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New year, new trends: What to watch for in healthcare in 2019 (Part 2)

Tags: public health

Last week, I discussed the five biggest health trends to keep an eye on in 2019. To recap, the first three items were:

  1. Putting patients at the centre of our healthcare system
  2. Using data effectively to improve outcomes
  3. Disrupting existing care paradigms

Today, I’ll be continuing on that theme, with items 4 and 5 on that list.

4. Ensuring that data are kept secure

A fully integrated, fully connected data warehouse is a wonderful idea that has a lot of benefits for all. However, placing all of our proverbial healtcare data eggs in one basket also makes it a very appealing target for hackers. One of the key healthcare stories that came out of last year was the WannaCry attacks on the National Health Service in the UK. Approximately 16 health services organizations were hit by these ransomware attacks, which demanded organizations pay $300 to $600 to restore access. This led to ~6,900 appointments being cancelled, although NHS England did say that no patient data was compromised or stolen as a result. Given the richness of the data available, the sheer number of devices that could be accessed (desktops, laptops, phones, medical devices), this has led to cybersecurity experts saying that it’s not “if” a healthcare organization is attacked, it’s a matter of “when.” Therefore, we need security measures in place to ensure data are protected from this happening again.

The only foolproof way to secure data is to not allow access to it – defeating the whole purpose of an integrated data warehouse. Several data governance frameworks have therefore cropped up to answer questions like the below:

 

  • Where does the data come from?
  • Is the data of high quality?
  • Who manages the inflow of data (including new and existing data)?
  • How are data elements defined?
  • How is data transferred between stakeholders?
  • Who is allowed to access the data, and under what constraints?
  • What are the relevant laws/legislation that need to be adhered to?

From the above, you can see that the team must consist of a range of stakeholders. It’s not enough to have data reside in the IT department if it’s being used by physicians to measure adverse events, or by the business intelligence team to understand where money is being spent in a hospital. The teams need to exist side by side, and a governance team needs to have representation from all stakeholders, including patients, to ensure that the right data is available, at the right time, to the right people.

 

5. Making sure we care for healthcare providers

An issue that received quite a bit of coverage in 2018 was physician burnout. The combination of time pressures, lack of control, new systems (e.g., EMRs), as well as the emotional nature of the work, puts physicians at high risk of burnout and exhaustion (West, 2018; Southwick, 2018; Downing, 2018). In addition to the effect this has on physicians, this can also result in suboptimal patient care, and increased costs to the healthcare system. Contributors to burnout vary, and include issues such as work factors (e.g., inefficient work processes), as well as individual factors (age and sex both appear to predict future burnout). As a result, tailored solutions to different problems are required. For example, if work inefficiency is identified as a driver of burnout, then optimizing medical records and workflows may be a solution that can be adopted.

While much of the research has focused on physician burnout, there is also growing evidence that nurses and other health professionals are also susceptible to the same forces. A study described in HBR analyzed data from >80,000 health care professionals, including nurses, physicians and other health professionals. They studied two characteristics associated with burnout:

  • Activation, or “the extent to which a person is motivated by his or her work and feels it is meaningful”
  • Decompression, or “is the degree to which one can withdraw, recharge and enjoy life outside of work”

What was really interesting was that while all three groups had similar levels of activation, i.e., they all felt as motivated about their work, the physician group had the lowest decompression scores, i.e., while the nurses and other health professionals groups could withdraw and recharge, physicians were less able to do this.

As technology becomes more intertwined in patient care, and as more sophisticated systems are introduced and implemented, the perspective of the provider has to be kept in mind. While a shiny new system may sound great in theory, if in practice if it’s not tailored around efficient workflows, it may be a barrier to success.

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And there you go! The five trends that I think 2019 will bring to healthcare. What do you think? Do you agree or do you have suggestions for additional trends to keep an eye out for?

 

 

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