By Dr. Chris Hobson
2020 was an unprecedented year. The healthcare IT landscape in Canada is evolving rapidly as it tries to balance the need to respond effectively and urgently to the COVID-19 pandemic while continuing to manage challenges already placing immense pressure on the Canadian healthcare system. What will 2021 hold for healthcare IT in Canada?
Focus on COVID-19 data and improved predictive modelling
As jurisdictions continue to grapple with the COVID-19 crisis, the importance of high-quality data and sound predictive scenario-based modelling will become more apparent. Decisions on opening and closing businesses, schools and so on depend on an effort to balance the need to manage the spread of the disease with trying to keep the economy functioning. Nine months into the crisis, there are still important gaps in data including test results completed by public health missing from the clinical record, tracing community-based spread and detailed knowledge of true infection and mortality rates. The other intangibles are the public’s level of “COVID fatigue” and the willingness to take a vaccine, once available. Epidemiologists want and need to make better quality predictions to guide policy decisions and enable regions to be prepared for realistic disease scenarios. The focus on collecting and interpreting accurate data and the increased use of tools such as AI and machine learning will improve predictive modelling for decision-makers across the country.
Increased use of COVID-19 capable technologies
COVID-19 capable technologies will continue to play a vital role in managing the pandemic. Access to a central registry, at the provincial or federal level, would give each province the critical information required to make the best-informed decisions. Essential COVID-19 data including test results, contact tracing, potential exposure alerts, and immunization certification could be captured and stored in a secure method accessible on a patient’s smart phone. Access to data not only helps the providers and decision-makers, but also the population in doing their part to manage the pandemic.
Introduction of a COVID-19 Vaccine
A COVID-19 vaccine is on the horizon and we expect to be vaccinating high-need sub-populations by early-2021. Although this is promising, efficiently and equitably distributing the vaccine is likely to strain our current infrastructure. The most obvious need is to immunize enough of the population to reach the threshold for herd immunity, which for COVID-19 is thought to be around 70 per cent of the population that have to be immune. We also need to accurately track vaccination data to understand who has been immunized and to support ongoing resource planning.
Improved integration and collaboration between public health and the healthcare sector
Public health plays a critical role in managing a pandemic; the need to share data in a timely manner accelerated integration and collaboration between public health and other stakeholders in the healthcare industry. The need to be connected will fuel the ongoing evolution of EHRs in Canada as EHRs offers the capacity to hold and manage various data sets. We should expect further integration and collaboration with a shared goal of population health improvement, collaborative use of data and community engagement.
Ongoing adoption of virtual care models
Before the onset of COVID-19, the health system was moving, however slowly, towards proactive care based in the community; the pandemic brought an urgent need for restructuring to move quickly towards virtual care models such as telehealth, remote monitoring and related technologies. The health community is seeing the benefits and value of virtual care including meeting patient demand for convenience, timely access to care, cost efficiencies and increased collaboration across a circle of care. Virtual care will significantly contribute to the long-term sustainability of the Canadian healthcare system.
A new model of accessing care
We are seeing an increased appetite for on-demand technologies. What if there was a way to guide patients and help them understand the health system’s offering? Enter a new model of care navigation, the Digital Front Door, where the health system first engages with patients and can assess their needs through an online symptom checker that also connects them to the most appropriate care. This model allows for increased patient engagement and can reduce inappropriate use of emergency department and alternate entries to the healthcare system.
The COVID-19 crisis puts pressure on the system to be more efficient across the board and look for innovative ways to cope with an increased patient load. There are urgent needs for restructuring aspects of the healthcare system, aided by patient friendly technology in the direction of virtual care. 2021 will see emphasis on the importance of accurate and timely data; increased access to virtual care and collaboration amongst decision-makers while continuing to manage the many facets of the ongoing pandemic. As we look ahead to 2021, it seems we are in store for another pivotal year in Canadian healthcare.
Dr. Chris Hobson is Chief Medical Officer, Orion Health.