Dr. Lucie Opatrny, president and CEO of McGill University Health Centre
Photo courtesy of Future of Health
LOS ANGELES – During the recent Future of Health Annual Summit, Dr. Lucie Opatrny, president and CEO of Canada's McGill University Health Centre, sat down with MobiHealthNews for an in-person interview to discuss the differences between the U.S. and Canadian healthcare systems, technology implementation at McGill, and how AI implementation requires strong governance, data validation and quick course corrections.
MobiHealthNews: Can you tell me a bit about you and McGill University Health Centre?
Dr. Lucie Opatrny: I'm a physician by training, and I'm currently the president and CEO of the McGill University Health Centre, which is a group of five hospitals, academic hospitals, in Montreal, Quebec.
MHN: How is the healthcare system in Canada different from the health system in the United States, and what could we learn from the Canadian healthcare system?
Opatrny: What's special about FOH [Future of Health] here, where there are multiple countries, is that I think everybody can learn from everybody else.
So, the major difference between the Canadian and the U.S. health system is that it is a single payer, which is the government, and the government decides on fee scheduling, financing of institutions and so forth, including the payment of the almost total physician salaries as well.
And so, it is different primarily in that when people change jobs, they do not have to worry about, well, what is the insurance like? Am I going to lose my insurance? What's the new insurance? So, that part of the equation is not there.
That being said, the Canadian financing model is not ideal either, but I think that is probably the main difference.
MHN: At McGill, you oversee everything. How do you choose which technologies are appropriate for your healthcare system?
Opatrny: So, I would divide it into two different types of technologies. One is what, as an administration, we identify and use, and the other ones are the ones that are built by the clinician scientists who are there.
So, clinician scientists, when they want to build a new app or they want to do research toward innovation, you give them as much leeway to do that. You don't want to stifle that at all.
As an organization, the ones that we select and purchase for implementation have to really focus on the area where it can address a pain point. Our pain points are workforce in that it is difficult to recruit and retain, or the lack of, for example, nurses.
So, can we identify technology that is going to diminish the burden of administration, for example, of nurses to be able to have them more at the bedside? Or let's say we don't have enough people to clean the wards, can we have robots that come and do that which can be done by technology? So, we've really focused on investing in those areas where we identify pain points.
MHN: When you're looking at technology and thinking about the future of healthcare, what technologies make you nervous? Are there any that you think may be moving too fast or don't have enough oversight?
Opatrny: Where we're leading to is a bit of the AI ... because most other technologies, you have an oversight and you know where it starts and you know where it ends.
The element about AI, which is generative, is that you are not too sure how new information is modeled, how it is integrated. You need a very solid governance structure put into place that you know understands very well what data came in to be able to make that decision, and also, as time goes forward, what new data is going to alter it, and to have checks and balances to make sure it still does what you want it to do.
So, it is more about being able to really understand and put into place checks and balances, to be able to glean that which is good and hopefully minimize some of the concerns, and the very valid concerns, that we see in recent months that have been raised by people who are very cognizant in the field.
MHN: The Future of Health event brings together many executives and leaders from different countries. If you are considering implementing an innovation or technology from another country, how do you ensure it will be a good fit for McGill?
Opatrny: That's a fantastic question. So, for sure, there are elements that are very much similar. There are patients who have breast cancer pretty much everywhere. So, there are diseases that are the same everywhere. So, what you want to see is, is that patient population similar or not? And then, do you have data to show that this particular intervention might have the same outcome as where it's coming from?
You do have a requirement to look at your in-house data and do some preliminary analysis to make sure that you are getting something that you think you are getting. And then, once you apply it, you have to also see whether or not it has that outcome, and if it does not, well, you set parameters for quick fails and then you move on. But if you do not take any risks, then you don't move on.
MHN: Do you consider how another country regulates healthcare devices or software?
Opatrny: So, there are devices that we use in surgeries that it is good to have approval elsewhere, like the FDA, but we also have a system of approval.
AI is different in that I have the feeling that we are constantly playing catch-up. If you look at cybersecurity, you know, we always try to make patches after we see what hackers have managed to do.
But, a little bit with AI … I'm not sure that there is rigorous governance anywhere. I do think that we can inspire ourselves from amazing work done everywhere, including phenomenal work done in the United States. I think that we also have, and I feel as an organization that we have, the duty to do our own governance.
The HIMSS AI & Cybersecurity Virtual Forum is free to attend on Nov. 18. Learn more and register.
