Neil_Mehta), associate professor of medicine, Cleveland Clinic
* Catherine Peirce (@c_peirce) Project Manager, e-learning at Association of Faculties of Medicine of Canada
Given that the title of the session was “Everything you wanted to know about social media but were afraid to ask your students” it is impossible to quickly summarize the information transmitted at this session – one replete with both wisdom and practical tips and tools to use.
(To those unfamiliar with Twitter and hashtags, the meeting feed at #SMB14 was a demonstration in itself about how Twitter can be used to relay information and promote discussions far beyond the geographic confines of one meeting room)
A few one liners from the panelists provide some pearls of wisdom and a sense of the sentiments expressed:

“Twitter has become my personal learning network” @nlafferty

“Computers don’t stop people from listening. Boring teachers do.” -@ARJalali

Curation “is more than just posting a link. It’s giving it context as well.” ‪@nlafferty
“A big part of this is introducing students to our networks” ‪@amcunningham

‪@ARJalali “think twice, tweet once.

”Think about relationships rather than rules“: ‪@amcunningham

Of 9 Cdn med school with social media guidelines “all are enthusiastic and encourage use of SM” CHEC-CESC scan via @c_peirce

‪@ARJalali tells med students on use of social media: “we’re not there to catch you”

Important to promote principles of Digital Professonalism by education, not rules: @toppsd

Time management an important component of teaching med students about SM: ‪@amcunningham

‪@ARJalali “My students are in a digital world that I’m not a part of.”

“Social media has helped me break out from the boundaries of my own institution” ‪@nlafferty

Perhaps the most telling moment during the course came through Twitter when – as Dr. Jalali was emphasizing the value of Twitter as a tool for teaching, networking and information gathering, – a medical student attending a session of the Canadian Federation of Medical Students at the same time tweeted a note that a straw poll of students at that meeting indicated few use Twitter.
Surely it’s time to do a better job of bridging that gap.