How Can Digital Technology Reduce Line Ups in the ER?


Driving eHealth forward requires synergy between private business and health care professionals.

While many health care professionals are expert at what they do, most are not experts at imagining and creating digital tools. And they are certainly not experts at how consumers of health care services interact with the digital world.

That’s why Signals and many other private companies were invited to the “BC and Yukon Forum: Fostering Collaborations in Digital Health Research” on February 5, 2015.  We were asked to join interested health researchers and health professionals to create some synergies between our respective areas of expertise. For Signals, this was of interest because in the past few years we have developed expertise in creating online tools for professionals (related decision support and guidelines) as well as tools for patients in the form of health and information support leading to behaviour change.

The Canadian Institutes for Health Research (CIHR), our national funding body for health research, chose two hot button topics — “youth mental health” and “aging well in the home” to bring these groups of experts together. They intend to provide funding to the health / research body that will be matched by the private sector in order to drive forward these eHealth collaborations.

It was a full day of panel discussions as well as interactive tables full of digital folks and health folks debating the issues of everything from information gaps to patient and family decision-making to society and self-stigma of mental illness.

Three of us from Signals attended and did our best to listen to the needs of the researchers and health providers. Many companies came to the session with a product already developed, as was the intention of the CIHR in issuing this Catalyst Grant.

So, after a full day of discussions with about 100 really smart people in the room, everyone had different a-ha moments. Here are some of ours. What does this “thing” (app, website, tool) need to do?

  1. It must save money. Unlike some of the existing products that were discussed in the break out sessions, we feel that digital health solutions must have a demonstrable impact on reducing the financial burden of the health care system. We know that CIHR has this expectation as well. That means, no matter what the technology, it must divert patients from more expensive health care to equally effective, but less costly digital healthcare.
  2. It must integrate. While it seems inexorably slow, the health care enterprise is becoming digitized. Right now there is a patchwork of electronic medical records (EMRs) across Canada which makes this very difficult. However, for any technology to be measurable and sustainable, it must integrate with some of the major systems.
  3. It must meet a clinical need. Many of the products we heard about were seeking a clinical need. This is backward. A useful technology should be developed to fill a recurring need identified by clinicians. Seems simple, but many companies seem to develop a tool first and then try to sell it to the health care industry.
  4. It must cater to existing digital behaviour. More than anything else, the private sector should know that users will not break patterns to use an app or website or device. We have mountains of data on how young people in particular interact with their devices and the content on their devices. We need to use that as a starting point, not a “whoops” after the fact.
  5. It must (ultimately) work. Seems obvious?! But there is little evidence that the myriad of health apps currently available actually work. We even heard from a panelist about a BC health authority-funded health app that did not have a research plan. Is it working? Who knows? We want to build a product that has prospective research built in from day one. Build, use, test, interate, test again, iterate again.

Stay tuned for more on this emerging Signals project. Many thanks to the Michael Smith Foundation for Health Research for organizing such a stimulating day of discussions.