How private-public partnerships can drive innovation

2015 CanadianCIO of the Year Award Winner, Lydia Lee, University Health Network…nominations open for 2016!

This is an edited version of a speech given by Lydia Lee, Senior Vice President and Chief Information Officer, University Health Network, June 16, 2016 to the Information Technology Association of Canada (ITAC) in Toronto.

It’s a pleasure to speak to you all about a topic that is of great necessity to all of Canada — innovation.

Specifically, I want to focus on how public-private partnerships move the needle on innovation in this country. Given my background, I’m going to refer to innovation in digital healthcare, but I would suggest that my remarks apply to other industries as well.

Hospital funding has been flat

Because we are required to balance our budgets, this means a real cut in healthcare spending of three to five per cent year over year.

For academic hospitals, this is particularly pressing. It not only forces us to provide care in sometimes – I would argue – dangerously lean ways, but it also eats into our ability to drive research which is the engine for innovation in new drug discovery, new technological invention, new models of care that can prevent disease and improve outcomes. In other words, this is a problem with far reaching consequences.

At 11 per cent of GDP, healthcare will continue to eat up a disproportionate share, taking away from other sectors, like education and critical infrastructure, which is why we all say that healthcare is unsustainable without significant transformation. We have to “bend the cost curve.”

But what if we, particularly in the public sector, did not just think of healthcare as one giant cost centre? What if we thought about the $220B annual spend in hospitals, physicians and drugs as one of the biggest market economies Canada has to support economic growth and prosperity? What if we looked at the 60-70 per cent spend on healthcare labour as a source of human capital and know-how who contribute to new discoveries? Instead of “average length of stay” in hospital, how about “productive days saved” for those who re-enter society as productive participants? And what if we didn’t just use our data for records management but as a source of accumulated knowledge that could prevent disease and improve health and wellness?

Bringing in new revenues

Over the past decade, our province has made substantial and innovative e-health advancements, but not without our share of challenges.

Over the past 5 years, I had the privilege to lead a program called ConnectingGTA – a regional electronic healthcare system built to serve six Local Health Integration Networks (LHIN) for the seven million people who live in central Ontario. This program was co-funded by eHealth Ontario and Canada Health Infoway and underwritten by the Ontario Ministry of Health and Long Term Care. This system, live for over a year and now available for use by more than 40,000 providers across all sectors in the continuum of care, not just hospitals, is also serving as the backbone for our provincial EHR.

I can tell you from the scars on my back, how hard it is to deploy a large scale initiative involving hundreds of stakeholders where we had to agree on data sharing rules, technical standards, change management approach, privacy and security harmonization and clinical policy.

At the core of ConnectingGTA’s success, we always prioritized clinical value over technical delivery. We had over 150 clinicians and human factors engineers involved directly in the design of the solution to ensure that it would deliver clinical value.

While we worked to ensure alignment with the technical standards and provincial blueprint that served as our backdrop, we always prioritized clinical functionality over technical functionality to ensure we never lose sight of the system as an extension of the clinical teams that used it.

Through projects like Connecting GTA, we had to learn how to do project governance on a massive scale in a highly risk averse environment, we mastered “extreme project management”, and pushed the boundaries of our provincial privacy regulation, so much that it required updating in what is now Bill 119. Despite the challenges, there are huge gains from these programs.

Up until this project, public private partnerships had a bad wrap. UHN, Telus and eHO may have had different motivations for wanting the program to succeed – clinical need, market share, government success and reputation – but we all had aligned incentives that compelled us each to do what we needed to do to get the job done.

Most importantly, we are starting to see the patient experience slowly transform with the availability of real-time longitudinal patient information at the front-lines of care.

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