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U N I V E R S I T Y O F A L B E R T A
S C H O O L O F P U B L I C H E A L T H C O L L O Q U I U M S E R I E S
D O N J U Z W I S H I N P H D
M A R C H 9 , 2 0 1 0
A L B E R T A H E A L T H S E R V I C E S
Web 2.0 and 3.0:Social networking applications for health care policy makers
Objectives
Identify what is confounding our ability to provide 100% of Canadians with their personal heath record?
Ask whether web 2.0, 3.0, health 2.0, med 2.0 are part of the solution to the lack of ubiquity and interoperability?
Identify social, political and policy barriers to ubiquity and interoperability of personal health records
Identify a framework and recommendations to remedy contemporary challenges
Healthcare Management ForumWinter 2009, pp. 6 - 10
The Interoperability Challenge
8 Persistent Challenges Errors
Poor quality care delivery
Poor experience of patients
Waste
Unknowing variations in policy and practice
Failure to introduce high value interventions
Uncritical adoption of low-value interventions
Failure to recognize uncertainty and ignorance
Sir Muir Gray in Castells
Old think Rethink
Health care providers
Boundary maintenance
Siloed services
Health care providers dispense
Top down
Extract truth
Citizens, patients
Seamless transitions
Integrated & coordinated
Providers & patients apomediate
Open & transparent
Interact to create truth
Contrast
Characteristics of Web 2.0 and Med 2.0
Web 2.0
Nobody owns it
Everybody uses it
Anyone can improve it
Health 2.0 and Med 2.0
Social networking
Participation
Apomediation
Collaboration
Openness
Citizen choice
Provider commitment to excellence
Researchers autonomy
Health Policy 2.0
Systems thinking – all government approach
Develop a patient – centered system
Give citizens their personal health record
Assure confidentiality, security and ubiquity
Become open, explicit and transparent in the governance, functioning and monitoring of the health care system
Political Barriers
14 health care systems that are disjointed and fragmented
Contest between access and choice
Agree on what constitutes effective health care delivery but squeamish on accountability
Trying to manage what is not understood
We appear to agree on values but not on what is valued
Social Barriers
The practice of health care – balkanized
Asymmetry of relationships
Contractual labor rigidities
Inflexible workforce
Policy Barriers
Solutions of the past become the shackles of the present
Conflict of values among citizens, providers, policy makers, politicians and researchers
Political will to steer political reform by not losing the support of citizens
Standardizing and defining terminology
Disincentives to reform or perverse incentives to maintain the status quo
Who owns the health record?
Policy Recommendations
Respect provincial responsibility for health care but not at the expense of effective national functionality
Define and standardize terminology of a high performing health care system
Converge toward standardized best practices in functional interoperability and informatics
Meet individual needs but maintain a population health focus
Monitor and report on individual and health system performance
Give citizens their secure and confidential health record Provide the Web 2.0 and 3.0 to patients and providers to
help themselves
Framework Advancing Health System Interoperability
Closing remarks
Health system interoperability is not merely a question of technical semantic interoperability Define the interoperability standards for a national health
information system
Political, social and policy solutions must be introduced confluent with technical solutions Replacing one set of problems with another set
New ones or the ones we know?
Political will, bureaucratic resolve and managerial courage are needed to turn system interoperability to reality
References
Castells Manuel, The rise of the network society. Cambridge, MA: Blackwell Publishers Inc.; 1996.
Juzwishin Don, Political, policy and social barriers to health system interoperability: Emerging opportunities of Web 2.0 and 3.0. Healthcare Management Forum, Winter 2009, 6-10.
Juzwishin Don, Enabling Technologies and Challenges for the Future of Ubiquitous Health: The Interoperability Framework in Ubiquitous Health and Medical Informatics, IGI Global, March 2010. ISBN: 978-1-61520-777-0