By Jolene Funk

As technology advances, the opportunity for innovation across different sectors grows. For the health care industry, the present moment offers a unique opportunity to push the boundaries of the possible, but also presents challenges as the sector struggles to adapt while maintaining patient safety, allocating scarce resources, and adhering to standards of medical ethics. On January 28th 2019, Shannon Lundquist, a Deloitte Healthcare Leader presented The Future of Health Care at the Munk School of Global Affairs and Public Policy. As a lead partner in Public Sector Transformation at Deloitte, she shared her experiences working with clients on the leading edge of health care innovation, and the opportunities opening up across the health care field.

A key consideration for many private and public health care organizations is where to invest. Canada is home to predominantly publicly funded systems and is at the forefront of new technologies including cyber security, blockchain, artificial intelligence, and advanced manufacturing. For policymakers and health care planners, this is a new era, as new private industry disrupters are also entering the market. There has been a shift away from traditional service delivery models, towards linking health services for customer use without owning physical assets or infrastructure. Companies like Apple and Google are launching their own health insurance services in the United States, and an increasingly large volume of personal information is being passed to private hands via health tracking apps. Therefore, the question emerges: what will the next generation of health care look like?

We may not yet know what the model will be for health care across the system in Ontario, but we do have some insight as to the next generation of hospital care. New digital hospitals are emerging and using technology to link systems and create paperless solutions in order to enhance patient experience, talent development, and operational efficiency. At the centre of this is the idea of patient ownership over their own health care map: their personal information, provider network, and wellness plan. A pioneer in the field close to home is Humber River Hospital. They were able to leverage their existing systems by linking electronic health platforms to improve patient and provider experience. Innovative designs include a hospital layout that makes transporting patients and medicine easier, and (with the use of sensors), robots that can navigate the hallways. A robot named Pepper assists patients and families trying to find their way around the hospital.  The building itself resembles more of an airport or a hotel and includes multi-purpose modular rooms enabled with technology to meet the hospital’s changing needs for patient care. Beyond the structural innovation to improve patient experience is the integration of information. Designed with General Electric is a command centre for patient information enabling the coordination of cross-disciplinary teams. Part of the hope with the digital hospitals is to improve patient experience by coordination and ending hallway medicine.

In another story of innovation in progress, Tytocare is enabling greater health care access in remote communities through remote physician diagnosis. Their app-linked TytoHome kit allows physicians to monitor and examine patients remotely by guiding them through the use of the testing kits, offering a potential solution to waning access to primary care physicians in many parts of Canada.  In Africa, Zipline, is attempting to tackle a similar challenge, by using drones to deliver blood services across the continent.

There are also new technologies to help with health behaviour change. Gamification is being used in Canadian hospitals serving children and youth, with games like Pokemon Go helping children to participate in physical therapy and create a more comfortable environment by moving around the hospital and interacting with staff. Providers have also used virtual reality to distract patients from pain and manage mental health conditions. In the world of teaching, Dr. Ahmed of London performed a colorectal surgery streamed using Snapchat Spectacles to 3.9 million followers. He believes the use of virtual reality will open an effective method for surgical teaching and training doctors around the world.

In the discussion after the talk, attendees asked questions regarding potential outcomes of the shift toward digitized health care. The use of artificial intelligence in imaging diagnoses is changing the role of radiologists to focus more on patient interaction, potentially improving patient experience as a result. Some resistance to this change in expectations is likely; however, as some areas – such as geriatrics – experience a chronic labour shortage, the changing labour model could facilitate a more efficient use of scarce resources. Within health care, different fields are also adopting technology at different rates, and areas – such as oncology and surgery – have more innovators and greater opportunity to incorporate technology. The adoption rate of new technology may change as innovation is embedded within medical schools, and new providers may be drivers of change.

A key concern in the health sector will always be ethics and information privacy. It is important to have service providers and policymakers engaging in discussion about these issues, particularly around the need for data sharing to support integrated care. With more patient information being available, regulations need to be designed to maintain privacy and control access. The need for informed consent adds an additional layer of complexity, and with new ways to track patients and link health information, the type of consent needed is no longer limited to the basic sharing of health information with a single provider.

New technology is emerging quickly, but to be adopted into the health care sector it needs extensive testing to ensure it is safe and an effective part of treatment. It also opens the doors to new liabilities for providers to manage the use of technology and understand it’s limitations. For policy makers, this means being on the leading edge of change and seeking opportunities to design innovation for health care as well as adopting existing technology.

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Jolene Funk is currently a first year Master of Public Policy Candidate at the University of Toronto’s Munk School of Global Affairs and Public Policy.  She is interested in innovation policy, health care policy, and how publicly funded systems will meet the needs of Canada’s changing demographics. She previously worked in community health care and studied the social determinants of health in Toronto. She holds an Honours Bachelor of Health Studies from York University.