Connecting the Dots: Interoperability and Seamless Healthcare Communication

[00:00:00] Joy Rios: Hello there, and welcome to the HIT Like a Girl podcast. My name is Joy Rios. This is a show where we talk about the million piece puzzle that is all things healthcare and where each one of our guests gets to come on and share their piece of the puzzle. So I'm really excited to bring on today's guest, Angela Jonsson.

Can you please take a moment to introduce yourself and tell us about the piece in the big healthcare puzzle that you hold on to?

[00:00:32] Angela Jonsson: Awesome! So yes, my name is Angela Jonsson. I am the vice president of public affairs, corporate strategy and communications at Canada Health Infoway. And also wear another hat as chief of staff.

So it's an exciting role at Infoway. What we do is connect systems. So ensuring that each of our systems are able to talk to one another in a clear and concise way. And so that is what we're after.

[00:00:57] Joy Rios: Is that one of those where you're trying to get different pieces of is interoperability, but is it interoperability among technology systems or is it other types of stakeholders?

[00:01:08] Angela Jonsson: So it's interoperability as it relates to ensuring that EMR, for example, so if you were to, the best way to explain it is that if you were to go to a hospital and you had previously gone to perhaps a walk in clinic, to get some information and then two days later rush to the hospital that information would be transferred.

So when you arrived at the ER, and perhaps you were incapacitated unable to, for example, get information and or say what you're allergic to. That information would pop up on the screen and they would be able to see where you had been before. In lots of parts of Canada and in some province they are interoperable, but in most cases that's not always happening.

And so it's really making sure that each of those systems can talk to one another and to bring it back to the patient so that they can actually see how that forward.

[00:01:59] Joy Rios: And you've been with the organization for how long?  

[00:02:02] Angela Jonsson: Five years, actually. It's almost my anniversary. So yes, five years.

[00:02:07] Joy Rios: I'm curious to know what kind of change or advances you've seen in your time with Infoway.

[00:02:13] Angela Jonsson: Yes. So you know what? I think healthcare is one of those spaces that is always changing. So I think much like politics, they say a day is a week in politics, anything can happen. I often feel like that about health care, that there's always something going on. There's always something transitioning.

I think that COVID really changed things for a lot of people, but we also became a bit more sexy in lots of ways, right? Is how are those systems connecting? Where's all of this data being stored? How is it being stored? How are we communicating with one another?

And so I think the digital world and lots of folks would agree is that it became exciting before I think we were fighting to be the cool kid and but after COVID and during that piece of like during COVID, it was like, oh, now we have to actually do virtual appointments.

We have to make sure that we have systems that are able to transfer information without being in person to do that. Luckily, we're now in a position where we can do both. And I think that some had seen, oh, this is actually beneficial to do virtual care. or to have those types of things available, but also not losing that in person ability as well.

[00:03:27] Joy Rios: You guys experience the same thing because we're starting to see it a little bit in the U. S. where there was a huge push for virtual visits, but because of reimbursement rates and whatnot, they're not really sure if they're there to stay. If it was just during COVID, do you guys feel a little bit more permanency with it?

[00:03:43] Angela Jonsson: I think it depends on who and where you are. So I think, and it also depends on I think the physician and the patient as well, right? What is it that actually needs to be addressed in this circumstance? I can speak from personal experience that my current family doctor does offer virtual visits, but also offers in person visits.

And so it becomes a bit of a preference. I'm not seeing that there's necessarily one going one way or the other. I think there was a bit of that Joy, to be honest, where it was like, wait a minute, now I want to be in person because I couldn't be in person. And I think that's happened with folks as they were also trying to get back outside, so to speak of, oh, wait, I can do things in person. I want connection. I want to see my doctor in person. I want to do all of these things.

And so I think there was a bit of an opposite reaction to what happened in COVID. And now I feel like it is starting to balance out and making sure that it's just fair and equitable across the board, because there are a lot of circumstances in virtual visits that for, I often think folks that in rural parts of our country or more remote virtual care really offers that.

