ITAC Online - ICT in Healthcare - January 2013
In ITAliCs

ICT, a Growing Force in Healthcare

The first applications of ICT in healthcare were hospital information systems (HIS) and medical diagnostics such as computer tomography (CT) and magnetic resonance imaging (MRI).  These days ICT is enabling patients and doctors to connect via simple text 24/7 using devices such as smartphones and tablets. Increasingly ICT is becoming a growing force in the healthcare sector as it is used to deliver better and more efficient healthcare services faster.

This is a timely development. Healthcare is important to Canadians and the need to make healthcare cost-effective, shorten patient wait times and get health information to both doctors and patients efficiently is growing. If you want to see how much ICT can make a difference here just read about Laura Adams’ breast cancer journey and how an Electronic Health Record could have made a huge difference. In this issue we take a look at what Canadian companies like NexJ and Mihealth are doing for your and my healthcare as well as hearing what the Chair of the ITAC Health Board (and Director, RelayHealth at McKesson Canada), David Mosher, has to say on ICT in healthcare.

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Connecting People & Information to Save Lives

Bill Tatham, Chief Executive Officer, NexJ Bill Tatham, Chief Executive Officer, NexJ

Today, thanks to Information Technology (IT), we can do our banking online; chat with friends and family in real-time by text or video; and post updates about ourselves using social media. Ordinary people are more empowered than ever before thanks to the information that is available on the Internet and their ability to connect to it through smartphones and tablets.

Given all of this, just think about what it would be like to see our secure personal medical records whenever we want to, have 24/7 access to our doctors, and be able to check whether we are doing enough to maintain our health and improve our wellness.

NexJ Systems (NexJ) is a leading cloud-based customer relationship management (CRM) software company that was founded by the former management team of Janna Systems Inc. in 2003. It has built on the success of its CRM solutions in the insurance and financial sectors to create Health solutions (which include NexJ Health Exchange and NexJ Connected Wellness). NexJ Health solutions address some of the most complex information management problems in healthcare by providing connectivity to multiple health information systems, enabling the integration of disparate patient health records, and allowing organizations to personalize the way they support patients so they can effectively manage their own wellness and health conditions.

“When you look at the issues in healthcare: 50/50 correct prescription for patients, the unsustainable high budget spend on managing chronic diseases, and the need to focus on wellness to reduce the rate of preventable illness, one thing is crystal clear ― we need to rethink healthcare,” said Bill Tatham, NexJ’s Chief Executive Officer. “NexJ is in the business of rethinking how things are done. So in healthcare, our goal is to increase the quality and safety of care, influence patient behaviour towards wellness, and reduce costs and inefficiencies.”

Ultimately, NexJ Health Exchange and NexJ Connected Wellness work together to provide organizations with the fastest and most cost-effective way to achieve patient-centered care. Examples here include:

  • NexJ Health Exchange provides standards-based interoperability between proprietary and standards-based health information systems, Electronic Medical Records, and Health Information Exchanges. This enables organizations to completely access accurate clinical information immediately, at the point of care.
  • Accessible through the web or on a mobile device, NexJ Connected Wellness provides 24/7 personal health coaching, chronic disease management, appointment booking (that benefits the patient and physician, reduces the administrative burden and the incidence of  “no shows”), and enables patients to complete pre- and post-clinical surveys and assessments online, so that providers can consistently apply clinical best practices, quickly identify potential problems, and take immediate corrective action.

Essentially, NexJ connects people and information to save lives and improve wellness. This is not without its challenges. According to Bill, the environment that NexJ operates in is very competitive. In addition to local markets, it focuses on selling globally (including emerging markets such as India and China where people-centered healthcare is a growing need). NexJ also strives to achieve getting the initial product references that prove their solutions work through research-based and clinically tested deployments. NexJ teams with academic institutions, such as Harvard University, healthcare providers, such as the Saskatchewan Cancer Agency, and industry partners, such as Research In Motion, to prove the commercial viability of research which in turn funds additional research, thereby creating a sustainable innovation chain.

