An interview with Kevin Dean
Interview by: Alistair Craven
Kevin Dean is Managing Director of Connected Health for the Cisco Internet Business Solutions Group (IBSG), focusing on helping healthcare and public sector leaders develop strategies and implementation plans for “Connected Health” information management and technology.
He has experience in numerous aspects of health IT strategy and execution, including helping to develop the UK NHS IT strategy while on secondment from IBSG. He and his team are now working with national and regional governments around the world, as well as advising the European Commission and World Health Organization (WHO). Kevin’s team provides advice for groundbreaking projects such as the Health Academy, a joint WHO/Cisco initiative to provide health education to schoolchildren in developing nations.
Since joining Cisco in 1999, Kevin has also become a trusted adviser on e-business strategy to some of the world’s largest companies and public organizations across many industries including energy, transportation, and retail. Kevin’s background is in consulting, working primarily in the oil, chemicals, and pharmaceutical sectors. He has concentrated on supply chain management and purchasing, but has also been involved in activities such as large-scale global enterprise management system implementation, assessment of investment priorities for EU funding, and guidance and assessment of investment success for government programmes including advanced robotics.
Q: Can you give us some insight into your day-to-day role on the Connected Health Team?
Our job is to transfer Cisco’s vast strategic experience in new information and communications technologies (ICT) to healthcare organizations, to help them achieve more using ICT, and to do this faster than they could without our help. Uniquely, our measure of success is the customer’s satisfaction with our advice.
Q: As much as $1.9 trillion was spent on healthcare in the United States during 2006 – a figure that is increasing at a faster rate than the nation’s gross domestic product! What do you make of this situation?
Rising healthcare costs are indeed a global concern, with significant increases also seen in several countries in the European Union and Canada. Chronic conditions account for a great majority of these costs, with most of these conditions occurring among uninsured or underinsured patients. Unnecessary spending is also driving up costs, largely the result of inefficient healthcare practices, such as redundant testing, unnecessary hospital admissions and manual paperwork. Healthcare IT can play a critical role in helping to deal with increasing healthcare costs – especially if business processes are changed along with the use of technology to connect a patient’s journey.
Q: You deal with national and regional governments around Europe, as well as the European Commission and World Health Organization. Is there consensus among such parties on the key issues facing healthcare professionals and the best ways in which to tackle them?
Three factors that unite all healthcare systems are the desires to:
- Raise the quality of care
- Improve access to treatments
- Ensure that the cost of providing effective treatment is as low as possible, while being consistent with quality and safety standards.
Healthcare professionals, therefore, face immense challenges. As healthcare systems evolve, these challenges include the requirement for ever-increasing amounts of clinical knowledge; increasingly complex patient journeys that involve multiple professionals and organizations; and rising patient expectations for the speed and quality of care. Add to this the rise in long-term chronic diseases, and you have a potent, consistent set of issues that require healthcare systems to find new ways of preventing disease and caring for patients efficiently in both healthcare and social care terms.
Q: Can you describe a few of the major benefits ICT can deliver in the practice of healthcare?
We believe that the next revolution in healthcare is not about medicine – it is about using information and knowledge to focus citizens on keeping healthy, and to drive patient-centric, safe and efficient care, ultimately changing the way care is delivered. This is the essence of our ‘Connected Health’ concept, where Cisco is playing its part in enabling collaboration across the health and care continuum for safe, affordable and accessible healthcare.
Among the major benefits that can be realized through the use of health ICT are:
- Dramatic improvement of information flow and sharing of information where, when and to whom it is needed, increasing the quality and safety of treatment.
- Significant reduction of healthcare costs through better decisions and improved visibility of patients’ treatment histories, tests and so forth.
- Important changes in how patients access, receive and experience healthcare – increasing convenience for patients while reducing costs for healthcare providers.
Cisco’s position is that significant, measurable efficiency gains from healthcare ICT are realized only when a portfolio of complementary technologies – networked infrastructure, wireless solutions for mobility, robust Electronic Medical Records (EMRs) with decision-support capabilities, and others – are in place. Most important, these technologies must also be used seamlessly by clinicians and patients, which implies significant process and organizational change.
