I was first encouraged to read Reframing Healthcare by Dr. Zeev Neuwirth, when I interviewed Daniel Yeboah who is the Founder and General Manager of Ellerca Health Corp, whose mission is to improve patient care through leading technologies and innovation. You can listen to that episode here.
I am glad that I had the opportunity to add it to my reading list! I think that the book makes some excellent points on how to transform healthcare delivery from its current state and reading through the suggestions outlined from a health informatics lens was especially interesting. In this blog post, I am going to go over some key lessons I learned from the book and how the concepts can be integrated into the health informatics field.
- Approaching healthcare delivery from a marketing mindset
In the book, Dr. Zeev makes the point that we should reframe our mindset when it comes to healthcare delivery to the marketing mindset of “rebranding, redesigning and reorganizing”. As the creator of the Health Analytic Insights podcast, many of his points resonated with my entrepreneurial spirit, such as understanding your audiences’ pain points. For instance, when it comes to creating content for the podcast, I try to survey my audience and create content that is tailored to the questions they have (i.e. How do I break into this field with little to no experience?). Dr. Zeev highlights that it is important to understand the problems of your patients and create a customized solution for the patient, instead of a one-size fits all approach.
In terms of the health informatics field, this makes me think of how we can get feedback from the patient not just at the end of care through a patient satisfaction survey but throughout care, how can this information be collected to improve patients’ experience when they first enter the hospital, during their stay and when they are discharged (aka following the journey of the patient). By understanding where the breakdown in care happens, by highlighting that in a dashboard or report, health informatics managers can understand which areas can be worked on (e.g., Are patients having difficulty finding parking?, Is it difficult to book an appointment? etc…)
Caption: Reframing Healthcare - The importance of user design in healthcare
In the book he provided a powerful example of how system and user design can have profound effects when they shifted the placement of the no-name drugs to appear above the brand name drugs. Both of these drugs would have the same effect for patients but the no-name drug was the low-cost option for patients, by simply shifting the placement of the drugs, they were ordered more often by clinicians than before. When you work in such a busy and rapidly changing environment such as healthcare, creating small changes that are more user-friendly for the clinician or patient can have a large impact.
In a previous blog post, I talked about the impact of user design in the hospital and gave an example of Holland Bloorview Kids Rehabilitation Hospital in Toronto, Canada where they built an interactive floor so kids can play and this can help to reduce the anxiety they might be feeling with their upcoming appointment.
In the health informatics field, we might think of ways to help mitigate issues such as appointment no-shows and a lack of medication adherence, leading to hospital readmissions. However, when speaking to user experience design experts on the Health Analytic Insights podcast (listen here and here), it’s clear that whether one might consider building an app or digital product if you don’t clearly define who your target audience is and what are their specific pain points, by conducting informational interviews, it’s not guaranteed to have any real impact. In addition, when it comes to building digital products it’s important to have a diverse background of people in the room, to ensure you are not missing any key considerations.
The design of initial EHR systems was built around billing and scheduling systems but it is now being used for storing patient information from various health systems. Since the purpose of the EHR has changed rapidly over time this has resulted in clinician burnout and a desire for more customizability of the EHR. I think in the future, more clinicians have to be involved in the design of EHR systems to help deal with these recurring issues and in addition, health informaticists should be involved as more people are interested in using data collected by these EHR systems for enhanced predictive analysis. - Providing niche healthcare services
This book highlights the sad truth that healthcare outcomes are often correlated with your zip code and those in lower-income neighbourhoods have limited access to transportation and healthy food. This book talks about the importance of customized care and brings about the idea that care should look different for those who have several comorbidities versus those who are relatively healthy. This might result in faster service for everyone if those with more complex care needs can be served by specific care providers.
This reminds me of an article I read on how low-risk pregnant people use technology such as home monitoring equipment to monitor their blood pressure and have access to an online supportive community and easy access to registered nurses via phone if they have questions. This helps pregnant people not have to take time off work and find transportation. This also can allow clinicians to spend more time with high-risk pregnant people. In this situation to me, the use of technology here provides a customized experience for the patient, instead of the patient having to adapt to multiple appointments that might not work for the patient.
These are the concepts that resonated with me from reading “Reframing Healthcare”, I would suggest the book to anyone interested in finding ways to change their existing healthcare system. I would also suggest the book for health informatics professionals who are interested in understanding how a digital design can aid healthcare. Have you read this book? Comment down below which parts resonated with you?
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