Bill sees a trend towards people-centered health care on a hosted platform that enables greater connectivity and that puts a stronger emphasis on health and wellness.

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Interview with David Mosher, Chair of the ITAC Health Board

David Mosher, Board Chair at ITAC Health and Director of RelayHealth at McKesson Canada David Mosher, Board Chair at ITAC Health and Director of RelayHealth at McKesson Canada

Tell me about McKesson Canada and McKesson Information Solutions Canada Ltd.

What’s interesting about McKesson is that I sometimes get people who haven’t heard of the company. This surprises me as McKesson is the largest healthcare company in the world. It’s been around for 180 years and, in Canada, alone it has about 2,500 employees.

It is also pretty diversified: From IT solutions such as hospital information systems and a cloud-based, secure electronic health record solution, which I am responsible for, to things like a surgical wait list benchmarking. It’s a wide variety of healthcare solutions not including the distribution business and specialty drug side. Not being well known could be attributed to the fact that McKesson is a company that gets it done without seeking a lot of attention. It has not put a lot of value on educating the market but it is starting to do more of this.

How has the use of information technology in healthcare changed since the introduction of IT in Healthcare?

If you look at things that historically have been done well like PACS (Picture Archiving and Communication System) which manages MRIs, X-rays, etc., health IT has had a huge impact. The ability to use those tools to diagnose patients has made a huge difference. Getting doctors to use electronic health records, and right now in Canada we are at about 50%, has helped as well. We have had less success in creating a comprehensive electronic health record. Right now information is scattered everywhere in the system so we do not have a true picture of patients especially as they move among providers.

The rise of mobility is going to be big. Physicians will have the ability to truly use healthcare IT when they are interacting with a patient: With a tablet type device they will do more evidence-based medicine and physician order entry will start to increase. Computers on wheels and other clunky solutions are a thing of the past. Thanks to all these mobile technologies it is a totally different world and the practice of medicine is changing really quickly as a result. Patient expectations are changing too. They can access their financial information and contact anybody at any time using social media or email. From a healthcare point of view, they haven’t been able to do this but that is going to change really quickly.

What are the challenges of being in the hospital information management systems business?

The first challenge is that most of the buying of healthcare IT solutions is either managed by government or they mandate the process that hospital or health regions need to follow. The process is inefficient, slow and expensive for customers and vendors. It is also restrictive and does not allow companies to really offer innovative solutions because they are pigeon-holed into commodity-based solutions. Something innovative that can really change things will be hindered by the procurement process. I think that this is really hurting our ability to implement IT innovation in healthcare and have a greater impact.

The second challenge is standards. There are standards about how health information is used and exchanged between systems. Standards are a good thing but standards in Canada do not align well to those in the US and do not align across provinces. So a Canadian company that wants to sell solutions in Canada and the US has to adhere to different standards in different regions. This makes doing business difficult and expensive.

From your perspective, are there any key trends in healthcare that all business should be aware of?

There are two key trends. We have seen a lot of large healthcare projects that have failed. The trend is that people are realizing that they need to use a different approach. So I expect to see a dramatic rise in cloud-based service solutions because they can be implemented quickly, are considerably less expensive than large IT projects, and the benefits are realized much faster.

The second big trend is about patients taking more responsibility. Previously patients would stay in the hospital for two weeks until they were better and all the care would be delivered there. Today, in an effort to drive down healthcare costs, patients are discharged sooner and more care is being given in the community. Patients now have to deal with homecare nurses and do more for themselves. So expect to see the introduction of more and more tools to make the patient better able to manage their own healthcare and, if they have had a major incident or chronic disease, take better care of themselves using smartphones or other similar tools.

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Go Anywhere Health Information!

Dr. Wendy Graham, Founder, Mihealth Global Systems Dr. Wendy Graham, Founder, Mihealth Global Systems

Transparency Market Research recently reported that the global mobile health (mHealth) market is expected to reach USD 10.2 billion (from USD 1.3 billion in 2012) by 2018.This growth is driven chiefly by factors such as the growing adoption of smartphones and the increasing incidences of chronic diseases.

