Successfully innovating in health isn't just about understanding technology, it's also about understanding people and the system, writes this founder.
By Joy Bhosai (Founder & CEO, ChatrHealth)
Thousands of years before the interwebs existed and way before we could capture, snap, and chat about anything, anywhere—Hippocrates urged his medical colleagues to ‘use reason’ and observation to guide the care for patients. The revered father of medicine went on to say that "medicine is of all the arts the most noble" and that "it teaches in each instance particular details and correct measures" for not only health, but life." Thousands of years later, for me at least, these sentiments define both the art and honor of delivering care to patients. It is a field, that in its true art form, requires us to learn and grow from each experience, regardless of how advanced our technical feats have become. At the core, contributions to health in whatever form require that we understand the social institutions that shape how health is delivered and experienced.
It's About the System
What is exciting about the digital health space is that we are positioned to not only honor such social institutions, but to improve them. While I was a medical student, there were instances for which I began to realize that no matter how good of a doctor you become, the practice of medicine is limited to the system that you operate in. The way we communicate, the way information is shared, and the way we ensure quality care for patients is often limited by ‘the system’. You can be a smart, but your care for a patient is one of many in a team, and similarly your team is one of many others in the hospital.
Sitting in the operating room (OR) while on a rotation in school, it became evident that there are some steps that can be automated and checked to ensure the quality of care to patients. Although I did not doubt the knowledge and dedication of the health teams in the OR, simple things, like normal and emergency procedure checklists and automated safety modules were not standard protocol there, which is true for most hospitals across the nation. This was puzzling. I learned in school that simple things like checklists could reduce mortality by over 50%, lower hospital-acquired infections by 82%, and save hospitals money by at least $200,000/year on average. But why were we, and many other hospitals, not there yet?
Operating rooms, like any other health site that involves direct care to a patient, are built upon a lot of bureaucracy and, by convention, trust in the health team. If our team at ChatrHealth, were to introduce tools for use in the operating room, we had to not only acknowledge, but also respect the provider experience and the system. For better or worse, to introduce technology in these systems requires buy-in from the team (the users) with little input from the people who will benefit from it most (the patients). To introduce technology that would ‘disrupt’ the way patients are looked after, meant that we had to ‘protect’ the health team's experience and ‘value’ how it would apply to their workflow. Often times, this meant that to uphold experience and honor simplicity, we removed features that we thought were ‘neat’ to include.
What has made working in the digital health space so meaningful has been the chance to see people outside of medicine—software developers, graphic designers, and engineers—working together with clinicians to address such obstacles. Thinking about ways to improve care requires our team to go through the exercise of extracting cultural meaning and humanistic experiences that extend beyond what one may find through clinical presentations. How does the care team interface with the tool, what would keep users engaged? Why would hospitals be incentivized to use such tools? These are questions we constantly have to address. An anthropologist at heart, I have always viewed health as a human experience that lives beyond the clinical data points and diagnoses. Working in digital health makes respecting that a requirement.
What has been most inspiring is the feeling that our group, like many other digital health companies out there, is working towards a cause that exists beyond ourselves and our company. After working on patient safety tools at ChatrHealth, what has most rewarding has been the chance to be around talented individuals outside of medicine. What I felt I was my limitation before -- having only a grasp on some medical knowledge -- has been knocked down by harnessing the talents of others to work on patient safety tools. The Hippocratic oath to ‘do no harm’ above all for patients is lived through not just physicians nowadays, but also through the technical talents of individuals outside of medicine. Being around individuals who live for a cause outside themselves each day has been nothing short of inspiring to be around. It’s what makes this space so very exciting.
About the guest blogger: Dr. Joy Bhosai (@Bhosai) is the founder and CEO of ChatrHealth. Joy received a MD with Distinction from UCSF and a Masters in Public Health from Yale. Through previous public health work in Africa and Asia, she developed innovations to improve access to health services. She's worked with Health 2.0. Follow ChatrHealth on Facebook and Twitter.