Written November 20, 2022 from MHST 604: Policy Analysis and Development
The Government of Ontario has invested billions of taxpayer dollars in digital and virtual care technologies since announcing its 2019 digital-first for health strategy, and not much has changed. Money has been invested, standards created, technologies purchased, and providers trained, and yet, much of the hardware is sitting stagnant in our medical facilities, aging and quickly going out of date. For Ontario to go “Digital-First for Health,” we must rebuild from the ground up. Deficits in health policy and outdated legislation are hindering the effective implementation of healthcare innovations. It is time we change health policies that were written before the digital revolution and make them applicable to the present and the future. Only then can we see Ontario’s digital-first for health strategy succeed. Numerous surveys and studies have found the broad provision of virtual care correlates with more convenient access to timely care at a lower cost to the health system. Since 2019 many other countries have effectively integrated virtual healthcare options into their workflows, with a substantial cost saving to their systems payers. These updated measures will make the provision of virtual care clear for organizations and care providers, thus promoting acceptance of these technologies, with fewer wages lost navigating complicated legislation. Healthcare is increasingly becoming consumer-driven, with patients demanding easy, convenient access to care, but the healthcare climate in Ontario is highly risk-averse with stringent regulations for new technologies; health organizations operate with a heavy burden to comply with a multitude of convoluted regulations to ensure privacy compliance and protect the public when developing and implementing models for virtual care. These excessive regulations cause healthcare organizations to maintain the status quo because finding, vetting, and piloting new digital health models become much more expensive to be able to comply with these orders, effectively disincentivizing innovation across all levels of the healthcare system. Implementing the personal health information protection act (PHIPA) in 2004 was the most recent gross legislative update to health care in Ontario. In 2020, many aspects of PHIPA were updated to include changes to personal health rights and penalties for offences under PHIPA, as well as new technology requirements. All aspects of this governing change, except changes made to the technology section, which include rules for consumer electronic service providers, have been implemented since, and the proposed changes are not enough to fix this problem. We must modernize health legislation and policy to support virtual care transformation by establishing clear frameworks which provide direction and allow innovators to build the tools that will serve our populations in the best way for our health while minimizing financial risks. We must enable data sharing and information flows within the circle of care, and innovators and researchers should have access to deidentified information to stimulate research, innovation, and economic development to ensure that governing bodies can make better decisions for the populations of Ontario through data-driven insights. With updated health policies across a broad spectrum of the citizens of Ontario win when health care organizations can provide a wider breadth of care for a lower financial price. Rural and remote-dwelling citizens ultimately have better health outcomes by having greater access to care from within their own communities. Healthcare administrators avoid lengthy and expensive processes for vetting virtual care innovations by having well-defined standards and accountabilities. Over time, this can allow for a better understanding of trends in health care. Should the people of Ontario just ‘wait and see’ how the digital health environment is going to play out? Or should we demand structural investments in our health policies to provide value-based care with virtual options for all healthcare consumers in Ontario so that our taxpayers don’t have to continue to pay the price for poorly defined health systems goals?
References
Armstrong, C. M., Wilck, N. R., Murphy, J., Herout, J., Cone, W. J., Johnson, A. K., Zipper, K., Britz, B., Betancourt-Flores, G., LaFleur, M., Vetter, B., Dameron, B., & Frizzell, N. (2021). Results and lessons learned when implementing virtual health resource centers to increase virtual care adoption during the covid-19 pandemic. Journal of Technology in Behavioral Science, 7(1), 81–99. https://doi.org/10.1007/s41347-021-00227-1
Canada Health Infoway. (n.d.). Digital health initiatives: Virtual care. Retrieved November 1, 2022, from https://www.infoway-inforoute.ca/en/digital-health-initiatives/virtual-care
Craig, A., Beek, K., Godinho, M., Ansari, S., Jonnagaddala, J., Linhart, C., & et al. (2022). Digital health and universal health coverage opportunities and policy considerations for Pacific Island health authorities [Policy brief]. World Health Organization Regional Office for South-East Asia. https://apo.who.int/publications/i/item/digital-health-and-universal-health-coverage-opportunities-and-policy-considerations-for-pacific-island-health-authorities
Desveaux, L., Kelley, L., Bhatia, R., & Jamieson, T. (2020). Catalyzing digital health innovation in Ontario: The role of an academic medical centre. Healthcare Policy, 16(2), 55–68. https://doi.org/10.12927/hcpol.2020.26353
Dong, L., & Keshavjee, K. (2021, March 1). Ontario's digital health program has a data quality problem, despite billions in spending. The Conversation. https://theconversation.com/ontarios-digital-health-program-has-a-data-quality-problem-despite-billions-in-spending-153539
Government of Ontario. (2019, November 13). Ontario expanding digital and virtual health care [Press release]. https://news.ontario.ca/en/release/54594/ontario-expanding-digital-and-virtual-health-care
Hein, G. (2019). Digital first for health [Presentation]. https://www.ontariomd.ca/documents/events%20info/esc-toronto-2019-presentations/digital%20first%20for%20health.pdf#:~:text=Digital%20First%20for%20Health%20would%20integrate%20Ontario%E2%80%99s%20digital,of%20system%20interoperability%20and%20reduced%20fragmentation%20and%20redundancy.
Jaana, M. (2021, May 6). When will Canadian health care fully ride the digital connectivity wave? Policy options by the Institute for Research in Public Policy. Retrieved September 27, 2022, from policyoptions.irpp.org
Kim, S., Hsaio, W., & Olewiler, N. (2022, September 16). Data sharing should not be an afterthought in digital health innovation. Policy options by the Institute for Research in Public Policy. Retrieved September 27, 2022, from policyoptions.irpp.org
Le, A. (2022, June 1). Digital health has failed, but that doesn't mean the future is hopeless. Fast Company Middle East. https://fastcompanyme.com/technology/digital-health-has-failed-but-that-doesnt-mean-the-future-is-hopeless/
Ontario Hospital Association. (2020). Ontario hospital association redesigning care through digital health implementation [Report]. Ontario Hospital Association website. https://www.oha.com/guidance-and-resources/hospital-policies-and-operations/redesigning-care-through-digital-health-implementation
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