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Square system, Round Technology: Embracing All Perspectives To Accelerate Consumer E-health Adoption

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Chris Hadfield is an incredible person: engineer, fighter pilot, commander of the International Space Station and the first Canadian to walk in space. He dreamt an impossible dream and doggedly mastered the skills required to achieve it. His book “An Astronaut’s Guide to Life on Earth” begins with a story of how grandiose vision and practical detail collided during one of his peak achievements.

“Floating in the airlock before my first spacewalk, I knew I was on the verge of even rarer beauty. … it was a moment I’d been dreaming of and working toward most of my life. But poised on the edge of the sublime, I faced a somewhat ridiculous dilemma: How best to get out there? The hatch was small and circular, but with all my tools strapped to my chest and a huge pack of oxygen tanks and electronics strapped onto my back, I was square. Square astronaut, round hole.”

I thought of this story while reading the latest issue of Longwoods Healthcare Papers – “Understanding the Gap between Desire for and Use of Consumer Health Solutions” (which, coincidentally, includes a commentary to the lead essay by me and NexJ CEO, Bill Tatham). The issue’s contributors agree on the transformative potential of consumer e-health solutions. The perspectives span a continuum of pragmatists to visionaries. The pragmatists help us appreciate the practical barriers and enablers. The visionaries stretch our thinking about what is possible. We should embrace all perspectives because yielding value from consumer e-health technologies requires simultaneously focusing on its transformative potential to empower patient-consumers while untangling the real barriers to adoption.

The lead article details the gap between consumer desire for e-health solutions and their availability. All commentaries agreed that consumer e-health technologies represent an opportunity to “move the focus of the health system upstream to self-care and health promotion, a move that has been on the horizon since the Lalonde Report in 1974.” Visionary commentaries suggested health system leaders could “…be bolder in our vision for our future health system: for consumer health solutions to drive our focus on the management of chronic illness and self-care.” And that the sea change of consumer behaviors toward virtualization, enhanced information and communications and self-serve options is an unstoppable train that the healthcare system better jump on soon. Pragmatic commentaries focused on the need for concrete changes to regulatory, legislative and funding frameworks to facilitate “timely and appropriate adoption of new technologies among healthcare providers to enhance patient care”. They also reminded us that “trustworthiness is the cornerstone of the practice of medicine” and that regulation to ensure stewardship of personal health information is the bedrock of this trustworthiness.

Embracing all of these perspectives – most importantly the patient’s – is essential to achieving value from consumer e-health technologies for patients, providers, payers and citizens as well as full breadth of system stakeholders including pharmaceutical manufacturers and pharmacy retailers. Visionaries sometimes accuse pragmatists of being naysayers and pragmatists sometimes accuse visionaries of being unrealistic. It is a rare individual who can embody both the dream and the real work required to achieve it like Chris Hadfield. As organizations and system stakeholders develop a shared belief in the transformative potential of consumer e-health technologies, perhaps we can accelerate pushing the square shape of today’s healthcare system through the round hole of patient-consumer desire for technological empowerment.