Michael Green: Connecting the Digital Dots in the Healthcare System
(Access show transcript) Michael Green and his team have much to be proud of during his current tenure as President and CEO at Canada Health Infoway, including introducing an electronic prescribing system, helping family physicians adopt electronic health records, and much more.
Show Summary
Michael Green understands that forging relationships with those who support Canada Health Infoway’s mission is crucial to navigating our complex system and accelerating innovation. With this understanding top of mind, Canada Health Infoway works with different systems and stakeholders across the globe to strategize, innovate and advance digital health.
“Rather than trying to reinvent the wheel in Canada or any other country, it’s often better to try and take the best international practice, and then try to implement that at home,” says Michael when explaining the importance of collaborating with international organizations who set health standards.
In this fascinating episode of HIROC’s Healthcare Change Makers, learn all about how Canada Health Infoway is impacting the advancement of digital health in Canada, Michael’s expert strategies for finding partners to support Infoway’s mission, how his team is adopting and securely implementing artificial intelligence (AI), as well hearing who inspires Michael, and much more!
Mentioned in this Episode
Transcript
Imagine you could step inside the minds of Canada's healthcare leaders, glimpse their greatest fears, strongest drivers, and what makes them tick. Welcome to Healthcare Change Makers, a podcast where we talk to leaders about the joys and challenges of driving change and working with partners to create the safest healthcare system.
Philip De Souza: Hey, listeners. It's Philip from HIROC here. Thank you for tuning into Healthcare Change Makers, and for being a fan of our show. We really appreciate it. As summer is upon us, we've been fortunate to connect with many of you over the past few months at a variety of healthcare conferences, forums, and meetings. Thank you for including HIROC, and keep letting us know how we can show up in the community, because we really value these connections. I personally enjoyed meeting many of you in person, hearing what you think about the show and who our future guests could be. So keep them coming.
Okay, back to this episode. Our guest today is Michael Green. He's president and CEO of Canada Health Infoway. During our chat, he touches on many different topics, and in just 30 minutes we cover Michael's personal journey in healthcare, the advancement of digital health in Canada, and how Infoway's keeping AI at their fingertips, and so much more. I personally appreciated Michael's insights about the importance of forging partnerships in healthcare. Really important. Last but not least, if any topics covered today resonate with you, be sure to consider sharing this episode with someone you think will benefit from the knowledge sharing, because that's what HIROC is all about, sharing valuable knowledge so others can scale in their communities. Okay, let's get to it.
Everybody, welcome. We're happy to have Michael Green with us today. So Michael, please tell our listeners a bit about yourselves, your personal journey in healthcare, of course, where you work and what you do.
Michael Green: Sure. So, yeah, I've been in the healthcare field for quite a long time now. Originally I worked in a hospital in the biochemistry labs, and then I went into private sector. I worked for medical device, pharmaceutical companies and so on. And then I finally ended up in Canada, and about 10 years ago I joined Canada Health Infoway.
Philip De Souza: Wow, very cool. And so you mentioned the hospital and biochem. How is that different from your day-to-day today? I'm sure very different.
Michael Green: Yeah, very different. I mean, basically I was working in a diagnostic laboratory doing all sorts of tests on people, and I did that for a number of years, but then I went into a sales role with a medical device company. And so I was in sales for five or six years and then went into marketing and kind of grew from there, basically. And in 2001, in fact, at that time I was working in a diagnostic imaging business and running their UK subsidiary, and I was offered a job in Canada. So I came over, did the same thing here, ended up running the US then Latin America, and then finally I was looking for something new and this position with Infoway came up.
Philip De Souza: Oh, very cool. And it's quite the journey. And speaking of Infoway, who is Canada Health Infoway? What is your mandate?
Michael Green: Yeah, so basically, Canada Health Infoway, the organization was formed in 2001, and I think it was the premiers of all the provinces together with the Prime Minister at the time. And the reason that the organization was formed is at that particular time, they wanted to have a strategy for the electronic health record. And the country didn't have that. I think things were being done in a kind of ad hoc manner. And so Infoway was funded, and the organization managed to put together a number of experts and came up with a kind of blueprint of how provinces and the country could establish an electronic health record. And that blueprint took probably 10 or 15 years to put in place, and it included things like lab information, diagnostic imaging, drug information, discharge reports, and a number of the core elements that people felt were important to have in the patient record. And it really showed the provinces how they could store that information in a standardized way so that they could exchange it between different healthcare settings and so on.
