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By Lee Fairclough

Digital health: Transforming care and adding value

This week is Digital Health Week, a yearly acknowledgement of the transformative power of digital health technologies to support the delivery of health care.

That such a transformation is desired by patients and caregivers is not in doubt. Canada Health Infoway notes that 80% of patients want access to their own records and other digital health solutions. This enthusiasm was confirmed recently in a survey commissioned by the Canadian Medical Association which found:

  • Three-quarters of Canadians would like to see more technology as part of the health care system
  • 7 in 10 Canadians would take advantage of virtual physician visits and many believe that it would lead to more timely care, convenience and overall care.
  • Over half (56%) would likely wear a mobile device that monitored their health continuously.

Despite these figures, digital care has been relatively slow in coming to Ontario and the rest of Canada for a variety of reasons related to the challenges of putting the proper infrastructure in place, privacy and security concerns and some resistance from health care providers and patients.

However, progress is being made. Health Quality Ontario is working with others in the province to routinely embed tools and resources that advance quality care into the digital systems clinicians use to deliver care. This encourages the real-time use of evidence to support individual patients in the moment of their care. This approach now extends to one of the most challenging issues for patients and clinicians alike – appropriate use of opioids.

In a project launched at the Thunder Bay Regional Health Sciences Centre, clinicians are using an opioid “digital order set” to provide guidance on appropriate prescribing to manage pain after surgery. Digital order sets are guidelines or checklists embedded in the electronic systems used by physicians in hospitals. The opioid order set is just one of 40 developed to encourage best practices and help accelerate the adoption of Health Quality Ontario’s quality standards.

Another Health Quality Ontario initiative – MyPractice reports - is also helping primary care physicians in the community optimize their prescribing of opioids and support effective pain management. The confidential, comparative reports about clinicians’ prescribing patterns, practical ideas and resources for improvement combined with support to query patient-level data in their electronic medical records enables clinicians to assess their own practice relative to peers and, implement ways to provide better quality care to patients.

Two new reports from Health Quality Ontario demonstrate that different forms of digital health can provide good care and be cost-effective. One of these – remote monitoring of patients with heart disease has seen Ontario take a pioneering role, while the other, providing psychotherapy over the internet, is a promising use of digital health in the key area of mental health.

Last month, Health Quality Ontario issued a final recommendation in favour of funding remote monitoring for patients with implantable cardioverter-defibrillators, cardiac resynchronization therapy devices, and permanent pacemakers. In this approach, people with heart disease who have an electronic device implanted, have information from the device recorded and sent automatically to health care professionals for secure assessment via the telephone or over the internet. A health technology assessment that HQO’s Ontario Health Technology Advisory Committee used as the basis for its decision found that remote monitoring for this condition is good value for money, and that patients overwhelmingly report positive experiences.

Also, last month Health Quality Ontario sought input on a draft health technology assessment and a draft recommendation about internet-delivered cognitive behavioral therapy for mild to moderate major depression and anxiety disorders. The draft assessment shared that this approach improves symptoms and provides good value for money.

While many working with digital health are frustrated with the pace digital technologies are being integrated into frontline care delivery, examples like these demonstrate that inroads are being made based on evidence to support positive change and that quality care is being advanced through the use of innovative digital tools.

Indeed, the framework for quality care developed by Health Quality Ontario notes that ensuring “technology works for all” is one of the key enablers of a quality health care system.






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