The digital transformation of healthcare is not a singular event: rather a series of experiments that move the organization forward. This week, we explore the efforts of two children’s hospitals – sharing how they hope to save lives and money by evolving their relationship with technology.
It’s a cliché to say that digital has changed our relationship with work. But when it comes to actually revisiting the well-worn paths of our day-to-day work, setting aside firmly entrenched norms and envisioning an entirely different way of doing things can be a major stretch of the imagination.
Take for example, our relationship with doctors. We might notice a symptom of illness. Schedule an appointment. Attend an examination. Undergo a course of treatment as prescribed. And revisit the doctor’s office for follow-ups as needed. It’s a familiar pattern of interaction that’s been ingrained since the advent of modern medicine…
Is it the only way? Is it the best way?
Digital technologies enable us to reason over large sets of data, reach locales that were once considered too remote or too inefficient to access, connect with wider sets of individuals and approach challenges proactively rather than reactively.
I came across the powerful culmination of these attributes recently in this video from Microsoft and the Children’s Mercy Hospital. I’m not a terribly sentimental person, but wow… it’s such a beautiful and inspiring example! No stretch of the imagination here: the potential value of digital transformation comes through in technicolor detail.
The Children’s Mercy Hospital – took a rare step – rather than enhancing and evolving the doctor-patient relationship as we’ve always conceived of it, they considered how it could be re-architected for the digital age. Cloud, mobile, advanced analytics and frameworks for rapidly developing purposeful applications for the workplace have changed our ability to do good things at scale.
The impact is profound. Doctors and nurses have access to information in near real-time and higher quality indicators of health. The children affected by Hypoplastic Left Heart Syndrome (HLHS) can be better monitored in their own home and with less stress to their new parents. Typically, a quarter of the babies diagnosed with HLHS do not survive – but since the implementation of the program in 2014, no baby with the disease has died.
Digital workplace: A program-based portfolio of purposeful applications
Many of the organizations that approach Nonlinear Enterprise come to us with a wide-reaching vision of digital workplace and aspirations to address the needs of ALL employees. A monolithic multi-year project is outlined from the get-go through RFPs. These organizations desire a system that unifies employees and provides access to everything that might be needed to do one’s job. The projects are broad but can’t afford to address any one area very deeply.
The CHAMP program at Children’s Mercy provides an alternative picture of digital workplace that doesn’t seek to boil the ocean. It solves an important problem for a select group of patients and staff. The focused approach also facilitates the realization of clearly measurable outcomes. Once a successful pattern is identified it can be used as a blueprint for addressing other similar challenges; the CHAMP program is apparently being considered to address the needs of adult patients with cardiac issues.
Imagine a workplace comprised of similarly focused applications, deployed as a coordinated program as opposed to a big bang effort once every few years.
There are boundless healthcare challenges that could use a digital rethink. Underscoring this point, I had the opportunity to take part in an event last week organized by Hacking Health, IBM, and The Children’s Hospital of Eastern Ontario (CHEO). It was a real meeting of the minds: participants included health care practitioners, support staff, as well as members of the design and technology community.
Born in Montreal, Hacking Health has grown to a massive grassroots collective of individuals interested in advancing technology-based solutions for health. The group organizes talks, workshops and hackathons worldwide with the intent of generating innovative approaches to healthcare. IBM brought Hacking Health to Ottawa and served as a primary sponsor and organizer of the initiative.
The event I attended was framed as a learning opportunity about design thinking and a chance explore challenges faced by CHEO staff. Future hackathons are planned that will hopefully result in working prototypes designed to address these challenges.
For about five years, IBM has been striving to reinvent itself as a design-led business and has shared much of their ideology about design publicly. Employees of IBM’s Ottawa-based Design Lab expertly facilitated the Hacking Health teams using these methods.
Members of CHEO shared their challenges through Sparkboard (pictured below) – a tool for organizing interdisciplinary hackathons. In preparation for the event, participants were asked to select an area from the Sparkboard that interested them most. Challenges ranged from finding a way to improve communications between physicians and patients with brain tumors to determining alternative means of diagnosing obstructive sleep apnea in children besides a “sleep study.”
One thing I liked about event was that the diversity of the participants brought to light unexpected and scrappy approaches to what seemed to be deeply entrenched work practices.
My team was focused on crowdsourcing knowledge synthesis in medicine. The current approach to systematic review is a nuanced process - that as a generalist, designer and technologist - I’m not terribly familiar with. As we built our empathy maps and user journeys, I was struck by how similar this process was to what Nonlinear has been exploring recently in the legal industry. I can’t speak for the whole team, but my impression was that many of my team-mates walked away from the event with bright eyes and new perspectives on how the problem might be solved.
When outcomes outweigh the investment
One of the CHEO-based members of my Hacking Health team spoke to the challenges in finding people, time and money to undertake a systematic review. The effort can take months or even years. She described a painful process of scraping together enough money to employ students and residents to do the work. Many reviews are never started, never finished, or are out of date by the time they are made available to the medical and research communities. The tools available, according to the medically inclined members of my team, are archaic. The “as-is” process was thought of by my team as predominantly “human” work – searching and scanning abstracts… leaving the question open to how aspects of the process could be augmented or automated for productive gain.
A quote by William Gibson comes to mind: “the future is already here — it's just not very evenly distributed.” As the evening wore on, the facilitator of my group quietly uttered to me that IBM already offers a solution that addresses this particular challenge. With my background with Microsoft and search, I had been thinking the same thing.
There’s a real potential to save money, time and people by modernizing the process – but connecting medical practitioners with knowledge of the advances in the technology sphere is one of the biggest hurdles. That’s one of the things that makes the Hacking Health approach so interesting.
For the Children’s Mercy CHAMP program, the investment paid off; a very smart move by technologically-minded Dr. Girish Shirali. According to a piece by Microsoft, “babies with this disease are the most expensive patients in the cardiac clinic” and are “in the hospital the longest.” But the data they now produce allows them to detect problems earlier and avoid readmission. Essentially, they avoid costly “emergency events.” A real decrease in the cost of care can be measured. In my view, this is a pattern very much worth repeating.