VPSA members gathered online and in person recently to hear from PHSA’s chief clinical information officer about opportunities and plans to advance digital health technologies. Dr. Damian Claydon-Platt talked about the challenge of how to bring the clinical and patient voice into IT decision making.

“Digital disruption is here; it’s up to us to leverage the opportunity,” he said. “Physicians need to understand that digital transformation is not an IT project; rather, it is a clinical journey enabled by technology.”

Digitization of health care is driven by a desire to improve the quality, safety, and efficiency of patient care. Dr. Claydon-Platt acknowledged the transition from paper to electronic health records is disruptive and that the learning curve for something like CST can be from six to 12 months. However, he said, the vast majority of colleagues at Lions Gate and St. Paul’s hospitals now say they would never go back to paper records.

“The physician voice is vital to ensure such transitions are delivered effectively. We need to think about how we use these tools. The opportunity delivered by CST is much more than simply putting notes into an electronic record. We need to be thinking about what can we do now in a digital environment, that we couldn’t do in an analogue one….”

Dr. Claydon-Platt was one of the earliest physicians in Australasia to become a certified health informatician. He came to BC in late 2018 to work at PHSA IMITS and has been involved with the CST team since the start of 2019. He believes that as the digitally enabled care environment becomes more complex, it is even more important to bridge the gap between physicians and IT specialists to get the technology right.

“Our business systems (administration; HR; payroll, finance) were first digitized many years ago,” said Dr. Claydon-Platt. “We’ve had digital silos in places like radiology, pathology, and cardiology for 20 years. Now we’re digitizing the medical record (eMedication solutions; EHRs; Vendor Neutral Archives) and looking to share the data (Health Information Exchange). We need that to happen before we can leverage more sophisticated technologies such as analytics, artificial intelligence, genomics and augmented and virtual reality, to truly enable precision medicine and realize digital transformation.”

It is important, said Dr. Claydon-Platt, that we recognize that IT projects or health technologies do not always work well. When they do not, we need to learn why: what are the lessons we can take away? Failure can happen when we underestimate the health system’s complexity, or when we do not engage with the end users early enough to understand the clinical need or problem to be solved. Technology providers need to ensure that they properly understand the clinical environment and workflows, the clinical requirements, and the end-users need to be cognizant of the technical constraints and limitations. Expectations need to be managed and change needs to be communicated and supported.

This is where clinical informatics plays a crucial role. Clinical informatics is the application of informatics and information technology to improve the delivery of health-care services. Clinical informaticians partner with health-care providers and technologists to bridge the gap between increasingly complex clinical and technical environments. Dr. Claydon-Platt pointed to multiple clinical informatics structures that already exist in our health-care system, across VPP, and the province, though we are all at different levels of maturity.

Because of CST, clinical informaticians have come together across VPP and five LMCs to form the  Clinical Informatics Council, which originally focused its attention on CST, especially the shared need to support and maintain it. It is now pivoting to play a more active role in organizational transformation. This includes looking at how electronic health records can be optimized and leveraged in ways that were not possible in an analogue environment. Dr. Claydon-Platt stressed that EHRs are not the only area that requires attention, although they are key systems. By way of example, he spoke of the more than 70 IT solutions (just within PHC) that are relied on daily to deliver care, and how clinical informaticians work to ensure all these systems support care and service delivery.

“We need a physician and clinician lens, and we need physicians and other clinical stakeholders to tell us how to improve our information management and technology services,” said Dr. Claydon-Platt. “The onus is on us as physicians to get involved, and to help drive the conversation in the right direction. As an emerging discipline, clinical informatics is continuing to work with the sites and IMITS to help evolve the structures and processes to enable a more structured and methodical involvement of physicians and clinicians in IMITS initiatives to minimize risk and maximize opportunity.”

VPSA members who would like to become more involved in informatics at VCH are encouraged to reach out to Dr. Claydon-Platt at damian.claydonplatt@phsa.ca. “It’s up to each individual to say how much they want to do,” concluded Dr. Claydon-Platt. “Whatever you can bring is a great place to start.”