We speak to Dr. Lawrence Rosenberg, Dr Justin Cross and Danina Kapetanovic about how digital transformation is enhancing the management of patient care at Jewish General Hospital.
Montreal's Jewish General Hospital has been operating since 1934, founded originally with a mission to meet the healthcare needs of the city's growing Jewish community. Located in one of Montreal's most diverse neighbourhoods, today it is one of Quebec's busiest and largest acute care hospitals.
A McGill University teaching hospital, Newsweek magazine ranked it in their top 5 hospitals in Canada two years' running, and number 1 in Quebec. Cardiology and Oncology and Emergency Medicine are particular specialties, along with research through their Lady Davis Research Institute.
Now the hospital is embarked on a digital mission to ensure they can continue meeting the healthcare needs of an aging population, by moving their care out of the four hospital walls and into the community.
A big component of their digital strategy is innovation. Danina Kapetanovic joined in April 2020, with a mandate to strengthen the organisation's culture of innovation and spearhead the new Connected Health Innovation Hub. Called 'Orot', which means 'illumination' in Hebrew, the hub will enable them to form partnerships with industry and implement new technologies.
"Innovation is the means to an end, and this end is our vision of "care everywhere"" Kapetanovic explains. In Quebec and Canada we have an increasingly aging population, and although they live longer they aren't necessarily healthier. We're looking at ways in which we can make our healthcare system sustainable in order to meet the growing needs of the demographic change."
"We turn to innovation because we believe that with the technology that exists out there in the age of information, with the advent of machine learning, artificial intelligence, cybersecurity, big data science and analytics, we can strengthen our system and add value, but it requires us to look at the way we provide care and then figure out meaningful ways to integrate technology into that model of care."
Entrepreneurship is key, and the hub will be vital to fostering new partnerships. "The idea is to bring entrepreneurs inside our system and help provide them with ideas, access to users, and with an understanding of how the system works as a business so that they can in turn provide solutions that will transform healthcare" Kapetanovic says.
Their digital strategy has in some ways been confirmed by the Covid-19 pandemic. Telehealth was part of their plans before the outbreak, but as President and CEO Dr Lawrence Rosenberg explains, they found themselves setting this up much more rapidly than they ever thought possible. "We were able to maintain at least 70 per cent of our ambulatory activities that way, including about 80 per cent of the activities from our cancer center" he says. "That's the way of the future - the hospital at home, virtual care, and tele-triage as far as the emergency room goes, are all fundamental pieces of the strategy."
The strategy also involves a very heavy emphasis on data science, and collecting and analysing data in real time, as well as the creation of a new electronic healthcare record. "We call it the connected healthcare record, which will enable us to put in place an electronic healthcare record for all the individuals in our territory, reflecting the continuum of care" Rosenberg says.
"Other parts of the program include the creation of a command center, which will allow us to integrate the various elements across our health network that are under development at the moment. This all needs to be tied together and protected by a robust cybersecurity foundation."
"It's really a next generation strategy to ensure the viability and the vitality of the hospital and our network into the future. I think the pandemic was a wake-up call, which points out very concretely the directions in which we need to be going to better serve the population in our territory. What's interesting is what we're learning from this pandemic and how to react to it. We conceived of our digital health plan almost 2 years pre-pandemic, so in some respects, our response to the pandemic and our agility is validation of the approach we had already decided to move towards."
An exciting development for 2021 will be opening of a new innovation lab, intended to be a physical space where they can host presentations from staff and industry representatives as well as hackathons. "The idea is to create a space to track industry and get it to take residence with us, so we can actively pursue collaboration and work together as closely as possible" Kapetanovic says.
Both Kapetanovic and Rosenberg agree that people play an essential role in making this digital journey successful. "Healthcare institutions aren't necessarily structured to innovate, they're structured to provide care” Kapetanovic says. "Innovation requires people to go above and beyond the call of duty, and the spirit of ingenuity, entrepreneurship and innovation is something I've found absolutely awe-inspiring in my short time with this institution."
JGH has recently launched a website that includes calls to action to join their community of innovation practice - an initiative that will help them showcase examples of innovation and best practice - but also highlights the success of staff. "People thrive when they feel appreciated" Kapetanovic says. "The website very specifically zooms in on innovation and really puts staff at the center of it all."
"Health IT projects are successful when the technology meets the needs of the organization and when the end users are involved in the implementation of the technology" Dr Justin Cross says. "When you're moving your organization into a new digital ecosystem and a new care delivery paradigm, you can't just focus on the technology. You also need to plan for and help your organization transition from a culture perspective, from previously siloed ways of doing things to more integrated ways of doing things.
"The focus is on how we're now bringing our organisation along and transforming how our teams work and how our care is organised, how we want to interact with our patients and how we deliver care to them" he adds.
Despite the challenges the pandemic has thrown up, Kapetanovic says they are very clear about their future direction and what drives their strategy. "Democratise care with the use of technology, empower the patient, center the care on them, and push it as much as possible out of the institutional walls, and closer to the patient."
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