And the organization, on the one hand, we had funding where we were able to target certain initiatives. One I mentioned earlier was the EMR, Electronic Medical Record one, where we helped fund family physicians to implement electronic medical records in their practices. And what we did though is that we came up with a kind of business plan of how this should be done, and also we ensured that the investments they made were in technologies that could speak to each other, so they didn't end up with a standalone solution that couldn't communicate with any other health system.
So our role, I would say, has been, one, to be a investor in new technologies to try and speed up adoption. But then also more and ore we're a convener and a expert forum really, where we can look at problems that may need to be solved in every single province, but if you can solve them on a national basis, then it saves an awful lot of time and effort. And in addition to that, we spend a lot of time coordinating with international to make sure that Canada is on the top of all the different standards and technologies that are coming out.
So it's a fairly complex kind of program. And at the moment, one of our biggest initiatives is called the interoperability roadmap. And basically, that is designed on ensuring basically that a patient should be able to, one, have access to their information on a device of their choice, and that when they go and see a healthcare provider, that provider should have the relevant information about their case at their fingertips when they're seeing the patient, and then also, if they need to refer any information to another healthcare provider or send the patient to somewhere else, they are able to electronically send that information rather than using faxes and paper.
I think healthcare, generally is behind business in terms of implementing digital technology successfully, and that's not just the case in Canada, it's the case in many places. Healthcare is a very complex business, if you like, or a complex art or science, and there's so many different connections and so many different types of inputs that are coming in. If you think about banking, for example, really, you're only doing a couple of transactions, a credit or a debit, but in healthcare, there's so many diseases and so many different treatments. To put those all together is very tough. But I think the good news is we're kind of on the last part of the journey, and I think people are equipped with the tools, and it's just a matter of making sure all these final connections are made.
Philip De Souza: No, I love the fact, I love your other analogy about the banking and how it's just... It's true. It's just debit and credit, whereas with healthcare, there's so many things to check or uncheck or add or...
Michael Green: Absolutely.
Philip De Souza: There's just lots. Lots. You're right. There's so much more. Now, when you said it that way, I was like, "Yeah, he's right there."
Michael Green: And also, most people, you don't just go to one doctor, you usually get referred to different facilities. You may have an orthopedic specialist who's at one place and a cardiac specialist somewhere else. And so you've got all those other complexities. And then if you travel somewhere, you would like to take your record with you. And a big initiative we're working on is called the International Patient Summary, which is an international standard. And basically, the idea is that you should have, say for example, a QR code where if you travel to another country or to another province, the QR code could be scanned and that would give the person access to specific parts of your medical record, well, without you having to carry a paper file with you, which no one would be able to do.
Philip De Souza: No, that's amazing. All these advancements would definitely help the patient that much more, but also create, I guess you would say, a frictionless system, and a system that extends beyond borders.
Michael Green: Absolutely, absolutely. And I think another area that I haven't mentioned but I think is a very important one that it was introduced since I became CEO is that we've introduced an e-prescribing system called Prescribe It. And basically that system gets rid of paper and fax prescriptions, and it has the ability to send a prescription directly from a family physician to the pharmacy of the patient's choice so that when the patient goes to pick up the script, it is available immediately, and also, the doctor gets a notification that the patient has taken the script, so he knows that the patient has collected the drug. In Canada and the US as well, as you are probably aware, there's a big crisis of drug abuse with opioid drugs, and one of the issues with that is that sometimes people can forge a prescription, a paper one, take it into a pharmacy, and get an opioid prescription. But with an electronic prescription, it's totally secure, so that won't happen. So it's going to be a safer way of prescribing, and also eliminates a lot of unnecessary paperwork and fax discussions between the pharmacist and the doctor.
Philip De Souza: Wow, you and your team definitely have a lot on the go, Michael.
Michael Green: We're pretty busy. Yeah.
Philip De Souza: What would you say are some of the biggest achievements for Canada Health Infoway during your tenure as president and CEO?
