Health systems are, on balance, very bureaucratic and have fixed structures which are not open to innovation. In fact, innovation is seen to be disruptive and therefore resistance is present.

But to overcome the gaps in the system which have become more apparent in COVID 19, there has to be an acceptance of innovation in clinical management and system wide management.

Four critical elements support development and deployment of innovation in a health system:

(1) workforce capacity to actualize innovation;

(2) an organizational infrastructure that supports integrated, systematic, repeatable pathways for change;

(3) an innovation-nurturing culture; and

(4) strategic external partnerships and collaborations. 

It will be interesting to see if there is motivation over time to innovate by health system designers and health policy analysts.

Raymond Rupert patient advocate and healthcare consultant.

Reference:

• Ryan J. Vega, MD, MSHA & 
• Kenneth W. Kizer, MD, MPH

Vol. 1 No. 6 | November — December 2020
NEJM Catalyst Innovations in Care Delivery 2020; 06DOI: https://doi.org/10.1056/CAT.20.0263

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I took a course at Harvard Medical School about ten years ago. It focused on the use of telehealth technologies in treating mental health disorders. The evidence was presented. It proved that virtual mental health interactions were as effective as face to face meetings. 

Coming out of that course, I was convinced that telehealth was an acceptable technology and ready for prime time.

My timing was wrong. By delivering mental health services with a virtual meeting with the patient, it was felt by the traditional institutions to be inappropriate. 

And since I had adopted telehealth for my substance use disorder medicine work and in delivering travel health healthcare services by partnering with pharmacists in smaller communities, I was informed that this was not appropriate. I was labelled a disruptor.  

The traditionalists will reiterate until their last breath that doctor patient interactions must occur face to face. 

Enter COVID19 and that changes dramatically. 

Now almost all mental health services are delivered using telehealth. And many patients find it much preferred. As do the doctors. 

Raymond Rupert patient advocate and healthcare consultant.

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