Q: In working towards placing physicians at the centre of ICT-enabled, collaborative communication across the care continuum, you suggest establishing a basic electronic care record that results from physician-patient interactions. Can you tell us about this?
Yes. The establishment of an EMR is an important foundational component of an overall ‘Connected Health’ environment. An EMR alone, however, cannot produce the necessary improvements in healthcare delivery and outcomes. While we believe that an EMR is an important step to help connect clinicians with other caregivers and their patients, the real discussion should focus on the entire ICT environment and its adoption into the working environment, not just EMR.
“Improving the way in which information and knowledge are communicated – among clinicians and between clinicians and patients – is the next-step in addressing the massive cost and quality challenge facing healthcare systems.”
Q: What are the main barriers to technology adoption? Which concern you most?
By far, the highest barrier to technology adoption in healthcare is the need to change well-established working practices in a complex series of relationships among clinicians, and between clinicians and patients. This takes time, and must be led by clinicians and patients themselves to show that the new working practices are safe and provide high quality care. Clinicians and patients must also be able to trust the systems they use. This is why Cisco has developed the concept of the Medical-Grade Network – ensuring a robust infrastructure is available to support new processes and transactions.
Demonstrating real benefit is also complex – in healthcare, improved processes and treatments can take a long time to show hard evidence. Often, that evidence must be derived from indicators. For instance, early diagnosis of disease, and application of best-practice treatments supported by ICT to share knowledge and patient journey information over several years, may lead to a patient not being ill in the future. This outcome, however, is difficult to prove and to account for. There are, however, real, tangible benefits in terms of improving the safety and access to care that can be used to demonstrate the need for investment in the short and medium term. Our message is that the benefits are significantly higher if a strategy for Connected Health is created, linked by a consistent infrastructure to enable communication, rather than islands of isolated information and automation.
Q: You note that most available technologies today fall far short of true interoperability. How big is this problem, and what can be done about it?
Healthcare is still using a plethora of clinical and business applications in most environments. Since the industry has not developed global standards quickly enough over the last 20 years, many of these applications cannot exchange data or collaborate to deliver seamless processes. Healthcare is also complex in its use of language, definitions and terms, so the resolution of standards is not straightforward. There are, however, some interesting developments to refine standards for interoperability – for instance, through initiatives like Continua (for which Cisco is a founding member) that aim to make home care devices interoperable out of the box.
Q: Some of your research indicates that as healthcare costs have risen, the quality of care has not. How can technology help to make a difference here?
The quality of care is affected by many factors, and the application of technology can improve the performance of many of these. For instance, quality problems can stem from a lack of up-to-date knowledge available to the clinician; clinicians nowadays are deluged with advice and guidance on best practices, treatments, and so on. Delivering on-demand access to knowledge – in context, at the point of care via wireless infrastructures to hand-held devices – is one way in which the knowledge gap can be overcome.
Further, capabilities offered by Cisco’s Unified Communications platform can be used to create an ‘Expert Network’ of colleagues who can connect to each other and collaborate about patient care.
Indeed, collaborative technologies can have a profound impact in improving healthcare outcomes and the overall quality of care by creating new synergies and improving the efficacy of treatment modalities. By collaborative technologies, we mean IP telephony, videoconferencing, instant messaging, IP phones and IP-enabled contact centres, and Cisco TelePresence, to name a few examples. These technologies can enable new levels of communication and collaboration among care givers, resulting in the delivery of high quality and efficacious care. In addition, these collaborative technologies are helping to create new, patient-centric care models where patients have access to information, including treatment protocols and alternatives. As a result, patients are taking greater responsibility for their care and are demanding new and higher levels of service.
Q: Are there any closing comments you wish to make?
Yes. Improving the way in which information and knowledge are communicated – among clinicians and between clinicians and patients – is the next step in addressing the massive cost and quality challenge facing healthcare systems. To achieve high-quality, cost-effective outcomes, health promotion and care-giving processes must change dramatically. Such changes require pervasive, secure and reliable communication of data, voice and video – connecting health and care. Cisco is committed to helping healthcare organizations make this necessary change.
Find out more about Cisco’s Internet Business Solutions Group.