That opportunity to have that fair and equitable care that they otherwise may not be able to have in person.

[00:04:57] Joy Rios: One of the other use cases, I think, for virtual care is people that like, honestly, like families, when you have a lot that you're juggling and you've got kids and appointments and schools and all of the, if you can just talk to a doctor virtually without interrupting your entire life and still being able to manage the million things that are going on as an individual, or who are perhaps working and also taking care of their family.

I feel like that's something that once we've experienced it, it's really hard to go back.

[00:05:26] Angela Jonsson: I totally agree. I think, and the sandwich generation, some of my colleagues are talking about that is that it makes it, it doesn't make it easier, right? Because you have kids or, and you have, perhaps you're taking care of your parents or other elderly folks in your family.

And how can you possibly do it all by working full time and doing this, taking a full day off is not possible for a lot of people. And that's also not especially in this economy, I think. I need to be very mindful of that and what that means for people as they're taking care of those loved ones. I also think it's interesting too because I think that brings up a good point that, for example, having medication and being able to look at what was recently prescribed for perhaps your mother that is not able to do that so you're joining on these appointments and that you're available for those things as well as health care, right?

If you wanted to see your record as a patient, it's sometimes difficult in Canada to be able to get that. Oftentimes you're paying, you're doing all sorts of things, but through an interoperable system, if everything is talking to one another and the systems are talking, then you're actually able to have that at your fingertips, similar to how you have your banking information with those privacy and all those things intact.

So I do think it offers a wide range of benefits. And I think that we have a very savvy generation. We use computers and our phones for everything, right? So why not healthcare too?

[00:06:51] Joy Rios: I also imagine you guys are dealing with a ton of stakeholders, tons of stakeholders, so you're like, help me understand your organization.

It's a non profit that's federally funded, but in order to make sure that both payers, patients, and the healthcare system are all connected and talking to each other. Do I have that correct?

[00:07:10] Angela Jonsson: You do. Yeah, that was great. You can take my job. I'm going to go into podcasting and you can take over.

[00:07:17] Joy Rios: What if we do Freaky Friday, we can switch. I think you do a lot better than me to be honest. I think that your job is pretty difficult and I don't know that I would want to step into your shoes. It sounds like it's a lot.

What is your day to day like? How do you do you work on projects? Are you in meetings all day long? Are you in a government office? What is it like connecting all of these different stakeholders for you?

[00:07:41] Angela Jonsson: So for me, it's a bit different because I come from a background of public affairs of communications. And so essentially my job is to take what a lot of our experts are doing, our subject matter experts in the field, when they're talking about standards like FHIR and HL7 and All of those things are super vital.

If you ask me to go in and start talking to you about standards, I wouldn't be able to. But my job is to understand what it is that they're saying and then be able to communicate that out. And there is lots of translation in some ways of, I always say, would my grandmother understand what it is that we're trying to say?

And so I think that kind of goes to your question of there's so many stakeholders. How do we go out? How do we communicate? And that is vitally important, and I would say my day to day, no day ever looks the same, and in my world, I, anything from being traveling to different provinces and territories, meeting and educating both on our elected officials to make sure that they understand the work that we're trying to engage within the province or territory, as well as meeting with what would be our bureaucratic department staff in each of those provinces and territories and connecting them back to the federal government and what Infoway is doing.

And just to go back to Infoway's role, it's a very unique role. We are a pan Canadian health organization and sit between the federal government and the provinces and territories. And oftentimes, there's so many different stakeholders that we do have, and so it's very important that we cater in that way, but that is our unique role that sits there.

So no day is the same for me. And I think similarly to my background, no day has ever been the same in my life. So there you to. 

[00:09:30] Joy Rios: But that’s great. That's actually like the best way. It's, I'm sure it's not rote, you're just, okay, I know exactly what's gonna happen today, but in a way that's exciting.