Michael Green: Yeah, I mean, basically we're an organization that's focused on digital health and innovation, and one thing's we do... We're mainly funded by the federal government, but in Canada, every province and territory, of which there's 13, all run their own health system. And so our kind of concept really is to work with all the different systems across Canada and really try and help them innovate faster than they might be able to do on their own. And sometimes, as you can imagine, it's just better to take a national approach. And then also, we have funding to invest in specific programs. And so that's the way we work with people, and we're a little bit like Canada's digital health agency, and so we do everything connected with digital health.
Philip De Souza: Very interesting. And how have these successes impacted the advancement of digital health in Canadian healthcare?
Michael Green: Well, since I've been with the organization, I was trying to think back to some of the big things we've done. And certainly when I joined, one of the programs we had just started was to try and help family physicians adopt electronic health records so they could get rid of their paperwork. And so they were able to communicate easier with patients and also get results and everything electronically rather than working with a paper system. And at that time, only about 20% of doctors had an EMR, and now, around about 94% of them have. And so we're pretty much at the leading pack if you look at other countries. And the good thing about that, it means that they are in a position then to use more and more digital tools.
And so you're asking me about some of the things that have happened since I joined, and certainly one big event would be the COVID crisis, when we all suddenly went into isolation and we couldn't go and meet anyone. And when it all started, I remember I called the Deputy Minister of Health in Ottawa and I said, "Look, this is a moment where digital health is really going to shine, because it's going to enable people to meet with their doctors and other healthcare providers virtually without doing it face-to-face, and so there won't be the risk of spreading the infection."
And we were able to actually take a number of funds that we had and really put them into programs, and we called it a rapid access program, where we basically worked with provinces, territories across the country, every single one, and we came up with tools to help them implement things like virtual care, vehicles between doctors and their patients, and also ways that they could rapidly deliver results back so that when a patient had a COVID test, they could rapidly get the results back to the health facility or to the patient themselves. So those were some of the things we did. And I think that whole episode, although it was a very difficult one for many people, it really did show the value of digital health and virtual care in the modern health system.
Philip De Souza: No, absolutely. And all the examples you provided, it seems that collaboration is important, and I'm assuming you and your team have a variety of connections with various folks from the healthcare system. How does that work, you dealing with a variety of stakeholders? How does that play into how you strategize and get the word out?
Michael Green: Sure, it's a very important part of our role, really, and also quite a difficult one to maintain. But as you can imagine, in a complex health system like Canada, there's so many different stakeholders that are into play. And so we really try and make sure that we can connect with the best people that are responsible for digital health, for example, in each of the provinces, that we can connect them with their federal counterparts at Health Canada, but also, there's a lot of other players. So we have private sector companies that have health IT solutions, and to really have an effective service, we need to help those individuals also connect, and so they're all working on similar programs.
And so I think there's a number of different areas where we hold kind of stakeholder meetings, and it may be in the area of, say for example, privacy and security, or it could be in the area of mental health, where we found that e-mental health is a really important tool for a lot of people that are delivering counseling and things like that, that they can do it either using an app or by a virtual service, and do it very effectively.
Philip De Souza: I like that you brought up, for one thing I wrote down while you were saying that, is that how you and your team are... I can envision you all as dot connectors, you're connecting the dots in the system.
Michael Green: Certainly, and also outside of Canada, because a lot of healthcare is based on international standards, international practice, and really rather than trying to reinvent the wheel in Canada or any other country, it's often better to try and take the best international practice and then try and implement that at home. And so one of the big roles we have is liaising with some of these big international organizations that set standards, and really helping provinces across Canada kind of synchronize and link into those to effectively get their systems speaking to each other.
Philip De Souza: No, absolutely. I'm happy you brought the point about partnerships, because as a fellow not-for-profit at HIROC, we understand the importance of forging these positive partnerships just like how you and your team do. So what strategies does your organization employ to find partners to support your mission? How have relationships with government agencies and tech companies and yeah, even HIROC too and other healthcare providers, how have they helped you and your team?
Michael Green: In a number of ways, really. We are proud of the private and the public partnerships we have. Some of the things we do is that we launch some incentive programs. So for example, we launched an early implementer program, which was really set up to help companies, or vendors, as we call them, kind of take their solutions and ensure that they would work with certain standards. And often, we'll work around particular national initiatives.
