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The art of balancing technology and human connection

The art of balancing technology and human connection

Lately, in the Faculty of Health Sciences we have been exploring the idea of the “flipped classroom”, an educational term used to describe the idea of switching the components of homework with the components of class time. For instance, instead of using valuable class time for a lecture, students are asked to watch the lecture as their homework, and time together in the classroom is spent on activities such as small group learning, debate, lab demonstrations, etc. The “flip” allows teachers and students to use their time together to problem-solve, revisit difficult concepts, brainstorm, and support each other directly. The outcome is a more flexible and influential learning environment.

There is no doubt that the sharp rise in access to the Internet and technology over the last several years has helped to make the flipped classroom a truly viable option. Now, not only is it viable – it’s becoming a necessity. These days, a decent Google search will provide you with any information you’d like with the click of a button. Our strategic advantage as an educational institution must be to provide our students with easily accessible and carefully curated information and compliment that with valuable lessons they can’t simply find online

As we aim to provide our students with the most comprehensive, balanced, and practical learning experience, I question whether we are doing enough to explore that same potential with our patients. Could we take the concept of a flipped classroom and apply that to the interactions between healthcare providers and their patients? Could ideas such as e-consults, Skype clinics, e-prescribing, and follow-up text messages reduce the need to meet a percentage of our patients face-to-face, thereby improving access and wait times?

These ideas are already being explored all over the world, with an estimated 100-million e-health visits worldwide last year alone. Further, it is approximated that 300-million annual visits to general practitioners in Canada and the US are for health problems that could be solved by an e-visit.[i]

Closer to home, the e-health theory, ever increasingly a reality, is being tested out by the Champlain LHIN, where they have created a web-based service for primary care providers to access specialist care for their patients. In the first 2825 sessions monitored, they found that 41% of e-consultations led to a referral being avoided, with the average time for a specialist to respond being reduced to two days. For their patients, the service eliminated unnecessary travel, reduced wait time, and improved treatment response time.[ii]

In other countries, we’ve seen the idea of e-health assessments taken even further. In the UK, patients can use a phone app to speak with a physician regarding common medical issues within a few hours of their request. If the consultation results in a prescription, the app sends the information to a pharmacist closest to the patient. Providers can also refer patients to a specialist or order diagnostic testing. Additionally, the app stores the patient’s consultation records for reference, and connects with other healthcare apps to help monitor daily health statistics.[iii]

At Queen’s we have a major asset in SEAMO. SEAMO is a five-way partnership between our Kingston-based hospitals, Queen’s, and our Clinical Teachers Association (CTAQ). This organization manages an alternate funding plan (AFP) that combines the missions of advancing patient care, promoting innovation and discovery, and delivering medical education. With SEAMO as an asset, I believe that we here at Queen’s are uniquely positioned to test many of these ideas out. As such, in June, we will be hosting some Canadian experts in e-health to discuss the practical application of these concepts and to start thinking strategically about how we might use technology to better serve our patients.

In many ways, technology will change the world of healthcare, but it is not a complete answer to our problems, and there are inherent elements of healthcare that it will never be able to replace – namely human connection, empathy, and compassion. But to discredit technology in healthcare entirely for those reasons would be to miss the opportunity to expand our abilities to teach, learn, and share more effectively. I believe there is an appropriate balance; and we can discover it in the arena of health care delivery if we become aggressive about exploring the possibilities.

I invite you to share your thoughts on the use of technology in healthcare at Queen’s in the comments below, or better yet, please drop by the Macklem House … my door is always open.

Richard

P.S. The author would like to thank Emma Woodman for her assistance in the preparation of this blog.

