09AprilINT

Sparking ehealth innovations

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Interview with Dr. Richard Scott
By Jennifer Cordeiro

“One of the things that attracted me to eHealth was that it’s a puzzle. But it’s a puzzle with some problems,” notes Dr. Richard Scott, Associate Professor in the Global e-Health Research and Training Program of the Health Innovation and Information Technology Centre (HiiTeC) at University of Calgary.

“If you think about a typical jigsaw puzzle that you put together, we always cheat. We have the full picture, so we know what it is supposed to look like; we have the edge pieces so we know what the edges are of the entity that we are trying to put together; we recognize patterns that make it easier for us to put the pieces together in one particular area; and then and only then do we struggle to put the pieces together in the middle. So we have a strategy, if you will, by which we go about putting together a jigsaw puzzle.

The problem is that we have only a few pieces of what we call ‘eHealth’. We have no ideas of what the final picture is supposed to look like; we have no edge pieces – we don’t even know where the edges are– and so we are very much struggling to try to put this puzzle together as we go, and that is both one of the most fascinating and most infuriating aspects of eHealth.”

Although Richard may have “unwittingly slipped” into eHealth (“It picked me!” he claims), his passion and interest in helping put this puzzle together is evident, “I was lucky enough to become a Fulbright New Century Scholar in 2001 and that exposed me to a group of thirty investigators from around the world who were interested in the topic “health in a borderless world”. And that was very profound to me because eHealth very much has created a borderless world. We have created something with no boundaries.” As a result of this work, Richard says his eyes – and heart – were opened to the needs and inequity that exists globally. Work with the developing world has become his passion. “I am able to contribute my expertise in a whole variety of areas in a whole variety of countries and I sincerely hope my involvement is in actual fact having an impact on how they view eHealth, how they approach it and how they implement the many solutions that are possible.”

While he may now have taken on the role of global eHealth ambassador, his academic and professional career path to this point has been a meandering among various paths of interest underlined by his fundamental desire to work in healthcare. Richard started his professional career in England working as a medical laboratory technologist. And, while working under his mentor at the time, Robin Wood, was advised to “get out and do something interesting”. Taking the advice to heart, Richard joined the Royal Navy and became a Commando helicopter pilot for three years. After finishing his service and still trying to figure out what to do with his life, he tried his hand at selling cars and encyclopedias before realizing he “couldn’t sell igloos to Eskimos.” Still interested in healthcare, and more specifically toxicology, he went back to school and entered a biological sciences program. Graduating with a First Class Honours degree, he was urged into a research career. While originally looking for jobs in the UK, Richard came across an ad in the New Scientist placed by a researcher from the University of Calgary looking for people interested in toxicology. Taking the opportunity, Richard immigrated to Canada with his wife, Moira, and enrolled in the biochemistry program, graduating with a PhD a few years later. Again, faced with a decision point about what to do next, he decided to get back into the medical side of things and entered a clinical chemistry program at the Mayo Medical School in Rochester, Minnesota, staying on as a Special Project Associate to specilaise in clinical and forensic toxicology. After completing his training there, Richard again came back to Canada, this time to New Brunswick, where he found a position that allowed him to practice as a clinical and forensic toxicologist. Happy with the work he was doing, it was not until 13 years later that Richard was introduced to the concept of eHealth when he was offered the role of Director of Research at a large Canadian hospital and asked to design and evaluate four telehealth applications. And while his academic and research focus has mainly been in this area for the past 13 years, Richard has not let go of his toxicology roots. In fact, Richard has combined his interest in toxicology with his passion for eHealth and has been credited with creating the area of environmental eHealth which analyzes the environmental costs and benefits of eHealth (see box below for more information).

As a TEKTIC Steering Committee member, Richard would like to see TEKTIC broaden its sights and expand nationally over the next few years. “The most important thing will be for us as a team, as a collaborative, to find some issues and activities, key collaborative initiatives, where we can each contribute and share our expertise... They need to be important initiatives that are attention and funding grabbing so that we can move forward. TEKTIC needs to become a viable, long-term entity and to achieve that, we need to find a raison d’être that is viewed as important to not only us, but to policy and decision makers and to the public as a whole.”

And, where does Richard see eHealth in the next 20 years? “If I were to be an idealist, what I would like to say is that eHealth would not be a term that we use. We would only find it in history books because all the technology we use that we now term ‘eHealth’ would just be another way of doing business, another way of providing health and healthcare… And, I hope it is not just going to be integrated into the health ‘care’ environment. I hope it is also integrated within the broader health environment. And that includes the general population… We need to understand how we can make health as tasty as McDonalds. We don’t sell health well enough as health professionals, so we need to do a much better job in that regard, and I hope that eHealth will contribute in that sense.”

On the TICr with Richard

First job- Bus boy in British pub.
Hobbies- Reading sci-fi and being outdoors.
Last place travelled- A three week tour of South Africa, Sweden, Luxemburg and United Arab Emirates.
Favorite technological development- Cell phone and text messaging
Three things Richard bring to a deserted island- A radio, a cell phone with an endless battery and paper to write down ideas.

What is environmental eHealth?

Environmental eHealth is a new area of research created by Richard to understand the environmental costs and benefits of eHealth. As Richard notes, “eHealth has both positive and negative impacts on our environment. We need to know how to balance them.” This week, Richard will be at the "e-Health: The Virtual Dimensions of Health and Environment " first annual conference in the United Arab Emirates participating in workshops and presenting two papers: ‘The Potential Impact of e Health on our Environment - Introducing a New and Essential Concept’ and ‘An Example of How e Health Can Reduce Environmental Impact and Concomitantly Improve Health’. Richard is also currently looking for funding to plan an Environmental eHealth workshop that will bring researchers together to define the concept of ‘environmental eHealth’ and start an evidence base for this area. If you are interested in learning more about environmental eHealth or to obtain copies of environmental eHealth papers, please contact Richard at rescott@ucalgary.ca.