Talking HealthTech: 325 – The patient paper trail. Spring Summit 2022 Feature Episode

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The use of paper for collecting patient data across Australian hospitals is still predominant. Just for a second, consider the risk for clinical outcomes when the patient information sits on a shelf, at times in many locations, rather than being accessible digitally at the point of care. 

In this episode, Pete moderates a panel discussion among Berne Gibbons, the Head of Strategies and Partnerships at InfoMedix, Chris Mitchell, the Chief Information and Digital Officer at Hunter New England LHD and David Tralaggan, Co-founder of CDIA. Their conversation centres around the use of paper in the healthcare sector, how it inhibits digital progress, data accessibility and much more. 

Pre-session Poll Question

Question:

What are the biggest benefits for frontline healthcare workers from digitising healthcare information?

Responses:

• 50%- better patient insights

• 46%- saves clinicians’ time

• 4%- reduce clinician burnout

• 0%- improve job satisfaction

Meet the Panel

As CIO of Hunter New England Health, Chris has been executing the organisation’s inaugural digital health strategy that is all about eliminating the paper. Hunter New England is part of New South Wales Health and covers a massive geographic area that is around the size of the country of England. Within that area, they have over forty hospitals that he supports the ICT in digital health. Chris also supports community health centres and clinics. 

Dave is a practising medical doctor who works in the ICU, but most of his time is now occupied with Clinical Documentation Improvement Australia, often referred to as CDIA- an organisation he helped to kickstart out of some of his experiences as a junior. CDIA has partnered with hospitals in every state of Australia, the North and South Islands of New Zealand and some big names in Saudi Arabia. CDIA is all about empowering clinicians to deliver safer care to every patient by enhancing the quality of documentation. 

Berne is also a consultant to the agency- Stakeholder Engagement with Clinical and Digital Health Standards. She is also a founding member at UTS, where they have been developing a digital health research collaborative over the last five years. It will focus on improving the experience and knowledge of healthcare workers in digital technologies.

Healthcare’s Digital Progress Vs. Other Industries

Is the healthcare sector far behind or closer up in comparison to other industries when it comes to digitisation? 

There is no straightforward or simple answer to this question- there are a lot more nuances to it. Numerous factors can impact the digitisation of healthcare, and these must be considered. Considering the scale and the size of the complexity and the challenges in the organisations that are served, every decision made must be carefully considered. It has to be the right decision to start with, but everyone has to be taken on the journey from the very beginning, and that includes the different stakeholder cohorts and groups that need support.  

So, it’s hard to say that healthcare is behind, and it’s also hard to say that digital health lends itself to those self-service industries where people want to be able to do things for themselves in their own time, such as banking and insurance. Healthcare is about humans and people- that personal experience. 

Furthermore, if you look at some of the super high-tech stuff that is happening with precision medicine and artificial intelligence, it wouldn’t be accurate to state that healthcare is lagging. There is a really interesting contrast between some of the technology and some of the perception. Every industry evolves in this area at its own pace. 

Do Paper Patient Records Impact Patients?

At the end of the day, the medical record is for helping clinicians to know their patients and to communicate with caregivers, facilitating better care for patients. Also, one of the problems with this discussion is sometimes people approach the digital health question with really simplistic thinking. It’s similar to someone saying, “we need a digital record.” But what do you want that digital record to actually do? What problem are you trying to solve?

If you look back at the early stages of adoption in the US, a lot of places failed to answer that question. So, they had this record, and they could all access the record a lot quicker, but it led to more problems sometimes than solutions. To some degree, Australia is a bit behind the US, and that serves as an advantage for us to learn from the mistakes that were made by the US. 

Once you are entrenched in some digital systems, it can be very difficult to unpick, and by looking at what has happened in the market for the last ten years, Australia is in a really good position to learn lessons from others and then leapfrog and implement digital health in a way that actually solves problems. 

The Appetite for Change Amongst Stakeholders

There is certainly an appetite for change in the hospitals, clinics and other healthcare facilities and organisations within the country. There are private hospitals that are now finally looking at different costing of the big solutions, and they are deciding to at least scan medical records so that they can access them digitally and get the revenue for services provided. With paper, that is quite difficult.  

Incidentally, there is a large hospital in Australia that lost half of its coders during COVID-19 because they didn’t want to be in the hospital and on the wards. Plus, it was costing the hospital extra to get the coders PPE-ready each time they needed to go to the wards. If they have a digital record, once it’s no longer on paper, they can log in from home or anywhere remotely. 

We need to look at the difference between the reasons why public and private want to have digitised records. Together, there needs to be interoperability, standards and policy change so that the sector knows that it must follow specific standards. However, there is no way to interoperate with paper, so digitisation is necessary. 

The Reality of Discontinuing Paper Records

This concept seems simple but is far from it. For example, Hunter New England Health took a best-of-breed system approach, which means they have good digital clinical support in certain areas, but it’s completely fragmented, and they have lots of paper. Even scanning records takes time. 

Another thing to consider is the poll result of digitisation of medical records reducing burnout, coming in at 0%. Employee and workforce experience is important because any good organisation needs job satisfaction in order to attract and retain a talented workforce. Therefore, while this digitisation of medical records is geared toward reducing clinical risk and fragmentation, it’s just as much about workforce wellness and staff wellbeing. 

As with anything digital health, you always have to bring it down to the basics- what are we trying to achieve and do our actions help us achieve our objectives? So often, these are forgotten, but software isn’t about computers; it’s about people. As such, the implementation phase is just as important as the product itself. 

What Would Solve the Paper Problem?

Of a fact, we can’t keep throwing technology at this wicked problem that we have. Having a round table talk with all the stakeholders looking at where the industry currently is and where we would like to be, could help to find the ultimate solution. 

Having a single EMR would make a world of difference, but it would not solve every paper problem. There will still be plenty of work to continue that digital transformation after the initial wave. It should always be a wellness exercise for the staff as well because every solution should work toward reducing burnout, just like Chris’ mission; to reduce the friction between the people and the technology. 

Offering green credits for the dilution of paper in healthcare could be another potential solution, especially for younger people. Also, looking back at the sustainability agenda, there are a lot of parallels to where IT and digital were probably fifteen years ago. People are coming to grips with the whole sustainability angle, and things are starting to shape up, but there is still a lot to do. 

Final Thoughts

Continue to make digital health about the people, the participation of the patient in their own care and making stuff better for the workforce and our community. Digital health is not so different to any other part of the business; it offers solutions. So, we must ask the relevant questions:

We can’t keep putting off transitioning or adopting digitisation of the patient’s medical records or the way we do things. It should not be so disruptive but something that makes a difference mainly to the outcomes for the patient, especially when dealing with a multidisciplinary care team. 

_{Source talkinghealthtech.com}