Recent innovations in modern medicine are nothing short of miraculous. Kidney transplants can be done with minimal surgical invasion via robots. Prosthetic eyes can give partial sight to the blind. Some babies have even received heart procedures while still inside their mothers’ wombs. And yet, despite advancements in the OR, something as simple as locating the right equipment, or the right doctor, can often leave hospital staff feeling like they’re stuck playing a game of hide-and-seek. “When we talk to our staff, the amount of time they spend looking for stretchers and wheelchairs is inordinate,” says Humber River Hospital president and CEO Dr. Reuben Devlin. “You’d think it’d be easy in a hospital. But in a busy hospital, at the beginning of the day they’re all in one place. At the end of the day, they are all over the place.”
Missing wheelchairs are one issue; lack of communication between medical staff is a problem with potentially more serious ramifications—and it’s one affecting doctors’ offices across the country. “The biggest problem with the health care system is that it’s very siloed. Communication is very difficult,” says Dr. Sanjeev Goel, a family doctor from Brampton, Ont. “Patients don’t just see their doctor. They see the specialist, the hospital [personnel], the home-care nurses. We need one unified communication system.”
Recognizing the lack of an IT solution for electronic medical records—which Goel says are better as a documentation tool yet hardly user-friendly for real-time communication—he and a team at the non-profit organization Health Quality Innovation Collaborative helped launch Synapse, which acts like Facebook, with each account centred around a patient. Instead of keeping friends updated with recent vacation pictures, the collaborative health platform keeps nurses, hospitals, family doctors, the patient and any relatives she wants in the loop with real-time updates on her medical file. Since its launch in 2012, Goel says Synapse now has about 3,000 users across Ontario. Like many new digital health ideas, it’s still a long way from being on every health care practitioner’s smartphone.
“We’re a paper-, pen- and fax machine-based health system,” says Zayna Khayat, the lead of MaRS Health, an innovation hub in downtown Toronto. “If you think of our start-ups as 21st-century trains, driven by 21st-century engineers,” Khayat says, “we’re putting them on 19th-century tracks.” Of the 300 health start-ups currently in the works at MaRS, Khayat notes, approximately 200 are for digital health. And new innovations don’t necessarily need to be the next big personal wearable health technologies, such as Fitbits or smart clothing with sensors to monitor vital signs. In fact, the most important digital advances in the health care system might simply be finding better ways for the many skilled practitioners to interact more efficiently and easily with each other and their patients. Some can help out before the patient even walks in the door. ShiftHealth, a Toronto-based health care technology company, uses a tablet and web-based platform called TickiT, which allows patients to upload their medical information onscreen in the language of their choice—using pictures when needed—which is then translated automatically for others. “Your doctors and their team get that data converted into their language before you meet with them,” Khayat says. “And they don’t waste 12 of the 15 minutes of your visit rehashing your whole medical history.”
It’s not just the surveys or charts getting a digital upgrade in Canada. Sometimes it’s the entire building. When the new and improved Humber River Hospital in Toronto opens its doors this October following a redevelopment, it will be North America’s first fully digitized hospital. Spanning 1.8 million sq. feet with 656 beds, the hospital aims to do a lot more than simply cut back on paper. Those with appointments can check in at home—similar to an airline check-in—and skip the registration desk. Show up early and go for a coffee in the retail area until an alert on your cellphone says the doctor is ready to see you.
Doctors and nurses at Humber River Hospital, meanwhile, will be equipped with personal digital assistants (PDAs). So when patients hit the call button from their rooms, for example, the nurse receives a buzz alert and can immediately connect with the patient via video. No more staff rushing down the hallways, only to be asked for extra painkillers. And no more patients left wondering why it’s taking so long for someone to respond.
In fact, staff will do a lot less carrying altogether as automated guided vehicles—though some like to call them robots—will deliver supplies such as surgicial trays, housekeeping supplies, linens and non-narcotic medications around the hospital to supply rooms on each floor. (Alas, patients shouldn’t expect the robots to deliver a meal right to their bedside.) Blood tests can be sent to labs straight away via pneumatic tube, with results sent directly to the doctor’s PDA.
When a staff member enters a patient’s room—be it a doctor, nurse or cleaner—radio frequency identification (RFID) in the nametag will trigger a photo and job title to pop up on the patient’s in-room screen. No longer will patients wonder who’s who in the swarm of hospital staff. “We obviously want to be the digital hospital of 2015,” Devlin says. “We also want to be the digital hospital of 2025.” With that in mind, a centre for health care technology will be located right in the middle of the building, so new products can be tested in a real hospital setting.
As for the bothersome hunt for stretchers and wheelchairs, that too will be a thing of the past, as each will be tagged with RFIDs. Need a wheelchair in room 12 for a CT scan? The system will automatically contact the closest staff member, who will be informed of the location of the nearest available wheelchair.
All of these advances will cut down on labour time, a massive cost saving, considering that staffing compensation accounts for 60 per cent of the total cost of hospital budgets, according to the Canadian Institute for Health Information. The upgrades may not sound as fancy as smartphones that track individual sleep patterns, but don’t expect to see doctors at Humber River Hospital walking the hallways wearing Google Glass or the latest smartwatches. “There is no toy factory here,” Devlin says. “If it’s not functional and it’s not going to improve our operations with patient care, then it’s not on.”