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How hospitals can learn from retail stores

Special to The Globe and Mail

An orthopedic pediatric surgeon at the Hospital for Sick Children, Dr. Kellie Leitch is the inaugural chair of the Ivey Centre for Health Innovation and Leadership, based at the University of Western Ontario. She is overseeing a program that aims to develop health-care leaders to change the health system through innovation.

The Ivey Centre for Health Innovation and Leadership just released a report on future innovation opportunities and challenges in health care. What are we missing?

There are numerous things that we have not adopted into health care. We need to take those great ideas that exist with other industry leaders and adopt them; for example, barcoding. Barcoding has existed in the retail sector for years to track things and to manage supply chains. We don't do that everywhere in health care, especially pharmaceuticals, medical devices and other supplies. Supply-chain waste in health care is estimated to be 15 per cent to 30 per cent, the same as the retail sector had before it automated its supply chain. For Ontario hospitals it could be a $50-million annual savings.

Why did you begin thinking about health-care innovation?

There was one time when I was a senior resident that I'll never forget. Early one morning I was told that a knee replacement surgery was going to be cancelled; not because there wasn't a surgeon or nursing staff available, or because there was a problem with the equipment, but because we didn't have a bed for the patient after the procedure. This inefficiency in the system was going to postpone a surgery. For a patient, that's devastating. I decided to do something about it and managed beds instead of learning my trade in the operating room. I did my MBA during my residency with the goal of returning to an academic institution to train others to be leaders and drive change. Innovation won't just be a medical device or a pharmaceutical, but how we process things better.

What innovation changed the way you work and improved the care your patients receive?

There have been a few, but the pivotal one was introduction of PACS [picture archiving and communication system], which is an electronic x-ray service. All through my residency training and when I was a medical student, we carried around X-ray films. There is only the one copy. If someone took the copy or it was lost, it meant re-x-raying patients, which you didn't want to do. With electronic x-rays, everyone has access to them, it's safer for patients and we can provide a higher quality of care and see more patients.

Can financial incentives increase the development and adoption of health-care innovations?

The McGuinty government in Ontario has provided a fee-for-service incentive for physicians to do early diabetes checks. Before, you might or might not check for the signs of early type 2 diabetes. Now, if you check, give people advice that they may have the early signs and help them to correct it, you receive an incentive.

What innovations do doctors and nurses say we need most of all?

The items that come to the front of mind are all those centred on communications and IT, which create efficiencies in processes. Electronic patient records, giving patients the ability to book their own appointments online or via [a mobile device], opportunities that allow patients to receive results or be monitored in a safe and private manner through their PDAs. If someone can go online and book a flight and pay for it, why can't a patient do that for my clinic instead of calling an administrative assistant, leaving a message and waiting for the call back?

© The Globe and Mail

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