The rapid development and adoption of smartphone applications has already revolutionized much of our work and private life. It is also radically transforming the relationship between patients, doctors and healthcare providers by improving healthcare delivery and access to medical information.

One of the companies that is on the cutting edge of this transformation is Mihealth Global Systems. Founded by Wendy Graham, a North Bay, Ontario doctor with more than 25 years’ experience in the field, it has come up with Mihealth, a Mobile novel health application that can be accessed from a smartphone or via a patient website. It offers the real opportunity to take the patient-doctor relationship to the next level by enabling easier access to and better management of health information.

"Mihealth makes going to a new doctor or specialist easier as your health information is right there in real-time and you don’t have to repeat your history numerous times to different people,” says Wendy. “Moreover, both the patient and doctor benefit from the secure 24/7 access to the relevant health information from anywhere in the world."

Through Mihealth:

  • Patients can:
    • Have convenient, systematic access to their health information (lab, test results in real-time)  through secure password protected messaging on mobile phones or the Internet
    • Communicate securely with a provider, doctor or nurse to receive updates, appointment reminders and clinical advice as well as ask questions
    • Have 24/7 access to organize and manage critical health information as well as maintain personal health records containing their personal health information which has been validated by a physician
  • Doctors can:
    • Connect with their patients like never before with 24/7 access to their health information. Doctors can check in on patients and stay up-to-date with their medical histories via the Mihealth network so when patients come in for a consultation, they can get right to caring for them.
    • Enjoy platinum-level, password protected secure messaging and have more information available to make better decisions
    • Check in on patients more regularly and encourage more proactive care

Beyond this, if you have loved ones with health issues, Mihealth helps you keep them at home by providing you with secure access to their medical records, medications, doctors’ names, etc. It does all of this with platinum-level security thanks to its collaboration with Diversinet, a Toronto secure technology provider specializing in applications for health care.  In fact, it’s more secure than most Canadian banking sites. This is reassuring given that the security of personal health information is paramount.

The Mihealth app works on multiple mobile platforms including iPhones, BlackBerry, Google, Android and Microsoft phones so personal and family medical records can be updated when you visit a doctor. This means that the focus can be on treatment instead of reviewing past history. Best of all Mihealth facilitates interoperability for patients as they move between healthcare providers and institutions containing patient data that is not integrated, while at the same time improving the exchange of information between patients, doctors, clinicians, emergency room staff, specialists, and other health professionals. The cost for getting all of this is affordable ranging from $59 (about 15 Starbucks lattes) per individual to $224 for a family of four.

According to Wendy, Mihealth has been well received by patients and doctors and for good reason.

"Mihealth lets patients carry a digital version of their health record, contact their doctors via simple text to ask for a lab test (and avoid the cost of an unnecessary trip to the doctor's office) and receive messages concerning test results, scheduling or changing of appointments. It also provides doctors with patient test results on their smartphones and access to accurate health information that can be used in in real time.”

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Congratulations to the 2012 Winners!

Awards Gala

ITAC Health Project Team Patient Care Innovation Award:
The DI-APP Team - Ontario's Diagnostic Imaging Appropriateness Pilot Project

ITAC Project Team Innovation and Care Delivery Award:
Distributed Kiosk Project by Capital Health & McKesson

ITAC Project Implementation Team of the Year Award:
Orion Health and eHealth Saskatchewan Portal Implementation

ITAC Health Corporate Citizenship Award, Small Medium Enterprise:
Gordon Point Informatics

ITAC Health Corporate Citizenship Award – Major Canadian:
NexJ Systems Inc.

ITAC Corporate Citizenship Award - Multi-National Company:
TELUS Health

ITAC Health Chairman’s Award of Excellence:
Dave Wattling, TELUS Health

Canadian Health Informatics Awards Gala is an exclusive event celebrating the outstanding achievements and excellence in the Canadian Health Informatics community. The CHIA Gala recognizes and honours the contributions of individuals and companies in the efficient use of information technology to improve the health of all Canadians.

