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Worlds colliding…industry vs. academia May 13, 2008

Posted by Hans in : academics, nature of ehealth, opinion , 1 comment so far

It’s interesting to see how differently ehealth is viewed by academics and industry.  To one, ehealth is the potential of using new mediums to explore ideas and possibilities, while to the other, ehealth is more of a means to an end.

For the past few years, I’ve been in the academic world exploring the limits of our existing evaluation theory as applied to ehealth innovations.  As a researcher (or perhaps more aptly, ‘would be’ researcher), I focused on the concepts of ehealth and how one could evaluate these constructs.  The pursuit was academic and intellectual, even though I tried my best to remain grounded in solving, what I perceived to be, real problems.  Perhaps that’s why much of my writing and thinking on this topic has been focused on the patient and how users of the technology (health care providers included) can be empowered by ehealth.

More recently, I’ve been exposed to the industry perspective of ehealth.  In this world, ehealth is all about programs and projects, about deployment schedules, funding options, and providing the framework to move a health care system along.  Here, there really isn’t any time for or value of the rigorous methodological approaches (and debates) surrounding randomized control trials, systematic reviews, or even articulating an epistemological viewpoint on how knowledge is constructed or derived.  Ehealth, in this context, is a business matter that requires analysis, forecast, and action.

For me, I feel somewhat stuck between two worlds, not having left the academic/research world, and yet being asked to help address some industry problems.  Discussions in the realm of industry hardly mention patients except in strategy/vision documents.  Ehealth is big business, dominated by government bodies and vendors.

I’m not saying that one is better than the other.  I merely point out something that wasn’t *real* to me until recently.  I always knew that industry is different and operated differently than the research world, but perhaps I was a bit naive about how much difference there really is.

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Health care leaders lag on IT policy February 24, 2004

Posted by Hans in : nature of ehealth, news , 1 comment so far

I came across an interesting news article talking about Newt Gingrich and his frustration with the health care system’s unwillingness to adopt IT. He gave a presentation at this year’s HIMSS conference. Basically, he tells a story of how the youngest in our society are at ease with technology, pushing for more technology, and yet our health care system is somewhat of an anachronism in today’s information-driven society. He uses an example of how a certain state is mandating printed/written prescriptions over electronic ones.

Question: Just because the rest of society is moving in one direction, does it mean that health care should? Should health care move at the same pace, or to the same degree? What about those who choose and prefer paper-based solutions? Do we leave them “behind”? One last thought…how come we always talk about those six-year old kids using technology, and not about what technology can do for the elderly, homeless, or disenfranchised?

I’m not suggesting that we shouldn’t use technology. It’s just that we haven’t demonstrated that we know how to use technology effectively within the context of health care. We’re all still banking on the *potential* benefits of using more ICTs. I guess after reading Neil Postman’s Technopoly some of my doubts took form. Also, as a “scientist”, I adhere to the principle that new interventions do not make a difference (i.e., null-hypothesis) until proven otherwise. This particular lesson was learned during my on-going discussions with my thesis committee.

Centre for Health Transformation

Came across this site based on the article listed above. You can find information at http://www.healthtransformation.net. Apparently, the goal of this centre is to provide options that will help accelerate the transformation of the health care system “to an individual-centered 21st century system of health and healthcare characterized by better outcomes and more choices at lower cost”. There may be an interesting opportunity for the Centre for Global eHealth Innovation to collaborate with this group. I’m going to contact them to see if there’s any interest. Will keep you updated.

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Technological determinism and eHealth January 27, 2004

Posted by Hans in : nature of ehealth , 2comments

During a team meeting at the Centre for Global eHealth Innovation yesterday, a point was raised about an assumption that we may all unconsciously have regarding the use of ICTs to improve health and health care (i.e., technological determinism). I stumbled across an interesting quotation by a newly appointed VP to an “eHealth” company called Medseek.

“Information technology within the Canadian healthcare system remains the key in improving the quality and delivery of patient care. In light of ongoing budgetary constraints and human resources shortages, Canadian hospitals must continuously find innovative ways to reduce costs and increase funding.”

Of course, the VP suggested his products and company is the solution, but that’s not the point. My question is perhaps a little more basic: how do we really know that ehealth and technology will cause positive change? I do not doubt that there will be change, but will it necessarily be an improvement or positive. Neil Postman wrote about technology inherently facilitating (or perhaps even forcing) human beings to change, but cautioned that we do not really understand the nature of this change. Can it be that we change, but don’t realize the implications and/or the consequences which may be either positive or negative?

You can read the full quotation and announcement in the press release.

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