Involve clinicians in design
According to our respondents, involving end-users in the development of eHealth is critical to ensure the system’s eventual adoption.
Clinician-led design is important for a number of reasons. For one, it ensures that the program remains focused on addressing clinical issues and outcomes. But it also allows planners to identify both user-interface challenges and opportunities to enhance the system.
By including clinical staff in the development process, eHealth planners can create a ready-made group of peer evangelists that can be harnessed to drive greater clinical adoption.
However, it must be stressed that participation should include a wide cross-section of clinical staff, such as nurses, diagnostic technicians, specialists and pharmacists, in order to provide a holistic approach and ensure that strategies are mapped across the patient pathway.
Many program leads have found that, by focusing their training efforts on frontline and nursing staff, they have accelerated the system’s adoption while simultaneously building a critical mass of capacity within the clinical setting.
Empower the patient
In the eHealth system, patients are ultimately the owners of their personal health information and data. Rather than the traditional “trust my doctor” approach, this will result in patients taking a greater role in the management, treatment and monitoring of their health information, which will ultimately redefine the doctor-patient relationship.
What is more, eHealth systems will need to clearly define how patient information is accessed and shared across the healthcare spectrum, while maintaining the privacy and security of the patient.
Focus on evidence-based outcomes
Real change is often unsustainable without strong evidence to demonstrate its value. While more than one-in-five interview respondents stated that a lack of robust evidence is likely to threaten the widespread adoption of eHealth, a larger number noted challenges in developing a consistent set of metrics to measure. But measurement and the communication of findings are critical steps to driving adoption by healthcare professionals.
Do not underestimate the behavioral changes required
Even the best eHealth system will fail if the users do not have the right knowledge and skills to use it effectively. Respondents were clear that proper skills training and education are key components to driving clinician adoption.
While many eHealth initiatives include technical training and manuals for the specific platform, far fewer focus on the behavioral changes that must accompany the adoption of eHealth. These will be particularly important in engaging older clinicians who may be less tech-savvy and more resistant to changing their habits. Some interview respondents suggest a need to redefine the patient-physician relationship, to embrace the idea of an intelligent and informed patient. This will also require medical schools to revisit their training programs and rethink many of their approaches to education.
Manage the change process
eHealth represents a fundamental transformation for the healthcare system that, if poorly planned, has the potential to be highly disruptive. From the start, eHealth leaders must apply a change management approach that recognizes barriers and works with stakeholders to enable transformation. More than a quarter of our respondents identified cultural change as one of the most important aspects in this change process.
Align incentives in the system
Medical professionals must be properly compensated for providing eHealth services. However, many jurisdictions have not revisited their reimbursement policies to reflect the very different needs of eHealth.
A number of respondents also cited the need to incentivize institutions to implement eHealth systems through government grants, loans or cost-reduction measures. The ‘Meaningful Use’ provisions in the Obama Healthcare Reforms, for example, offer significant incentive payments for the implementation of Electronic Health Records (EHRs), but ties those payments to the provider’s ability to make significant improvements in patient care.
Case Study: United States: Veterans Health Information Systems and Technology Architecture (VistA)
Case Study: Manitoba, Canada: Computerized Provider Order Entry (CPOE)
- Clinician-led eHealth systems will enjoy higher adoption rates and greater clinician acceptance.
- Clinical value must be demonstrated to healthcare professionals, particularly through evidence-based outcomes.
- This requires the scaling up of eHealth project which would otherwise not deliver conclusive evidence.
- Many clinicians will require significant capacity-building in technology and the behavioural changes that accompany eHealth.
- Health professionals and organizations must see value and benefits from the system in the form of efficiency, clinical outcomes and financial compensation.