“Innovating in health” – I had to pause as I put those two words together in a title,Â as Iâ€™m not sure that they naturally belong together. What do I mean by that?
Imagine yourself needing to see a GP.Â You check online to see if you can book an appointment with your GP via their website or a GP booking agent – no such luck, your GP hasnâ€™t gone digital yet.Â So, you call the receptionist, spend six minutes listening to hold music and finally you get through to them. You spend another 10 minutes chatting and juggling diaries, you and the GP are both very busy. Eventually you find a time that works.
You pull out your diary and record that you have an appointment, so you donâ€™t miss it.Â On the day you turn up at the GP rooms, you wait in the queue at the reception desk to let them know you are there.Â They pass you a clipboard and a pen and ask you to update your details.Â You do so and then wait. 30 minutes turns into 45 minutes, turns into an hour – your doctor is running late.Â Eventually you get called in.Â You have your consult and are given four sheets of paper, printed. One is a pathology form, another an ultrasound request form, another a prescription and a medical certificate.Â You go back to the reception desk, pay your gap payment by credit card, get a paper receipt and leave.
You have to then present your paper script to your pharmacist, call the pathology centre, call the radiology clinic, book appointments and take your paper forms with youâ€¦.
OK, now imagine you are on your way to the airport to catch a plane.Â You pick up your phone, respond to an SMS that says your flight is soon.Â Do you want to check in online?Â You check in, without leaving your couch.Â You then book an uber that comes to your house, picks you up and drops you off at the airport – payment happens automatically.Â You use your phone to scan your digital boarding pass as you board the plane.
In an age where we talk about blockchain, artificial intelligence, drones, robotics and 3D printers, why am I still using a fax machine to get referrals to the hospital? Â At this point, it may seem all doom and gloom and youâ€™d be forgiven for wondering if healthcare will ever catch up with the rest of society and innovate.Â But we donâ€™t have to look back too far into history to realise that innovation has in fact been at the heart of modern medicine.
My daughter recently studied the discovery of Penicillin at school and it made me think of these early innovators in health. Â Dr Alexander Fleming, famously wrote â€śWhen I woke up just after dawn on September 28, 1928, I certainly didnâ€™t plan to revolutionise all medicine by discovering the worldâ€™s first antibiotic, or bacteria killer. Â But I guess that was exactly what I didâ€ť. Â This was a man who (along with Dr Howard Florey) challenged the status quo and innovated.
What drove these famous pioneers to invent, create and revolutionise how we practice medicine? Â It was an attitude, a mindset and an openness to challenge what we think we know. Â In medicine we are often taught not to think for ourselves, told to follow best practice guidelines, trust only evidence-based practices and be risk averse. While this approach may be important for standardising patient safety and outcomes, it unfortunately also lends itself to create a workforce that is afraid to try new things. Â In an age where technology is advancing more rapidly than ever before, we cannot afford to run five years of Randomised Controlled Trials on a new technology and its applications in healthcare – we have to find a compromise. Â We need to be able to maximise the benefits that are afforded to us with new technology, have an open mind and realise the potential it may have to improve patient outcomes.
(Image credit:Â Â UC3M)
Whatâ€™s more is that the technology to revolutionise healthcare is already here. Â I have personally observed amazing innovators in healthcare from Zipline, who operate a drone delivery system to send urgent blood products, vaccines and medicines to those in isolated regions; to BioDan, who 3D prints skin for burns victims; and BINA48, a robot owned by Martine Rothblattâ€™s Terasem Movement, designed to test the hypothesis that you can download a personâ€™s consciousness into a robot (non-biological body). Â We have impressive technology that can help change the face of healthcare – and we as a profession need to be open to it, support it and encourage it.
I write this at a timeÂ in AustraliaÂ whenÂ our very own national health innovation projectÂ isÂ about to commenceÂ with the roll out of the My Health Record opt out program. Â By the end of 2018, every Australian will have their own My Health RecordÂ (myHR). Â An individualâ€™s My Health Record is a digital health record for that patient that contains a summary of their health information. Â It allows health care providers and organisations to access a patientâ€™s information, (such as pathology test results, discharge summaries, shared health summaries and a history of dispensed medications under PBS) enabling better continuity of care and preventing duplication of tests. Â It will also assist in managing complex chronic conditions, allowing all care providers to see information shared with other members of the care team. Â For example, imagine a new patient presents to the Emergency Department and for whatever reason is unable to communicate their previous medical history or current medications to the ED doctor. Â The doctor will now be able to access the patientâ€™s digital myHR and see their previous history (which has been uploaded and shared by their GP). Â This allows for better treatment decisions by all health care providers involved in a patientâ€™s care.
Unfortunately, the myHR has been met with some negativity and cynicism from the medical community, citing concerns about patient privacy and extra work involved with having to administer the process. Â Many of these concerns are valid and worth discussing. Â However, no innovation is without its problems, but it requires involvement of the profession to help solve those problems.
Taking an active stance and offering to be involved early on allows healthcare professionals to shape innovation and its applications in health, and find solutions to the unforeseen problems that arise. Â If we sit back and only complain, we will not be able to move forward, and medicine will be stuck in a world of pagers and fax machines.
The My Health Record may not be a drone, a robot or a 3D skin printer but innovation comes in many forms and having a single repository for all your healthcare information is a significant step forward in health innovation.
In the future Iâ€™m sure I will feel more comfortable putting the words health and innovation in a sentence together. Â Thinking back to Fleming and Florey, medicine has been full of innovators throughout the years â€“ letâ€™s make sure we donâ€™t kill innovation through fear and closed-mindedness.
Dr Amandeep Hansra is a Clinical Reference Lead for the Australian Digital Health Agency