Last year, another example, we launched an industry collaborative, which was a platform where healthcare IT companies could collaborate with each other on different digital health initiatives. Other things we do is that we would create events like we have a program called the partnership program, where usually there's a week in Canada called Digital Health Week, it's in November. And we annually hold a meeting somewhere across the country to recognize that event, and we bring in keynote speakers who are experts in their field. And at those meetings, we bring together various different stakeholders. So we may have technical people or clinicians from hospitals together with the representatives from companies who are manufacturing the product. So we can put them together in workshops, and it's a kind constant service that we're kind of running, and it's very important to keep that collaboration going.
Philip De Souza: No, I love the fact that you mentioned a variety of those injects that bring people together. We're all about that too. And I know our CEO Catherine always mentions that she's glad that we have you and your team around to also share valuable resources and information with us. We appreciate that. And so with the focus being digitalizing healthcare, how is Infoway responding to and adopting artificial intelligence, the word du jour? What are the challenges and opportunities here that you see?
Michael Green: Yeah, well, certainly, AI is a new development , it's rapidly growing. Everybody's interested in it, everybody wants to have something to do with AI. So what we try and do is look and see how we can find applications for AI and really help people, help them guide them through various use cases that they could put in place. As an example, we launched a toolkit which was basically for hospital providers but also for vendors to support the integration of AI in healthcare, and looking at guidelines and best practices for implementing solutions in a way that really enhances care but also is safe and efficient as well. And there are a number of initiatives that we've helped pilot, and some of those, really, involve using AI to look at a patient doctor consultation, where it's possible to have AI monitor the audio of the discussion, and then come up with a report of what was said between the physician and the patient.
But the interesting thing is that the AI is able to kind of ignore regular conversation if someone's asking about the family and so on, and it hones down on the areas that are particular to the patient's condition or treatment. And then also what it's able to do, which can save a lot of time and effort, is actually pre-populate some of the forms so that the clinician, if they need to do a lab test or refer the patient for an MRI, the form is already pre-populated, and then they simply just have to check it and can send the form off without any further work. So there's tremendous potential with AI, and at the same time there's so many different solutions that are appearing. So what we try and do is try and provide some advice to people so that they can help them really guide themselves through the AI forest, if you like, and choose the particular approaches they can start with.
Philip De Souza: I like that analogy of the forest. That's a good one. Obviously, with things like AI, this last few weeks ago, we had here our hosted a cyber forum and we had a session on cybersecurity and AI, but I guess cybersecurity is an increasing concern for our collective partners in healthcare, with the amount of sensitive information involved. So what are some key considerations organizations should take for strengthening their cybersecurity posture?
Michael Green: Yeah, I mean that's a big concern, and healthcare information is very valuable, and certainly I think patients are always concerned that their information is going to get to the right person and it's kept secure and so on. And so there's a lot that needs to be done. I think that people expect health information to be like their banking information, and that it is secure. And if that isn't the case, people would lose confidence in these solutions. So what we try and do is help frontline institutions and care providers with tools to help them prioritize privacy and cybersecurity.
And I think there's a number of things we can help people do, help them understand how they can make their system secure, how they can do, for example, a privacy impact assessment , look at a threat assessment of a solution. I think there's a lot of very technical things that one can look at in terms of privacy and security, but there's a number of common programs that have to be put in place to make sure things are secure. And some of this is making sure that the manufacturers are putting the proper precautions in their systems to make sure everything is secure from that extent.
Philip De Souza: No, absolutely. Before I get to the lightning round, I do want to, after hearing your journey to where you are today, obviously, as you know, this is a leadership podcast a lot, so a lot of leaders and emerging leaders are going to be hearing you today. And so what caught my interest is your career journey. And so was there something in you, something that really drove you to... You've had a lens of a variety of roles on the frontline and you mentioned medical devices, et cetera. So I guess my question would be where did you get your drive from and your motivation to explore your career?
