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As Healthcare Providers, Technology is Our Friend (not a misprint)

February 19, 2018

Ask medical school applicants why they wish to enter the arduous 7+ year training process that it takes to become a physician and virtually all will have the following admixed in their answer: “Because I want to help people.”  The cynics among us will snicker, thinking that’s a canned answer lacking sincerity.  I disagree.  Most medical students I meet are sincere about their professional choice and want to do good.

Luke Fildes, “The Doctor”, 1891

In fact, a painting by the artist Fildes, from the late 1800s, depicts the purity of the patient doctor relationship. The patient in the painting, a child, will most likely die. But you see the doctor, at her bedside, at the family’s home, providing whatever care, comfort and compassion he could.

Fast forward to today. If you ask individuals finishing residency training and applying for their first jobs as attending physicians about their motivations, you’ll find that their answer will likely not be about helping people.  There are many reasons for this predictable change. In the last few years, frustration with electronic medical records has risen to the top of the list.  Most doctors quickly generalize these frustrations to include other technologies in the care delivery process.  That makes it tough for those of us making the case that technology can play an important role in improving care delivery.

I was privileged to speak at TEDx BeaconStreet this past fall, and chose to talk about this dilemma.  Many of the concepts in that talk are also covered in my recent book, The New Mobile Age: How Technology Will Extend the Healthspan and Optimize the Lifespan.

As healthcare providers, we’ve lost our way when it comes to the power of caring.  For more than 20 years, we’ve known that there is a positive correlation between a caring doctor/patient relationship and improved health outcomes.  Yet, for providers, today’s healthcare model creates unhappiness and frustration, forcing us to spend time on data entry, dealing with reimbursement issues and other mundane tasks instead of focusing our attention on caring for our patients.  And as our schedules come under more and more pressure, we will spend the allotted 7-10 minutes per office visit just skimming over each patient’s health problems, like a rock skipping on top of a body of water. All this is being compounded by the fact that, as our population ages — the older we get the more healthcare we need — we will run out of healthcare providers and caregivers.

What time is left to care, you ask?

Enter technology, in particular artificial intelligence (AI).  I was inspired a year ago when I read an article in the Harvard Business Review (February 2017) by Megan Beck and Barry Libert.  The title, ‘The Rise of AI Makes Emotional Intelligence More Important,’ gives you a hint at why.  They wrote about how the rise of AI makes emotional intelligence more important.  Most knowledge workers do a few things repeatedly – gather data, analyze, formulate a plan and execute that plan.  I immediately saw a parallel to the world of doctoring:  gather data = medical history and physical exam; analyze = devise a differential diagnosis; formulate = create a care plan; and execute that plan.  Beck and Libert point out that with the minimally sophisticated AI we have today, computers can do most of this work more effectively than people.  Yet, we pay little attention to the human side of care delivery that relies on those emotional intelligence traits that only humans and not machines possess — including caring, judgment and attention to quality. Likewise, I think care providers are underutilizing technology and continually trying to prove that our patients are better off if these routine tasks are done by humans.

Our traditional model of one-to-one care delivery is simply not an option, considering that, by 2020, for the first time in history, we’ll have more people over 65 than under 5.  That trend is projected to continue such that, by 2050, twice as many people will be over 65 as under 5.

The stark reality is, soon we won’t have enough healthcare providers to sufficiently care for our citizens.

We must adopt the use of technology to create one-to-many care delivery models, rather than the more traditional one-to-one model that is already overburdened. This is critical to bridging the gap between the growing number of patients and the diminishing number of care providers. I call this kind of delivery model connected health.

Healthcare professionals need to look for opportunities to outsource routine tasks to machines, not be afraid to do so, and appreciate the value of caring and human connection, judgment and attention to quality. We must develop these technologies to enhance and support the human interaction between a healthcare provider and patient.  If we do this, I believe we would improve care and satisfaction levels of both providers and patients.

