While disappointed HIMSS was cancelled, we all certainly understand and appreciate the thought process that went into it. There are many tough decisions being made at the moment, in order to keep as many people safe as possible. One result of these efforts will be a cultural shift to how we approach various services that are traditionally delivered in person, which does present both challenges and opportunities, especially in the healthcare space.
Ahead of the conference, I was especially looking forward to attending some of the sessions around AI and Machine Learning. The possibilities for Artificial Intelligence in healthcare are myriad: everything from assisting in diagnosis of rare diseases to reading of x-rays for cancer detection. An article in Forbes from February 2019 stated that investment in healthcare AI is expected to reach $6.6 billion USD by 2021. That’s a lot of investment, with Accenture predicting $150 billion in annual savings by 2026.
In retrospect though, what I should have been looking at were the tele-health vendors and who is doing what in the tele-medicine space. For instance, as indicated in a recent Washington Post article, Teladoc Health, America’s largest tele-medicine and virtual healthcare provider, saw its video appointments surge 50 percent since around 12th March, and they are increasing the number of staff in anticipation of even more demand.
Far beyond the unique and somewhat unprecedented circumstances in which we find ourselves today, there are many instances in which a patient will already be exhibiting symptoms and need the support of their doctor, but by attending an in-person appointment will be forced to come into contact with other people.
A better alternative is to have a virtual consultation. As a patient, you would be able to see (literally: see) your doctor through their secure web portal or an app on your phone. Totally private, totally secure. Your doctor can then discuss your symptoms with you, see the results from your thermometer, see how you physically look, and discuss your treatment options. And with same day delivery from a number of the large pharmacy chains, you can even get the prescription meds you need delivered right to your door. If you get worse, then your doctor already knows you’re sick and can direct you to the next level of care, including even sending basic tests to your home for you to do yourself.
But it all starts with that one face-to-face conversation, from the safety and security of your own home, with neither the hassle of going to the doctor’s office, nor running the risk of infecting others. And as communicated in a recent MGMA article, tele-health practices can become even more widely used when a patient hears positive reinforcement about it via education from providers, or directly from their doctor.
Yet relatively few people have access to that level of at-home care from their doctor, which is unfortunate given how many applications there are on the market that enable such face-to-face interaction. As expressed in a recent article in The New England Journal of Medicine, even though tele-health isn’t a panacea to issues of health care delivery, it can work well when infrastructure remains intact and clinicians have access to patients.
While tele-health solutions are on the roadmap for many health institutions, healthcare providers feel they are expensive to implement or believe there are security risks to the patient’s privacy when the conversation is not held in the doctor’s office. An additional difficulty occurs around billing insurance for such “visits”. But with the number of applications available on the market today, this level of patient-engagement should be the norm rather than the exception.
Unfortunately, as with any change to traditional processes, investment is often instigated by a strong increase in demand from customers, or in this case patients. The most recent example of this being the recent announcement by the Centers for Medicaid and Medicare Services (CMS) detailing the expansion of tele-health benefits for Medicare beneficiaries in the US, so tele-health solutions could eventually become standard operating procedure from here on out.
So, thinking of that, here is my take on ways that health systems can (and in some instances already do) engage with patients digitally, both to build trust with their patients and deliver the care required in these unprecedented times:
- Real-time chat with a nurse, available 24 hours a day, to determine if you need to go to Urgent Care or the ER. The chat with the nurse could even be facilitated by an AI-driven chatbot that prompts you for your symptoms, including prompting you for information you may not have thought to gather before calling the doctor (like your current temperature).
- Enabling the capture and recording of patient data from the home. What if the doctor could have your blood pressure, temperature, weight, and other vitals before their conversation with you even began? Depending on your unique circumstances, this may require some initial investment in equipment at home. Wi-Fi and Bluetooth enabled weight scales, blood pressure cuffs, and even thermometers do exist and let you track your data over time. Connecting your device data to sync with a secure app provided by your doctor will give them access to that data in real-time. The benefits of remote monitoring have been documented in this infographic from Maryville University.
- Tele-visits with the doctor. Using the power of video wherever possible, tele-visits allow your doctor to see you and help you determine the best course of action.
Pulling all this together, you have true tele-health. Where you can see the doctor and the doctor can see you. Where the doctor has all your data, before the conversation even begins. For the most urgent and dire cases, of course, you have to get to the hospital, and if this is a directive following a consultation with your GP, files can be shared electronically, and the hospital informed of your arrival.
The road ahead, will highlight how many institutions ramp up their tele-health capabilities as a result of Covid-19, and what changes it will drive in healthcare. One thing is for certain: our healthcare system will change as a result of our current situation. The only question is by how much?