Michael Green: One of the things I always wanted to do from an early age was travel with business, and working in another country, and that was one of my goals. And I think maybe by accident I came into the healthcare field, but I really interested by the science and by healthcare itself. And I think having worked in the hospital field, I saw the opportunity to go into industry, and I think with the industry, that allowed me to gain business skills , also to get that goal of traveling. And so when I was based in the UK, I was fortunate enough to get a position working with a company where I was working in Scandinavia, European markets and so on, which I really enjoyed. And I kind of went from there into marketing and then into sales management and management. And basically I ended up running division of a company in the diagnostic, in the lab business field.
And I think business has always kind of excited me. I'm quite a goal-driven person. I like to win, and I like the competitiveness of that environment, but also, I like areas that are innovative, where you can try out new ideas and grow new strategies. And I think that's something that really appeals to me. And in particular though, when you're working in a healthcare field, you also really feel you are part of the mission that you're doing some real good in terms of what we're doing. And in fact, when I look at the staff surveys we do at Infoway, I think one of the things that motivate most of the people in the organization, including myself, is the fact we do believe we are making a bit of a difference and helping to improve healthcare. And that's a very exciting challenge, and it's a very complex field, and I think the more you do, the more interested you get in that field really, I would say.
Philip De Souza: No, that's great. I appreciate that you told that nice story, but you also ended it off with a nice way that connects you as well as your team at Infoway to your North Star, and I think that will definitely resonate with our listeners.
Michael Green: Right.
Philip De Souza: And so with that, I'm going to take you into our lightning round where we ask you a few questions and you can answer with one word or a sentence or you can go long if you want. So Michael, what was your first job ever?
Michael Green: Right, that's interesting. So my first job ever I think was when I was still at school, probably around 16, and I worked for a department store in South London, and I was the assistant to a delivery driver and our job was delivering TVs and hi-fis. And I remember at the time when I was there, probably dates me a bit, but lots of people were buying new video recorders, and it was all about was it VHS or Betamax?
Philip De Souza: That's a good first job. If you were stranded on a deserted island, what three things would you bring to that island?
Michael Green: That's an interesting one. I don't know if you've ever heard of a program called Desert Island Discs, but it's the program I listened to as a kid. My parents used to listen to it, and basically what they do, they take a celebrity and they have to choose eight different discs, and then a luxury device they would take to a desert island. And it's been running now for years and years. But I think as far as I'm concerned, if I had a couple of few items, three things, I think I would like to bring my iTunes collection, probably a nice cigar, and also a fine malt whiskey. And I would sit there in the sunset kind of enjoying the music, smoking a cigar, and having a sip of whiskey.
Philip De Souza: This does sound very good. If you could have dinner with a famous individual, dead or alive, who would it be and why?
Michael Green: I think with something like that, you probably want to have dinner with someone who enjoys the meal and everything. And the person it comes to mind is someone like Winston Churchill, I think, who was renowned to be a great wit. So it would've been fantastic company, but also as a person who definitely enjoyed his food and wine. So I think Winston Churchill would be quite a good dinner partner.
Philip De Souza: No, absolutely. And is there a leader, it could be in healthcare, in business, or wherever, who you personally look to for inspiration or get ideas from or just enjoy hearing and value what they do?
Michael Green: I think with that, one person that comes to mind is Nelson Mandela, and the reason he comes to mind is that he's the guy I think made so many sacrifices and came up against so much adversary, but in the end managed to orchestrate one of the most fundamental social changes we've seen in our lifetimes. And the really good thing about him is that he also embraced his adversaries as well. And so I think as a kind of person, someone who had that spirit to kind of fight under such difficult circumstances but come up on top, but also be friendly with the people that put him in prison as well and kind of manage to bring everybody together, what a fantastic person.
Philip De Souza: Oh, that's a nice one, and that's a fantastic way to end off our conversation with you, Michael. So thank you so much for joining us today. You provided a great deal of insight on both yourself, your personal career journey, but also how you and your team are making huge strides across the healthcare system, and we appreciate that.
Michael Green: Thank you. It's been a pleasure chatting with you.
Thank you for listening. You can hear more episodes of healthcare change makers on our website, hiroc.com, and on your favorite podcasting apps. If you like what you hear, please rate us or post a review. Healthcare Change Makers is recorded by HIROC's communications and marketing team, and produced by Podfly Productions. Follow us on Twitter at @hirocgroup or email us at [email protected]. We'd love to hear from you.