Technology Adoption Amongst Canadian Primary Care Physicians
Technology is revolutionizing how healthcare is delivered. From Telehealth platforms to home-monitoring sensors and applications, from diagnostic apps and devices to cloud-based EMR, EHR and referral systems; and from self-management to healthy lifestyle apps. The use of technology in healthcare is no longer a matter of debate or choice. The technological revolution has already happened and with the exception of a few cases, it has led to improved patient satisfaction and outcome. Policy makers in various countries are embracing health tech and the adoption of this technology has generally led to better economic outcomes. The Canadian market is primed for adoption of the same technological advances. Canadians are quite tech savvy and in today’s world, the ability to provide quality care across our vast land vitally depends on use of technology.
Primary care physicians play a central role in our healthcare system. They are on the frontlines of our healthcare system and the key point of system interaction for end consumers (patients). Any major change in the system cannot be successful without their buy-in and adoption. We have come a long way in terms of technology adoption. Since 2004, the use of EMR systems by family physicians has risen from 24% to 73% and majority of doctors are themselves technologically savvy.
In order for technology to make a real impact in our healthcare system, it must be adopted by both primary care physicians and their patients. In this article, I will explore the issue of technology adoption by family physicians . There are 5 pillars to this topic:
- Misalignment of physician needs with technology solutions
There is a disconnect between the tech community and the community of physicians. Physicians usually lack the skill set to develop technology for themselves and tech people are usually not familiar with physicians needs. This results in products that are either beautifully designed but useless or potentially useful but terribly designed.
EMR systems are an example of “adopted technology” that does not obey fundamental UI/UX rules. Thats why vast majority of physicians use only 5–10% of the capabilities of the software.
- Poor education/awareness amongst doctors on the benefits of technology
There are a million yearly seminars and conferences on this topic. What is lacking is clear communication of the pros and cons of technology in a practice. Communication in an unbiased, fair and easy to understand manner. Remember, technology is fighting a very strong status-quo in healthcare. Change has never been easy. A lot of advocacy on the patient and physician side is required.
- Lack of motivation for doctors to adopt new technologies
The Canadian billing code does not motivate or incentives physicians to use technology. In a lot of cases, the billing code does not even recognizes the new methods of care delivery. For example, patient home monitoring or virtual visits, unless for very specific conditions, are not billable.
E-Consult is a great example of a motivating physicians to use technology to deliver better care at a lower cost. This platform allows physicians and specialists to connect with each other through video. Ontario Telemedicine Network (OTN) facilitates the sessions and both parties are getting paid for their time.
- The isolated nature of the EMR systems, which are designed and built with minimal capacity to interact with other applications
Security of the patient’s information and lack of clarity in the privacy laws has made physicians and technology vendors to become overly conservative. The current available EMR systems do not communicate with each other and external apps. There is minimal capability to transfer information through fax APIs.
- The challenge of making good consumer-facing healthcare products
Its very challenging to make consumer health technology products. Security and privacy issues comes to mind first but the real challenge is something else. The balance between making an easy-to-use interface while keeping the seriousness of the service is difficult to maintain. The consumers of healthcare are as diverse as a country can be. So you can not design for a niche market or a target demography. Also, keep in mind that the consumers will engage with your technology when they are not in their best health condition. They tend to be in pain or discomfort of some sort. That’s why they are seeking care. The healthcare consumer needs X, think that they need Y and tell you that they need Z.
On top of all that, the need for education that goes along the technology is very real. For example, studies showed that visits to ER spiked up after patients where given home blood pressure monitoring devices. Uneducated patients were left to interpret the numbers which lead to an increase in unnecessary visits to the emergency room!
Other barriers to tech adoption can also be discussed but the future is bright and the hope is real.
Some of those barriers are:
- Outdated privacy laws
- Lack of unanimous laws and regulations across different provinces
- Complicated care navigation system
- Complicated and bureaucratic healthcare system
- And unclear decision making process
The hope is because of change-makers and fresh ideas. The energy and optimism of entrepreneurs is going to change the system for better. They are pushing us forward everyday one step at a time.
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http://nationalphysiciansurvey.ca/surveys/2014-survey/ (conducted by CFPC, referenced by infoway)
https://www.infoway-inforoute.ca/en/component/edocman/3098-annual-report-2015-2016/view-document
Recommended Citation Price, Meredith, “Towards a Better Connection: A Federally-Led Uniform Reimbursement Scheme for Telemedicine” (2017). Law School Student Scholarship. Paper 914. http://scholarship.shu.edu/student_scholarship/914
https://cira.ca/factbook/domain-industry-data-and-canadian-Internet-trends/internet-use-canada (referenced by Infoway)