 

 

[i] http://www2.deloitte.com/content/dam/Deloitte/global/Documents/Technology-Media-Telecommunications/gx-tmt-2014prediction-evisits.pdf

[ii] http://www.trilliumresearchday.com/documents/2014_May28_Trillium_Distinguished%20%20%20Lecture-1.pdf

[iii] http://www.babylonhealth.com/

Photo: http://ihealthtran.com/wordpress/2014/07/minnesota-celebrates-10-years-of-e-health-progress/

David Goldstein

Fri, 06/30/2017 - 09:25

Dear Richard, this is a well articulated note. I believe you are correct and I look forward to assisting with this endeavour regionally. This is a great opportunity to demonstrate an eHealth vision and to lead the way for our LHIN while improving patient care.

David Goldstein

David Goldstein

Dear David,

Thanks for your kind words. I agree we may have a terrific opportunity and bold steps may be rewarded with better efficiency, better access, and ultimately, better care.

Richard

reznickr

Dr Lawrence Leung

Fri, 06/30/2017 - 09:26

Dear Richard,

Having almost finished my sabbatical year here at the Weeneebayko General Hospital as an ER/in-patient/OPD Physician, I am testifying strongly for the need of e-Health and more robust connection for over-the-network consultations.

Many a time the nurses at the even more remote coastal areas (Attawapiskat, Fort Albany, Kashechewan and Peawanuck) would consult me for a “red, painful, itchy” skin condition, I invariably request a picture or OTN consult that help me make the correct diagnosis and avoid blind/indiscriminate use of antibiotics or steroids. That, I call is essential in these ultra-remote areas with horrendous barriers of access to usual healthcare.

I too would like to volunteer in helping further e-Health development in these First Nations communities, which as you well know, our Department of Family Medicine has a long and fruitful working relations in the last 3 decades or so.

Best wishes,

Lawrence Leung

Dr Lawrence Leung

Thanks Lawrence. As you imply, there is a dramatic need for augmented eHealth in our more remote communities. However, I would also argue that there are important and wide-scale opportunities in urban environments as well. As this initiative unfolds we will be mindful to engage colleagues from both arenas of practice, and thanks for your kind offer.

Richard

reznickr

Lindsay Davidson (@lkdavidson)

Fri, 06/30/2017 - 09:27

This conversation will be of immense benefit to our prelicensure health care students, particularly if we can develop a way of simulating e-health tools within our learning management system as part of the project. I hope that the Teaching, Learning and Innovation Committee from the SOM can be involved in some way in these discussions.

Lindsay Davidson (@lkdavidson)

Jackie Butler

Fri, 06/30/2017 - 09:28

Dear Richard: When I was taking my BSCN at Queen’s in the 80’s all the talk was about computers and how we would all be computer-charting and it would free up our time to do other things…..namely have one-on-one connection with our patients to be able to provide them the physical, emotional and even spiritual care they required.
Over the years I’ve embraced computers as they definately make it more effecient to keep the patient records and to be able to access previous histories, notes, test results,etc
However my main concern now as a front-line nurse is that computers actually require more of my time to not only chart patient-specific notes but to chart on a myriad number of items related to protocols, standards, logging into machines in order to check blood, take out medications, etc….which- don’t get me wrong -has done wonders to improve patient safety and patient care but in the long run takes my time away from the patient at the bedside…..As the hospital is required to spend more money on technology and to constantly upgrade and fix bugs in said technology they still have to balance the books and with today’s tight economy the only way to do that is to slash those things that are the most expensive…namely nurses!!!
Front-line nurses are already understaffed and over-worked and the ones who will suffer in the long run is patient care!!!
I challenge the new grads to come up with a way to balance technology with meeting basic patient needs unless they think a robot can help patients brush their teeth, shave or get up to go for a walk when they are unstable all the while using their assessment skills at the same time…..If you’ve been unfortunate to have been a patient in a hospital lately or had a loved one admitted….there is rarely enough time as it is now to meet basic patient needs on top of the intensive care people require as they live longer and longer and have chronic and myriad health issues…
I would welcome any feedback from fellow health care practictioners who are at the front lines in hospital or long-term health care settings….

Jackie Butler

Dear Jackie,

A belated thank you for your thoughtful comment. I agree, balancing will be the way forward…and a complicated balance it will be.

Richard

reznickr

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