[00:09:38] Angela Jonsson: Exactly. For sure.

[00:09:40] Joy Rios: I'm curious. First of all, I think you'd make a great podcaster.

[00:09:45] Angela Jonsson: Thank you. I'll keep your name because I think it has a better ring to it.

[00:09:50] Joy Rios: But I think that's what you brought up earlier about trying to bring information back to the policy makers. And that's something that's of acute interest to me, because I think that, okay, how a lot of people are in the government that may not necessarily understand the bills that they're signing or bully and how that they impact to the community and patients and people everyday people. And so is that your job to help translate, okay, this is the decision that we need to make here's why we need to make it and here's why your support matters? So much, but not quite in a lobbying type way in a I don't know. I'm going to say do good or type way.

[00:10:29] Angela Jonsson: Yeah, in a more of an educating way is to say, hey, this is what's happening in your province or your territory or this is even what's happening federally. We get funded by the federal government, sometimes even elected officials won't even be aware of what exactly that means or the role as governments are large. 

There's lots of organizations. There's lots of arm's length. There's what we call pan canadian health organizations, etc I think it's really vital that, yeah, folks elected folks understand, hey, this is what is going on. This is why we need the support.

I often think that interoperability, we're trying to make it a household world and word, and to be honest. It has become way more people are using that word for the longest time. I didn't even know how to spell it. And so I'm like, here we are talking about something that the average person has no idea about what that means, but it's so vitally important. And I think that's true of politicians too. There's so many issues. There's so many things at play. How can you possibly be right on top of everything all of the time? 

And so that is part of our role is to make sure that we're educating on, okay, wait a minute, what is interoperability? Oh, it just means connected care. What does that mean for my mother? What does that mean for me? What does that mean for my child? How can I see that play out?

That is super important because always making sure that we're keeping the patient, we're keeping that human being at the focus of it. And that actually makes it a little bit easier to explain because everyone understands when it's like, Oh, I've been frustrated in Canada, especially it's, oh, you've gone here. Oh, you need to do this again because I don't have this, or I can't see that, or it takes X long time to get. These things, and I think there is some frustration, but when we are in an interoperable system, things can work a lot more smoothly.

[00:12:21] Joy Rios: Here is a, stop me if you think I'm crazy or out of line, just, I'm going to go ahead and… 

[00:12:26] Angela Jonsson: Never!

[00:12:27] Joy Rios: But one of the things that they say about Canadian health is, okay, first of all, it's paid for, but a lot of times people have to wait, they'll wait. The wait times are significant for folks. Does the interoperability quicken that up? Does that, does it make it faster? Would it allow for more patients to be seen in a more timely manner?

[00:12:47] Angela Jonsson: So I think we have a great healthcare system in Canada. Looking at across the world and seeing how the level of service that we get, there are wait times and that is dealt with within the province and territory on how to look at that. Interoperability really tries to make sure that it's a more seamless experience.

So even if you are waiting, that you actually know that information got there. It's less about, it's more about making sure that it's connected. If you think about how we still use fax machines in Canada today to make sure information is going in some parts of the U. S. as well. Other parts of the world.

We're talking about security and privacy and all of these things. If you look at that, even it's, you could question a whole bunch of other items in that area, but I really think that interoperability helps to make it a more seamless process for the patient so they can have all of their records. They know exactly what's going on.

They can speak to their physician about what is in their records so they're not confused. No one's Googling to wonder what does this mean? There's always those concerns because as I would imagine, I'm not a physician, but being a physician, if all of a sudden, here's your whole record. Oh, what does that mean? What happened? All of those types of things that we need to make sure that are communicated in the right way. So I think it's about finding that balance, but I think interoperability definitely makes it a more seamless experience for the patient.

[00:14:08] Joy Rios: For me, in layman's terms, I'm, that connects the timeline.

