Embracing Digital Healthcare: The “See one, Do one, Teach one” Approach
Now that digital healthcare technology is finally getting its due, are we ready for the shift? When talking to my kids I tell them about the pre-internet days of books and journals for school research and as a teenager how I had to use a telephone attached to the wall with a cord that stretched the length of my home. Now flash back to my parents and even grandparents’ age, with their stories of getting home electricity, a home refrigerator, their first television, the excitement of listening to their records and eventually 8 track music players, elder stories that are mind boggling to me so imagine when my children hear those accounts. So in our world of digital knowledge divide, how do we reconcile two year old children being able to turn on an ipad, go to the web and find their favorite website even before they are able to read versus the 95 year old patient being sent home with remote patient monitoring instructions and their new ipad knowing the concept of world wide connectivity and electronics was pure science fiction during their young days? How do we bridge the gap with the in-between Generation X crowd, of which I am a member, that remembers getting my first university email address to communicate with professors, the first time I bypassed the library for my dorm computer room to do research on the web, learning to use dial up AOL internet, and the novelty of using yahoo chat sites to talk to my out of state friends. Those late 1980s, early 1990s young adults, Generation X, comprises the majority of healthcare leaders currently defining the narrative of health delivery and the evidence based guidelines we all follow. How do we ensure health leaders are truly ready to lead the digital health transformation? And, lead in a way that entices all ages to engage?
The simple answer, healthcare leaders need to follow our age old medical training motto of “See one, Do one, Teach one.”
See the technology now available.
After the stress of switching from paper office records to electronic medical records, we need to open our eyes to the gifts of telemedicine, remote patient monitoring (RPM), remote therapeutic monitoring (RTM), artificial intelligence (AI), virtual care check-ins, e-visit interactive patient portals and HIPAA secure text messaging rather than holding a grudge about the previous required shifts in care delivery. Instead of belaboring the good ‘ole days, set the pace for our work partners and patients as an embracer of digital health. Open up to the reality that COVID created a world where face to face care is not always possible. As health leaders, be willing to attend digital health CME and learn about options for improved patient care outcomes, reduced hospital bounce backs, improved patient satisfaction and improved access to care even in underserved areas. Read journal articles about novel virtual care models and how to apply digital health CPT codes and actually get paid for the added remote care services. According to global consulting firm McKinsey and Company, digital health technology with progression to new virtual care models is predicted to grow within the next few years to $250 billion in healthcare dollars spent annually.[1] Accordingly, the journal Insider Intelligence estimates 70.6 million US patients, or 26.2% of the population, will use remote patient monitoring tools by 2025[2], that is, if health leaders embrace the shift to digital healthcare. As leaders of our industry we need to see the options with an open mind and understand digital healthcare is a product of necessity and improvement, not punishment.
Do embrace digital patient care.
Whether implementing online scheduling through your electronic medical record or now incorporating televisits into the day to day practice of medicine, do embrace a full scope of digital health options. Consider embracing remote patient monitoring to capture physiologic health data for chronic care management of diabetes, hypertension, CHF or possibly post-surgical RPM programs to improve patient outcomes, compliance and progression of activity in that critical post-op time period. Learn about artificial intelligence options for clinical decision support or AI over-reading radiology programs ensuring early disease changes are not missed given the frailty of our human eyes. Slow embracers of digital healthcare should willingly add virtual face to face visits and patient portal e-visits with the understanding that these patient interactions are considered dates of service by most insurance carriers and can be used when getting prior authorizations for procedures or imaging. “Required” face to face visits are open to interpretation and now include virtual face to face care in the majority of circumstances. Through telemedicine we can stop relying on location of care and can easily expand our medical reach beyond our traditional neighborhoods. Even the Centers for Medicare and Medicaid Services (CMS) have embraced digital healthcare with a wide array of CPT codes for remote patient monitoring, remote therapeutic monitoring, virtual check-ins and patient portal e-visits that were necessary after COVID-19 and for the moment are able to be reimbursed. With continued lobbying these expansions of telemedicine and digital healthcare will be permanent additions for added care delivery. In a September 2020 study by HIMSS Accelerate Health, a consumer telehealth survey of 2,052 patients showed approximately 40% of the patients have used telehealth at some point in the recent past with no difference among age groups.[3] Patient acceptance of telehealth is driven in large part by physician acceptance. And, physicians’ “previous experience with telemedicine is associated with improved physicians’ confidence in case management, a lower perceived risk of misdiagnosis, an increased ability to provide patients with health education, and a better physician-patient rapport”[4] through the use of digital health platforms. So, do more to embrace digital health and help broaden the landscape of health delivery.
