Balancing Clinical Needs with Healthcare Digitalisation

Alexis Villa, Sr. Director of Digital Health & Strategic Program Delivery at the University Health Network (UHN), took the stage to share key lessons from her experience in balancing clinical needs with the rapid evolution of healthcare digitalization. With a career deeply rooted in public digital health initiatives, Villa offered a unique perspective, drawn from her work scaling innovative programs not only within UHN but also across regional and provincial levels.

Villa began by discussing UHN's Altum Health, a division focused on rehabilitating patients with complex injuries, such as musculoskeletal issues, concussions, and mental health challenges. Altum’s work, spread across 12 clinics in Ontario, represents a microcosm of the larger challenges in healthcare digital transformation. Villa explained that despite the diversity of patients, clinic sizes, and funding sources, the need for a unified digital solution was clear. Yet, the journey toward seamless healthcare digitization was far from linear.

“We knew we had to configure it differently so that all of the customers we serve could have their needs met,” Villa said, reflecting on the need to tailor digital solutions like Epic to Altum’s unique environment.

Optimizing Clinical Workflows with Technology

The first challenge Villa highlighted was integrating digital tools into clinician workflows without compromising efficiency or quality. Initially, the team implemented 94 standardized flow sheets and 300 smart phrases in the Epic system, hoping these would streamline documentation processes. However, they quickly realized that the clinicians were struggling with the system. What was meant to be a simplification turned into a frustrating, time-consuming process.

“Our clinicians hated scrolling through endless forms. It wasn’t just slowing them down—it was reducing the quality of their work,” Villa recalled.

Recognizing this, Villa’s team made the difficult decision to pivot just one month after implementation. They transitioned from the flow sheets to a more intuitive, clickable form known as a navigator in Epic. This decision had an immediate impact, reducing the time spent on comprehensive assessments by one hour per report, while also improving the quality of the documentation.

Ensuring Patient-Centered Care

From the patient’s perspective, healthcare digitalization presented a different set of challenges. UHN introduced a patient portal, allowing users to access medical information, consent forms, and appointments, as well as complete surveys prior to their visits. Despite the convenience this offered, adoption rates were initially disappointing, particularly among older patients.

Villa and her team quickly adapted by implementing a "one-click" registration feature, which didn’t require patients to log into a portal account. This small but crucial change led to a significant increase in patient engagement.

“Some people just don’t want another username and password. That’s when we knew we had to provide options that worked for everyone,” Villa explained.

Overcoming Operational Hurdles

On the operational side, Villa emphasized the importance of optimizing clinic resources through digital tools. By consolidating scheduling, clinical documentation, and billing into the Epic system, UHN aimed to better understand resource utilization across its clinics. However, the output from these reports was initially misaligned with the diversity of the clinics, particularly given the differences in size and staff resources.

Villa recognized that while they had the right system in place, they needed to make further adjustments, specifically by creating proxy measures and predictive tools to better track and allocate resources.

“It’s not just about digitizing—it’s about making sure the digitization actually works for everyone, from our patients to our staff,” Villa noted.

Key Takeaways

Villa closed the keynote by offering several key takeaways from UHN's digitalization efforts:

1. Streamline before you digitize: Ensure workflows are optimized before introducing digital tools.
2. Iterate and listen: Continuous feedback from clinicians and patients is essential for success.
3. Invest in digital literacy: Supporting staff in navigating digital tools can greatly improve adoption and efficiency.

“Digital transformation is not a one-year project. It’s long-term, and we have to continue evolving,” Villa emphasized.

With healthcare digitalization moving rapidly, Villa’s experiences at UHN offer valuable insights into how to effectively balance clinical needs with technological innovation.