Other service providers have done this.  Companies like Uber, Amazon and even the banking industry have integrated their digital and in-person experiences. In the case of Uber, for example, the service is delivered in person by a human, but the surrounding experience is made incredibly more pleasurable, convenient and efficient for the consumer and the driver by the use of technology.

We all need to work together to get this right — to use technology to create one-to-many care models that recognize the value of human bonding in the care process. Most healthcare providers went into the field because of their desire to care for patients.  The paradox is that, in order to free up time to do this, we must embrace technology and outsource routine tasks.

Moving from one-to-one care delivery to one-to-many will allow healthcare providers need to get back to caring for our patients.  Technology is our friend in this transition.

12 Comments leave one →
  1. February 21, 2018 4:06 pm

    Well said. You can only mitigate this issue only so much with mid-level providers and scribes.

    Opportunity 1: Minor care: Shift the traditional one-to-one synchronous care model into a one to many asynchronous care (virtual care) model for minor problems. If your smart IT solution performs the history, and identifies minor problems, you can end with mid-level provider decision makers and spare the physician.

    Opportunity 2: Not Minor Care: using the same smart system, shift the burden of data collection on to lower level players (MA, LPN), allowing the provider to double down on decision making and care planning, thus enhancing throughput.

    This smart system needs to be operational in nurse call centers, ED’s, UC’s, and the office. All of these care venues can donate to what will be an impressive number of virtual care opportunities.

    This smart system should have an API that allows the history to be delivered by a chat bot or Alexa device.

    This smart system needs to be able to assess with competence more than sore throat, runny nose, and an earache. We need to handle hundreds of chief complaints to be effective.

    Great blog doc!

  2. February 21, 2018 6:08 pm

    very well stated

  3. February 21, 2018 7:54 pm
  4. Kimberlee Williams permalink
    February 25, 2018 2:31 pm

    Very good point, although many would and most definitely will argue that this kind of “leap” will take jobs away. I think that the one-on-one aspect is something we all are longing for. The 5 to 10 mins is just not enough. Would this sleep things up in waiting time? I think that more people are fustrated with the wait time then anything. That’s time we can’t get back!

  5. February 25, 2018 4:05 pm

    ideally, yes. for our lifetimes, though, there will always be some unpredictability in scheduling.

  6. February 25, 2018 6:53 pm

    I don’t see any provider losing their job. However, I do see them re-inventing their job to serve the changing demographic more effectively.

    Having nursing staff supplement our medical histories with additional information will only make us more effective diagnosticians. Moreover, this data collection (and triage sorting) step takes only 3-5 minutes! Seems like we should be able to fit this in to the 1+ hour wait most patients have anyway…. Knowing who is the sickest at any moment in time in the ED of the office is just plain good medicine!

    No provider is handicapped by too much information. Our greatest enemy is making medical decisions with incomplete information, or anchoring bias as the ED or office becomes swamped.

    The irreplaceable part of our (Providers) job right now is complex medical decision making and humanism. Nobody is standing behind us to do this. We are it. No AI system can do this right now and likely will not be ready for prime time for many years. We need new workflows (and IT) that play to our strength. This approach will deliver better care, more efficient care, and higher patient satisfaction.

    Dr. Kvedar has appropriately called attention to this.

    • February 25, 2018 8:15 pm

      thank you for your insightful comments

    • April 30, 2018 11:02 pm

      Regarding the medical decision making and humanism, I was curious how you thought disease guidelines and health system decision trees have assisted in this capacity or perhaps not? If you are interested in healthcare/Pharma posts, would love to hear your thoughts on my blog: blog.mylithe.com

  7. February 27, 2018 4:07 pm

    What a wonderful blog, I agree with you 100%. I’m a firm believer that the only way to move forward with technology and healthcare is to innovate and adapt. I’ve written several blogs about the topic on my website if you would like to glance at them. https://jonbelsher.wordpress.com/blog/

Trackbacks

  1. As Healthcare Providers, Technology is Our Friend | MassTLC
  2. Is talking to software the next big step in healthcare delivery? | The cHealth Blog

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