Picture of Gillian BartlettGillian Bartlett is Associate Professor and Research and Graduate Program Director in the Department of Family Medicine, McGill University

Picture of Rachel SimmonsRachel Simmons is an MSc Student in the Department of Family Medicine, McGill University

Any field that does not jump on the techno-bandwagon runs the risk of falling behind. Medicine is no exception, though many new technologies have yet to become mainstream in primary health care delivery. One possible reason? People were asked what tech advances they wanted, but nobody responded with what they needed.

We have been working on a project to improve the implementation a new electronic personal health record (ePHR) into different primary care practices across Canada. Despite our efforts, and apparent methodological success, there was no significant uptake. As researchers in primary care, we are drawn to the first word of HIT, ‘health’. We recognize this term, it that brings to mind the ideals of shared decision-making, holistic practices and patient empowerment. Where we should be focusing, however, is on that important final word: ‘technology’.

The field of consumer electronics may be cut-throat and competitive, but it also contains the potential for incredible innovation and creativity. It benefits from experts imagining and sharing products that most people would simply never think of. The success of their products is directly proportional to their ability to discover and tap into the needs of this new consumer base. Failure will never be blamed on funding or policy decisions, as often occurs in the research milieu –it will rightly be blamed on not adequately meeting a need.

As Steve Jobs, the founder of Apple, noted, “It’s really hard to design products by focus groups. A lot of times, people don’t know what they want until you show it to them.”So the question we should be asking becomes: what do people need from HIT in primary care? The aspects that tested best and have the highest uptake are those that facilitated communication between patients and their primary health care providers and clinics. Features that allow patients to book appointments, send physicians messages and view lab results with interpretations instantly and remotely are used most often. Communication is one of the big problems in healthcare, so it follows that the parts of the ePHR system that do the best are those that address this issue.

The future of HIT is limitless, but for now, let us get our ‘app’ together, and take a page from the Rolling Stones’ book: “You can’t always get what you want, but if you try sometimes, you might just find, you get what you need.”