I came across this intriguing tweet around the requirement for metrics and deliverables for “chief-innovation officer”.
This has interesting replies, but got me to think about a reimagined role for someone who will bring “innovation” in workflows. Therefore, if I were in a “CIO” position, here’s something I’d do:
- Redevelop inter-personal relationships with key personnel and the “lowest rung of the hierarchy”. The lowest rung is never heard due to multiple reasons in any organization. They are critical to ensure actionable work and goals. The lowest rung maybe radiation therapy technicians; they are often the best source for understanding issues around patient flows and problems faced by them. It could be the Onco-Nursing team, which is usually the first point of care. I always ask my nursing team to share any concerns about the patient; it could be financial issues or a feedback loop on a difficult consultation.
- The best innovation happens in eliminating friction points in care delivery. A breakthrough is achieved if there is new insight in the “routine work”, making it more efficient. I could practise it during the pandemic, where we reimagined patient workflows, enforced social distancing, and provided constant motivation as a team to avoid burnouts.
- The concerns for younger medical professionals (including work-life balance) are always valid. Everyone has gone through the grind, but seniors have to reduce workload and help adjust the other members in the process.
- Technology can be a great multiplier to improve efficiency gains. EMR’s remain the pain points, and there are numerous solutions that lessen its load. Automatic transcription, using scripts to automate mundane jobs and auto-populate form-fields, can save time to improve efficiency. Those hospitals without it can leverage interpersonal relationships to call for attention. For example, I use Telegram to get notified from the technician if the radiology examination is over, and walk over to a consultant for immediate discussions. Pathology/X-Rays or Lab Reports are sent over immediately. I have had coordinated complex emergencies likewise involving numerous consultants and in real-time, and that saved lives.
The higher the hierarchy, and depending on the feedback loops, one tends to miss the real impact of any policy decision. Besides, innovation happens in open-sourcing protocols, workflows, and holding it in public scrutiny. I am mentioning this specifically because interpersonal relationships cannot be replicated. Besides, innovation in public space also happens in communication through blogs, like this one, which serves as a test bed for raw ideas. I write extensively to form specific idea matrices, which allows me to interlink disparate topics. For example, a local hold up in the right of way for fibre-to-home can possibly impact future healthcare delivery, while apprising local municipal officials to understand that broadband access has become imperative. Likewise, 5G (and its various bands) and offloading to public Wifi’s will impact increased robotic automation. Embedded sensors (and QR codes) have smoothened the radiation delivery process and identify radiation delivery parameters in real time.
Wearables may cause a data deluge, but are impacting outpatient practices where patients demand explicit understanding of sleep data (as an example). I remember visiting some hospitals in the Toronto area to understand issues around specific healthcare delivery, and sat in the waiting area for pharmacy dispensation, which took an awful lot of time. Interlinking patient workflows through the hospital can easily track them through the process (while implementing humane-design principles). For example, bright colours and mobile applications can buzz through the availability of specific pharmacy or phlebotomy services. Mobile applications can be easily provisioned to provide feedback to gather real-time indicators around service availability. Besides, specific lighting and air-conditioning can be made responsive by adjusting flows depending on specific patient workloads. Innovations in healthcare delivery can also be done via smart notifications, wearables (by sending vibrating alerts), automating patient schedules, monitoring sleep and weight loss during radiation, and providing timed alerts, etc.
All of this is feasible only if there is a common vision and leadership guidance to define a successful metric of optimised standard patient outcomes. Anxieties around financial implications and “job-losses” are paramount, besides “out-of-pocket” expenditures cloud the judgement earlier during the patient journey. The first few interactions with patients are saddled with the weight of the diagnosis, emotional turmoil, and navigating through the hospital bureaucracy. I usually make small voice snippets so that patients can hear it again, at a later date. It re-emphasizes important points made during the consultation. I had also developed a Telegram based bot with simple navigation menus for patient education (I kept it simple for comprehension by a Grade 5 student). It allowed me to set up a one-on-one consultation and could be configured to auto-inform about my schedule.
The key takeaway is interpersonal communication and setting up feedback loops from the team with a continuous reemphasis on a common vision for service/delivery excellence and actionable goals. I believe these ideas transcend cultural and national barriers.
RadOncNotes 
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