Healthcare 2020: Community care, patient digital rights, AI and helping physicians avoid burnout

Early on each year, I like to take a look at the state of digital health in Canada and make some predictions for what lies ahead.

Canadian healthcare is on the cusp of significant change. Several initiatives will have a profound effect on how healthcare is delivered in Canada in the coming years.

The big picture challenges facing our health system continue. Long wait times, controlling costs, lack of care coordination, and fragmented care are some of the main issues. Inappropriate medication duplication, an ongoing opioid crisis, the rise in chronic disease and the aging baby boomer cohort round out the list.

With 2019 in the rearview mirror, here is what’s in store for digital healthcare in Canada for 2020 and beyond.

Patient-centred care – This is a movement focused on treating patients with dignity, including them in goal setting and decision-making, and ensuring proper coordination of their care. We will see a continued focus on increasing the capabilities of patient engagement tools including personal health records, patient portals and remote patient monitoring (RPM). RPM enables patients to play a more active role in managing their personal health and chronic diseases resulting in improved outcomes.

Increased patient access to data – In 2020, we’re likely to see a more cohesive lobby for an official patient bill of digital rights. This should both improve access by patients to their data and restrict the rights of other groups to access patient data inappropriately.

Many jurisdictions have introduced patient ombudsmen and advisory councils to their electronic health governance processes – a very positive step.

Patients are becoming increasingly eager to see all the information that their healthcare providers see. In the US, there’s been a significant move toward “Open Notes” whereby the patient has full access to everything the physician and other providers have written without limitation. Expect this thinking to emerge in Canada in 2020.

Helping physicians make sense of it all – Ensuring patients receive the highest quality of care in a digital world means giving physicians the data they need in a timely fashion. Despite waves of digital transformation underway, it’s still not easy for clinicians to find the data they need.

Clinician burn out is a significant problem across North America and a great deal of studies and research increasingly points to the clerical burden introduced by the EHR as a major cause for that burnout.

In 2020 and beyond, the Canadian healthcare system will see a greater focus on presenting meaningful, actionable data to clinicians. Smart searches and Artificial Intelligence based approaches can significantly help the move from ‘big data’ to ‘actionable data’, leading to more effective, efficient care, reduced cognitive load on physicians, and consequently less risk of burnout.

Artificial intelligence moves into care – We cannot discuss the future of Canadian healthcare without addressing the role of AI. Going forward, AI, machine learning and deep learning will help predict all manner of adverse events that today are left to physician intuition and judgement. It has already had major impact and benefits in use cases such as predicting surgical outcomes, adverse events like sepsis, and determining optimal staffing levels in emergency departments.

Measuring and delivering value – As healthcare providers struggle with an ever-aging population and increased chronic disease, the sustainability of healthcare systems will hinge on the ability to deliver value for taxpayer money. New models are evolving that reward providers for working in teams, and for improving the quality of care they deliver to the population – examples include the Primary Care Network in Alberta and Ontario Health Teams. While these efforts are still at an early stage, it’s reasonable to expect that cost pressures and related forces will cause the model to expand rapidly across Canada.

Moving care into the community – Provincial governments are increasing their spending and focus on the huge range and diversity of care offered in the community, including primary care and community clinics, with the aim of reducing the rate of hospital admissions. Expect to see an emphasis on better managing patient transitions in care from hospital to community, and in preventing readmissions, as obvious areas for improvement.

Canada saw progress in 2019. Many of the building blocks for healthcare transformation already exist, and now it’s a case of embracing them. The next decade heralds some fundamental changes to our healthcare system. If we are to maintain a sustainable healthcare system, it’s critical that we support physicians and empower patients to participate in their own care.

With another year behind us, and one that saw considerable progress in digital health, I look forward to seeing what 2020 will bring.