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Further reading: ICT in Healthcare

Here are, for your information, articles and a video on ICT in healthcare:

Bringing Hidden Healthcare Data Into the Open
What we are missing is easy access to other kinds of medical information that have a direct bearing on our healthcare. Read more about how self-described health IT hacktivist and author Fred Trotter, with a bit of crowdfunding cash, and a whole lot of patience, has hatched a plan to bring hidden healthcare data into the open in the US.

Where ER Doctors Work Entirely Via Webcam
In South Dakota, long-distance doctoring is bringing health care to rural communities. Here is how this is being done.

Big Data Is Transforming Healthcare
Read about a crowd-sourced venture that capitalizes “on humanity’s new ability to collect, analyze, triangulate and visualize vast amounts of data, in real time,” here.

Density and the city: How will Toronto health care cope with population growth?
Wait times at Toronto hospitals are already long (average current wait time in a Toronto emergency room is about eight hours) and will get longer as Toronto’s population grows.
Dr. Tarek Sardana, president of Orleans Urgent Care in suburban Ottawa, believes that delivery in high-density urban cores like Toronto could benefit from facilities similar to the one he leads. He describes it as a walk-in clinic on steroids.

Video: Scanadu's Tricorder, the Scout - Not carbon-based, but effective
Dr. Walter De Brouwer’s company has built a working prototype of a hand-held medical diagnostic system similar to the tricorder of Star Trek fame.

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ITAC Events

January 23, 2013

Annual Ontario Reception with Guest Speaker John Ruffolo, CEO, OMERS Ventures
This is your opportunity to hear from a global thought leader on Canada's future and network with your industry peers and colleagues as well as our government guests and our newly elected 2013 Ontario Executive and Board of Directors. If you want to kick-start 2013, this is your invitation to do so.


ITAC Committees and Forums

January 29, 2013

Public Sector Business Committee Meeting (Federal)

January 31, 2013

HR Forum: Planning Session


ICT Industry Events

January 22, 2013

ePrivacy Essentials

January 23 - 24, 2013

Canadian Forum on U.S. Export & Re-Export Compliance

January 30 - 31, 2013

9th Annual Mobile Healthcare Summit

February 4 - 6, 2013

Machine to Machine (M2M) Summit 2013

February 4-5, 2013

STAN Conference


For a full list of events, and to register for ITAC events, visit itac.ca

ITAC News

Update: First ITAC Executive Briefing Series - Corinne Charette, CIO of the Government of Canada
The Chief Information Officer (CIO) of the Government of Canada, Corinne Charette, spoke at the recent ITAC Executive Briefing Series in Ottawa. Read about it here.

PM Announces Venture Capital Action
Prime Minister Stephen Harper recently announced the Government's Venture Capital Action Plan to improve access to venture capital financing by high-growth companies so that they have the capital they need to create jobs and growth. Read more about it and ITAC's submission in the consultation process here.

ITAC present at pre-budget consultations with Minister of Finance, Jim Flaherty
In December last year, Karna Gupta joined a number of other senior executives from Canadian business at recent roundtable convened by Finance Minister James Flaherty to provide input to the preparation of the next Federal Budget.

Other News and Events

Employment, Investment, and Revenue in the Canadian App Economy
The Canadian App sector which is growing between 27-47% year, currently employs 55,000 workers in Canada (and growing to 78,000 by 2016), and has a projected revenue of 2.2 Billion.

New Deloitte Study on Women's Leadership in Canada
This new study from Deloitte and Carleton University is a goldmine of useful – and sobering -information about where women are in private, public and third sector leadership. The title says it all: We've made "Progress in Inches Miles To Go".

The Digital Universe in 2020
The IDC estimates that by 2020, as much as 33% of the digital universe will contain information that might be valuable if analyzed. This untapped value could be found in patterns in social media usage, correlations in scientific data from discrete studies, medical information intersected with sociological data, faces in security footage, and so on. Herein is the promise of "Big Data" technology.