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Digital disruption in health with a patient centred approach: interview with Richard Corbridge, CIO, HSE/eHealth Ireland

Sci:Com #SCICOM16

For eHealth Ireland being part of a conference that has a post-script, ‘Tackling tricky issues in science communication’ allows us to embrace a new community of knowledge and wisdom to enable us to explore new, exciting and innovative ways of communicating the messages of digital health.

The energy and atmosphere at the Ballsbridge hotel on the morning of Sci: Com was remarkable. Delegates attending the conference arrived bright and early and the buzz of a community who are joined together in a mutual passion for promoting the communication of tricky issues was palpable, with people buzzing around speaking about which breakout sessions they were going to attend and who they wanted to see presenting.

The theme of the event was ‘Let’s not go there,’ there are so many tricky issues for eHealth Ireland to communicate over the next year. The idea that we are now in a ‘post truth, post fact’ era for communications about science is one we are now struggling with, to think that we may have already lost the debate about vaccines and climate control in Ireland and other jurisdictions is terrifying. The priorities we have for next year means we simply can’t afford to have a situation where we are not communicating effectively about the sharing of clinical information.

The first speaker was Deborah Blum from the Knight Science Journalism Program at MIT. Deborah spoke about the role journalism can take in the communication of science. She spoke about the importance of trust in all communications  and explained that “the story of science is the story of people”, the story of people trying to understand the world around them and as such should be personalised, this is very similar to how we are now trying to communicate the messages of digital health in Ireland.

Deborah was passionate about the fact that as scientists, if there is someone standing on the street saying they don’t believe you how it’s up to scientists to find new ways, to provide them with facts and wisdom that can help them understand the situation in more detail. However, times, attitudes and protocol have changed and this needs to be recognised by all involved in communications. Nowadays if you are telling a story or writing an article on something and people do not believe or agree with you, then you need to recognise that you are opening yourself up in the digital world to these people and this can be a lot of people who don’t believe or agree you! It’s so important to “have some spine” when these issues matter, its imperative that you keep moving forward with your story, keep adding to the story to enable more people can be reached and maybe understand the story in a different way, at the same time always keeping the same message at the core.

Brian Sheehan who was one of the panellists on “The challenge of changing minds” panel quoted journalist Ursula Halligan “Our lives begin to end the day we become silent about things that matter” on the importance of being strong and true to your convictions. But having “some spine” is not always enough, you need to have support, to be part of a community that supports all in trying to bring the science and technology agenda to the public eye supporting that open dialogue around the benefits and challenges to the topic. eHealth Ireland have been working on building this community both on the ground and digitally, bringing  together people who have the same dedication to creating a digital fabric in Ireland, working towards building a better health service.

Science journalism in the age of denial was a phrase used a great deal over the day. Imagine communicating the benefits of digital in the same way as we are now learning to communicate science, how wonderful would that be to have engaged, informed views enabling education and informing direction.

A frightening but true point brought up was that “facts don’t exist or matter anymore”, the US election was run without science even featuring in any of the debates or any of the campaigns, and certainly even the small coverage it got during the period of time ended up being based on cherry picked soundbites that could be weaved to a specific agenda. If this is the case for the US election how can eHealth Ireland attempt to get the concepts of record sharing into the public domain based on the facts it has around the benefits of digital healthcare?

Trust was discussed in every presentation, at every breakout session. Trust is a key driver in communication. A survey quoted suggested that scientists are trusted only 10% more than hairdressers in the UK and teachers the second most trusted profession in the world.

There were in depth conversations around who people trust and why. Within eHealth Ireland we are working together with GP’s to create awareness but this also gives the eHealth Ireland team a nudge, again, to consider how we can build and collaborate with the education system to communicate digital health principles, ethics and guidance to the people of Ireland and whether considering how to do this through the school system could be a good way to target the right messages to the right audiences.

When speaking about  trust we cant forget we have another audience that are around the ‘camp fire’, in those that have walked away and don’t want to engage in the conversation. How do we get this group to re-engage? This group can highlight the concerns that need to be addressed for all! It is after all the involvement in dialogue that creates and builds trust not supplying people with facts, one of the panellists a scientist Viviene Parry rightly pointed out that education alone will not always create trust, people need to be part of a conversation have their views heard and understood before they can listen and embrace other perceptions. Kris de Meyer a research fellow in neuroscience at King’s College London spoke in great detail about how people have entrenched beliefs and two types of thinking processes. The first is intuitive, which is experiential, automatic, non conscious and creative. This interacts with the second which is reasoning which is more analytic, controlled conscious and verbal. He used an interesting metaphor of an elephant and a rider.

 

Intuition is actually the elephant and the rider is the reasoning who is trying to control the elephant and he is blames the elephant for not listening to him, rather than realising the elephant is hearing, feeling and seeing something differently to him. When people are confronted with tricky issues the thoughts that go through their minds are “Can I believe, Must I believe”? There are seventy years of research showing we automatically assign emotions, intentions and character traits to situations. This shows us that we cannot force this decision and any attempts to persuade can to some degree polarize opinion. Michael d Higgins speaks about the importance of “our children – all of our citizens – be encouraged to think critically” not what to think.

This needs to be looked at from a holistic perspective, communication and understanding why we do it is imperative in understanding what people actually hear. Language can make such a difference to fuelling the conversation. Semantics and the horn effect, a cognitive bias influencing whether people view something positively or negatively depending on how it is phrased can really impact the conversations. An example spoken about was the “E” in HSE how it influences peoples perceptions of the organisation, for some can see it makes them think about “executive” rather than the doctors, nurses and health care professionals who are working to build a better health service. Another example is that by putting digital in front of words, can automatically create a negative perception, one where its felt that people will have access to your information instead of looking at the benefits of it being digital and how this can mitigate the risks of it being on paper.

A fascinating piece of research by Dudo and Besley in 2016 showed that scientists say number one reason is to defend science, then inform, excite, build trust and finally to ensure messages are tailored.

Also it is interesting to see that scientists as individuals feel that these reasons are a higher priority than their colleagues. But we really need to involve the public make this a two way  conversation and dialogue, this will enable intrigue to be developed, allow the public to be part of the decision making, part of the science, this is the key route to trust.

Communicating tricky issues is about a social connection with your audience in a personal way. Getting to a level where we have engaged storytelling to informed citizens. Brian Sheehan the General Secretary of the Social Democrat Party in Ireland gave us all some excellent tips that they embraced in the ‘Yes Equality’ civil society campaign for the marriage referendum:

  1. Consolidate your strength work with those who are on your side
  2. Don’t look at your gains as a win but as a benefit from all
  3. Neutralise your opponents, don’t knock others beliefs, be respectful of others views
  4. Make it a national conversation
  5. Embrace social media you can reach a wider audience and build your community

 

The eHealth Ireland communication vision is to build on conversations that will bi directionally impart wisdom, developing from questions and curiosity from interested and engaged participants not on knowledge being pushed. Let’s encourage all involved to explore, investigate, think and imagine a future where they are part of the decisions being made. The reality is if we communicate well we can make big, big differences. One of the speakers spoke about their niece and how she did not want to ‘do’ science. However after visiting a science centre having conversations about science, learning about the different types of science, she is now studying astro-physics and her ambition is to be the first Irish woman on Mars. Wouldn’t that be an amazing place to get to?

Disruption and innovation in the Irish health system, by Richard Corbridge


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