So whether you saw somebody three years ago or 20 years ago, and then you have an appointment next week, it's, that information is available to you and I don't think any of us are have that or have had that like that is that's the future and hopefully the future is now, but that's what we're working on.

[00:14:27] Angela Jonsson: And I think you could be very savvy in the healthcare space and keeping everything in line, but even still in some complex situations or whatnot, it's to your point is wait a minute. Where is that? How is that do? And you can imagine that even newcomers to anywhere trying to understand a system is how do you make again?

That's about that equity issue, right? Is making sure that everyone has that same opportunity and looking at health care in that way, and then making sure that it is seamless. So that way we're connecting to international standards. So if you do have records or whatnot that are brought into another country, theoretically, this is the dream that It would be seamless in approach and that they would be able to understand and the systems could talk to one another.

That's a dream. That is a pipe dream.

[00:15:14] Joy Rios: I know we're not quite there yet and I can speak from experience. I've just had my first healthcare experience in Mexico and it is so different than the U. S. Both good and bad ways. I'm just, not very much technology to be spoken for us. But certainly in the terms of EHRs or patient portals, I don't have access to any of that or like digital access to my labs.

However, I had a doctor come in and talk to me for an hour and a half. And she literally said, I want to know every boring detail about what happened. Don't leave anything out. And I'm, in the U S we get 15 minutes. So try to get all the boring details in. It's going to be nearly impossible, but it would be incredible to be able to, that is the dream across international borders, to be able to share that level of information in a secure and private way.

I'm just, oh, there's the Holy grail. So how do you get to interact with the privacy and security aspects of that? Is that, is it more in communication or? How deep in your knowledge set do you have to be?

[00:16:17] Angela Jonsson: So I would say, for me, we do have subject matter experts that are dealing with that privacy and security, looking at that to help inform what is happening in provinces and territories, so that they're able to have legislation. They're able to look at what that means to ensure that a patient's record is kept private. And you have that opportunity to either opt out of a situation if that's not what it is that you're looking at.

And there is legislation right now that is forward to Canadian government, federally, to look at similar to the CARES Act in the U.S. where it allowed for that interoperable system, and that is exciting in and of that, and I think that we're all trying to get by the best that we can. And your story actually reminded me of a situation in which I remembered hearing from one of our patient partners, an Indigenous patient partner, and she had not always been treated well by, in the hospital and things like that, but when someone had come in and actually took time to talk to her and understand where she come from, they understood more of why she wanted to do what she wanted to do.

There was a different aspect and look to her care versus, and that actually honoured more of where she was coming from. And these are the types of things that, whether it might not be in the record entirely, but there could be things that could be captured in that way that can always help to make that a full experience for the patient.

[00:17:45] Joy Rios: Absolutely. And I think that just at the core, it's relationships, right? And to feel seen, to be seen, literally feel seen by your doctor or your healthcare staff of just, okay, I'm not just a number. I'm not just a cog in this wheel. You're not just trying to get me out the door. You care about my health and wellbeing and hopefully we all live happily ever after to the best of our ability.

[00:18:09] Angela Jonsson: At the end of the day, everyone just wants to be seen, right? And everyone does want to feel like, oh, I matter in this moment as they do and as they should. And so I think that is probably the most important thing. And so while it's, yes, we're talking about interoperability, we're talking about connecting systems and making sure, but at the end of the day, that is actually helping the patient to be able to see that more fully.

And I think to even learning from examples in Mexico where you work it really makes me think that oftentimes, and this is why I encourage people to travel and do things like that, because we're so often in our own mind, right? You are somewhat constricted in how you think. And oftentimes people have dealt with these things.

There are other solutions that perhaps are there that we just haven't looked outside because we're too busy. And I really think that can give a new way of looking at things. How you felt it's I didn't have this, but I had that and that really made me feel good and different about it. And so oftentimes I think that those are really good learning experiences and can help broaden by learning from other people.

