A Q&A with Digital Health and Social Media Innovator Wendy Sue Swanson, MD

9.05.19
By Candace Stuart, Director, Communications & Public Relations

CHIME19 keynote speaker Wendy Sue Swanson, MD, is founder and chief of digital innovation at Seattle Children’s Hospital, author of Mama Doc Medicine, a practicing pediatrician, blogger and a spokesperson for the American Academy of Pediatrics. Her innovations in digital health include digitizing complex medical curriculum, creating the hospital’s first Alexa skill, piloting technologies at Seattle Children’s and creating two apps.

She took a break from her busy schedule to talk about digital health, how health IT executives can help maximize innovations to better serve patients and their families, and her career path in this Q&A. This has been edited for brevity.

Q: Digital health is kind of a buzzword right now. For you, what does digital health mean?

A: One of the biggest problems is digital health means something different to everybody. I take an approach that digital health is the work and focus to use evolving technology to connect patients and families more efficiently with their data and each other and resources that they need and want. There are others who look at digital health and would say everything under the umbrella; that would even include machine learning, AI, robotics, information technology at large, consumer-facing or front-of-the-house technologies, virtual medicine and telehealth.

Unfortunately, at this time digital health has lost power in terms of terminology and so individual organizations sometimes will have to find what digital health means to them. However banal that sounds, I think that is a very important first step when funding or putting someone in place in digital health in an organization at the executive level (to define) what they believe it is and what they want it to be in their organization so there is no confusion about that.

I look at it from a patient- and family-centric view as a physician and technologist myself.  I can order groceries online in an app and have them delivered in a couple of hours. That could include an over-the-counter medicine or a book. This morning I sat at my kitchen and helped my children determine if they wore a coat or not by asking Alexa what the weather was today where I live. Those kinds of conveniences in some ways are being translated into healthcare delivery, research and the patient and family journey through an organization. That to me is the essence of digital health.

My own experience at Seattle Children’s for more than a decade and guiding digital health after founding our department in 2013 have shown me that even in our organization it is hard to get a unified, crystal clear understanding of what is digital health. And frankly, what is digital health today in some ways will be somewhat different a year from now because of digital technology and consumer trends.

My expertise is in communication strategies using digital technologies to build efficiencies and affordability into healthcare moving forward. That is primarily thinking about the patient, while simultaneously thinking about what I like to call dual centricity, thinking about the workforce. Building funding and executing a digital health strategy or pilot or solution has to maintain that dual centricity approach. When you are designing it you better be checking the boxes that improve the patient and family experience and/or quality of care. Simultaneously, you better be checking off the box that potentially will make it easier, more efficient or a higher quality for your physicians and staff to do their jobs, too. If you are not checking both of those boxes simultaneously, you shouldn’t be doing it.

Q: What can health IT executives do right now to help you achieve the goals you are talking about?

Think strategically in their own organization with their own code of ethics, what is the difference between digital health and IT? Is there a difference? If there is a difference in their mind, making sure their organizations understand that difference and appropriately create structure around the differences or similarities.

One of the most important takeaways if you have a chief of digital is they need an elegant and really good working relationship with the CIO. They need to share a vision for digital health. That doesn’t mean in my mind that digital health has to live in the IT department. They certainly need to be integrated deeply into IT departments because IT and data management, from the data warehouse to the electronic health record, all the information that has to be integrated is owned by those people.

If digital health means a patient- and family-centered solution for anything, if it is for the patient journey, if it is for the patient experience, if it is for scheduling, if it is for education and information sharing, if it is for the organization of an AI tool to improve angiography or mammography or whatever it is, it is going to need to be integrated longstanding into the ecosystem of information technology. That partnership has to be there.

I believe there is a distinction between information technology and digital health. As one example, when I stood it up our department, I stood it up reporting to the chief medical officer, not to the CIO. That was very intentional and was designed after working with my CIO on that. I want this to be an inventive and innovative space that is about the transformation of care delivery, not just about technology and data.

Q: How did your career evolve to position you for your role as the chief of digital innovation?

Really organically. I entered the technology space as a communicator and a physician. When I started the Seattle Mama Doc blog, it was the first physician-authored blog for a hospital in the country in 2009, it was because of my concern around the vaccine science and safety not carrying a voice online. I went to the hospital and said, “You need a blog. We need something that is kind of mom-to-mom but is pediatrician funded and good enough and credible enough to live on a hospital website.” I could put shingles on the internet but that is not the way forward; healthcare organizations need to start thinking about how information sharing is changing. Parents spend more time online than ever before. You have to take the physician’s voice to the home and social media is one of those ways.

When I founded the department of digital health at Seattle Children’s in 2013, it was to say, “Hey, the mama blog isn’t my end game here.” What we need to do is perforate the hospital walls a bit and let emerging technologies and startup companies use the hospital to get quality and safety data to evolve their technologies, but also recognize that these outsiders are shaping and changing the way healthcare delivery is happening – create a spirit of innovation.

The most recent one is in the Alexa space. We built a skill in Alexa called flu doctor. It is about advocating and advancing immunization communication, but we put them in our waiting room walls. Just that dinky little attempt of using an Alexa skill helped nudge the organization along to understand our journey. It can look small, but the learning can be great for an organization in digital health.

Who in your organization is nudging you, pushing you and exceeding comfort? No one said at the executive level, “We need an Alexa skill.” I said as an executive, we have to try this. And (by) trying it in a safe way that doesn’t put our patients and their families at risk, we are going to grow digital innovation capacity and we will do it at a low cost. We have to do it because it brings the organization along. Even having the conversation: Are we comfortable having Alexa sit in the waiting room of our hospital? Why are we comfortable or why are we not? What does that mean? If 40 million U.S. households now have these smart speakers in their homes, that is relevant. That is a significant portion of our population.

Digital health is so new. Information technology isn’t and yet there is so much new, innovation work in information technology. Simultaneously, digital health is new and will continually be new, particularly as it remains the kind of sexy word without a crisp universalized definition. We get to keep shaping that.