Teach medical partners and patients about digital health options.
In my practice of medicine I saw a great divide of patients embracing digital health technology either being “all in” or “all out” with the in-betweeners relying heavily on family members for all technology interventions like the patient portal, online scheduling and through the covid pandemic the first telemedicine visits. The elderly embracers were at times more savvy than me and inspired me to learn more since my delivery of medicine now included the role of health tech educator. Like most physicians I am adept at faking confidence until it becomes real so in the world of health IT I’ve jumped in feet first, knowing this has always been an area I’ve shied away from both from lack of time and in many respects lack of interest until COVID forced my hand. By seeing digital healthcare options, doing more to implement new virtual models of care and now teaching my colleagues, I am hoping that as one individual I can take steps to lead more patients and healthcare providers to the path of digital transformation- just as all health leaders can take those same steps. Collectively, we can reduce the digital knowledge divide and ensure digital health technology initiatives remain a valuable segment of our care delivery by sharing knowledge, creating a stepwise plan to implement new health technology services and, most importantly, being understanding as medical colleagues and patients embrace the changes at their own pace. Always remembering, small steps are better than no steps.
In summary, as a physician leader we should investigate and incorporate one new digital feature into our day to day practice of medicine. We should utilize our existing EMR to its full capacity and if that EMR vendor doesn’t offer televisit features, HIPAA secure chats and patient portals then consider switching to a platform that does. Also, investigate remote patient monitoring platforms and the varied uses of RPM programs since quality and access of care improves with these initiatives[5]. Patients of all ages are looking for innovation in care and the care providers that are willing to bend to the patients’ needs will be the preferred providers. About 25% of patients in an Amwell 2020 study on physician and consumer beliefs regarding virtual care and the future of telehealth stated they would switch to a new physician to access telehealth.[6] So, now is the time to see the benefits of the digital healthcare transformation, do more to embrace digital health technology and teach our peers and patients about the benefits of new virtual care models. In the coming months follow my blog, Dr. Sojourner’s Truth, for a deeper dive into the new models of virtual care delivery, discussions for reimbursement and necessary digital health documentation, and what steps we as health leaders can take to ensure we are ready to shrink the digital knowledge divide among our peers and patients.
[1] Bestsennyy, Gilbert, Harris and Rost. McKinsey Telehealth: A quarter-trillion-dollar post COVID-19 reality? May 2020.
[2] Dolan S. The technology, devices, and benefits of remote patient monitoring in the healthcare industry. Journal Insider Intelligence (Internet). January, 15, 2022. Available from: https://www.insiderintelligence.com/insights/remote-patient-monitoring-industry-explained/
[3] Havasu R. Consumer Perspectives on Telehealth. November 18, 2020.
[4] Noora Alhajri, Mecit Can Emre Simsekler, Buthaina Alfalasi, Mohamed Alhashmi, Majd AlGhatrif, Nahed Balalaa, Maryam Al Ali, Raghda Almaashari, Shammah Al Memari, Farida Al Hosani, Yousif Al Zaabi, Shereena Almazroui, Hamed Alhashemi, and Ovidiu C Baltatu. Physicians’ Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study. JMIR Med Inform. 2021 Jun; 9(6): e2925.
[5] Vaidya Anuja. RPM 101: What is Remote Patient Monitoring, Its Benefits, and Uses? Xtelligent HEALTHCARE MEDIA. https://mhealthintelligence.com/features/rpm-101-what-is-remote-patient-monitoring-its-benefits-and-uses
[6] Modahl, Kernan, Howard, Buraiyte, Hainer, O’Riordan, Getker. From Virtual Care to Hybrid Care: COVID-19 and the Future of Telehealth: Insights from the 2020 Amwell Physician and Consumer Survey. 2020.