It's not, we don't necessarily have the, it's not necessarily the right answer. I don't know everything that's going on. Neither do our SMEs. Neither do I. I would argue that no one, we have to share and we have to learn from each other. And so that's what I think is great.

[00:19:32] Joy Rios: I would echo that a million percent because I think, and that's part of the reason for having any, having this podcast is like to allow to see more, and learn more from people that we don't get to see as much and get out of our own headspace. Hey, I see the same thing over and over. So that's what I think is possible. It's hard to imagine what's possible if you're only seeing one thing. You're, there's a million other things that could be possible and could be perfectly great.

And it's, I love the idea of being able to imagine it could be so much, maybe it's not exactly as I want, but it could be even better because I can't even imagine it yet. So what is meant for me is something that I can't even picture yet. And how cool is that?

[00:20:13] Angela Jonsson: It's so true. Honestly, I always think it's the simplest way to innovate is to learn what people already do elsewhere because it's there for us.

It's there for us at our fingertips is that we just have to open up our eyes and see and be open to that in a bigger way. Right?

[00:20:30] Joy Rios: If somebody wanted to imagine having a job like yours, what did you study? Where did you, how did you, what did you do in order to get to where you are? And say your title again.

And also it sounds like it's communications. It sounds like there's a lot of public relations in a way. And also learning about government and technology. What's the major?

[00:20:51] Angela Jonsson: I would say that I came about it a unique way. I don't, now this doesn't mean you shouldn't go to school. You should absolutely go to school.

My degree was in political science, but it didn't necessarily lead me here. I was very involved in politics for many years and worked in different levels of government in Canada and even in the U. S. and seeing that actually made me want to make change. I think that I really got more interested in healthcare after I was working at the Toronto District School Board and looking at what breakfast and lunch programs are for students that are coming in that are not having that and how that impacts learning.

And so that kind of started in that health realm and then moving. I worked at the Ontario Medical Association, which represents all the physicians in Ontario. In an advocacy and government relations role, and so that really, I think, took off more from that healthcare space and then ended up here. Yeah, my role, I work in public affairs, which is really government relations.

It's talking to a number of our government stakeholders, both on the political and non political side, corporate strategy. Looking at how what we're doing, where we're moving, how we are moving with the funding that we receive from the government and then lastly.

That communications piece where, to your point, the PR, the media, how we're talking, what are those notes? So often I'm not on podcasts like this. In fact, I prefer not to be on podcasts. My team was, please do this. You're talking to Joy.

This is why I'm, oh yes, we all need to travel. We need to learn. I have all these exciting ideas. I don't think there's one way to ever get to a career. I think you just have to really be passionate and be open and see what the world has to offer because I think that's how I become better and or try to be better every day.

[00:22:49] Joy Rios: Angela, thank you so much for sharing your professional journey with us and all the good work that you're doing. If somebody wanted to connect with you or follow you or work with you, where would you point them?

[00:23:00] Angela Jonsson: You could go to our website, which is at infoway-inforoute.ca. So Infoway, Canada Health Infoway. You can definitely put us into Google. We're also on LinkedIn and we're on Twitter also now X and a whole bunch of other spaces. So yeah, please connect.

[00:23:18] Joy Rios: Great. Thank you. Thank you again. This has been a pleasure.

[00:23:22] Angela Jonsson: So much fun. Thank you.

[00:23:25] Joy Rios: Thanks for listening. You can learn more about us or this guest by going to our website or visiting us on any of the socials with the handle HIT Like a Girl pod. Thanks again. See you soon.

Again, thank you so much for listening to the HIT Like a Girl podcast. I am truly grateful for you, and I'm wondering if you could do me a quick favor. Would you be willing to follow or subscribe to this podcast or maybe leave us a rating or review? Or if you're feeling extra generous, would you share this episode on your Instagram stories or with a friend?

All those things help us podcasters out so much. I'm the show's host, Joy Rios, and I'll see you next time.

I'm the show's host, Joy Rios, and I'll see you next time.