There’s a lot of buzz about the internet, including the fact that a lot of it has been very successful in bringing together healthcare information technology. But this is not what we should be thinking about when we talk about healthcare. There’s so much more to it than that.
There are some very real problems: lack of access to information, lack of trust in doctors and hospitals, lack of access to care, etc. We need to take a hard look at these things and understand what they mean for patients and the healthcare system, before we think about building an internet-based solution to them.
Some of those issues have been well-documented: for example, access to care is often limited by cost; hospitals are increasingly turning to telehealth services instead of doctors; people in rural areas cannot access health services as easily as people in urban areas due to cost; there’s a lot more going on here than just information technology.
The reason I bring up health literacy is because I think that people don’t yet fully grasp the implications of technologies like social media and mobile devices for their ability to self-report medical diagnoses, which can lead them down the wrong path in terms of their health care.
There are many ways that tech can help people improve their health: providing transparency around treatment status (like with digital health records), eliminating unnecessary tests / procedures (like with telemedicine), providing context around medical diagnoses (like with cancer), helping people find information they might otherwise not know (like on social media), etc. Consider all this as part of an overall strategy: if you want patients to learn how they can better manage their own health online – i.e., how they can be better informed – then you have to educate them about all things digital throughout their lives so that eventually, when they come across a problem or choice that could potentially have an impact on them (e.g., getting cancer) – or even if they never find anything at all – then they understand why it matters and how best to deal with it after it happens and what kinds of actions could potentially be taken now in order for it not happen again in the future…
People don’t always understand this themselves — especially younger people — but as time goes on and technology becomes more pervasive within our lives — especially over time – this will become more apparent every day…
Technology in healthcare: Patient-oriented Healthcare
I like to call this the “Shopping Cart Paradigm” in healthcare. The idea is that a patient will be treated with one of several solutions, depending on what they are looking for and whether or not they are willing to spend money to get it.
One example of this is how information technology has transformed the way healthcare is delivered in the U.S. By giving patients a browser that allows them to navigate through online content, patients are now able to shop for doctors, hospitals, and all sorts of other services without having to leave their homes.
From a consumer-directed perspective, this makes sense because most people love shopping online. But when you look at it from an organization-centric perspective, there are some key problems with this approach:
- Patients often have little control over what is being done when they go online
- Doctors often have little control over what resources are being used when patients go online
- Patients and doctors often do not see eye-to-eye on how best to deliver care
- Patients can get lost in endless menus of options and find themselves unable to find care that interests them or fits into their busy lives
- Doctors may prescribe medication based on research that may not be supported by clinical experience or sound clinical reasoning.
The result is a patchwork system where patients have no real choice but to go from doctor A through doctor B until they finally find something that works for them (or if the doctor prescribes medication incorrectly).
Technology in healthcare can solve some of these issues if it provides something for everyone: the ability for anyone who wants healthcare information or wants help finding an appropriate provider should be able to do so easily and quickly – as opposed to having either a doctor or a website decide what’s best for you – which can take days or weeks. And I don’t just mean biosurgery!
Another problem with patient-oriented health care delivery systems is that in many cases, the patient isn’t aware of all the options available (and doesn’t even know who they are). When patients don’t know which physician would be best suited for them, why would they use their insurance company? If insurance companies only wanted money flowing into their coffers because people were paying premiums (meaning no incentive for physicians), then there wouldn’t be any need for payment models such as Medicare/Medicaid/etc., which currently exists under both public and private insurance systems
Technology in healthcare: Consumer-directed
I was recently told by a friend of mine who works for a large consulting firm that most of the C-suite in his firm does not understand what consumer-directed health care is. I think it’s unfortunate. Consumer-directed health care is an emerging trend that has evolved from the concept of a patient-centric healthcare system to one where the focus is on providing value to the consumer in terms of their health and wellness. It’s also relevant because it’s available to anyone regardless of income bracket.
Consumer-directed means, first and foremost, that people have the right to be informed and educated about their overall health status, as well as their current physical condition. They have access to personal health coaches and personal physicians within organizations such as my own company. When you’re shopping for a new car or buying any other type of product, you don’t just want someone telling you what features or different models are available. You want to know why they would buy this car over another one and how much risk they would take with it based on their experience with previous vehicles, obstacles they had previously encountered with those cars or people whom they were dealing with in those cars, etc… You want to be able to do all that without being put on hold for hours (and sometimes days) just so your salesperson can explain why it’s better than your neighbor’s car or why he thinks it’s better than yours as well — all without having been put through any sort of marketing pitch!
Consumer-directed healthcare addresses this need by providing consumers with information about how their bodies work, what kind of medicines they need, how much time they should spend exercising versus sitting around during the day — all backed up by solid data science research. A good example is The Body Clock Diet , which tracks your sleep patterns and shows you an alarm when you’re starting to nod off while walking around in traffic at 3 AM while still giving you enough energy so that you can make it home after work! Another example is HealthKit , which stores all sorts of information about your daily activity: calories burned , distance covered , steps taken , heart rate , etc… All this information is stored securely on your Apple Watch so no one else has access to it but yourself! This is all part of making yourself healthier — not just for today but for the rest of your life!
Now imagine if everything became like this: if every person had access not only to personal information centers such as Health
Technology in healthcare: Health Literacy
Healthcare has gone through a major transformation. The first thing that comes to mind is the increasing number of people who don’t have insurance coverage, but are insured. In the past, it was more common to see patients with chronic illnesses being treated in hospitals by doctors and nurses who had extensive medical training, both in terms of understanding the patient’s condition and in terms of treating that condition effectively. Now, I think we can all agree that healthcare is highly personalized. We know that our bodies are constantly evolving. We know that even healthy body parts can become diseased or damaged over time-we just don’t notice it until it becomes a problem.
In this era of technology and digital health care, we have to ask ourselves:
What do your patients need from you? Do you need to help them learn how to use an iPhone or take their phone with them everywhere they go?
Do you need to introduce them to new technology so they can understand what’s happening when there’s a problem with their car?
Or have an iPhone or iPad app for them?
Or do you need for them to be educated about how their bodies work so they can understand why something is happening within their body?
What do your patients need from you today? This question should be part of every conversation between a doctor and a patient.
Technology in healthcare: Digital Health Care
- Misconception: Healthcare should be a patient-centered process, with patients determining their own treatment. Reality: Healthcare should be patient-directed—with the patient as the decision-making authority.
- Misconception: Everyone has access to a computer or smartphone. Reality: Not everyone has access to a computer or smartphone, and those that do have are almost certainly inundated with spam and irrelevant information daily.
- Misconception: We can create amazing products with just technology. Reality: Those ideas are pretty much impossible to execute, at least at scale.
- Misconception: User interfaces make all the difference between success and failure in digital products and services. Reality: There is no one-size-fits-all interface for digital products and services, and that’s okay!
- Misconception: Digital health care is just another model of healthcare delivery. Reality: Digital health care actually uses many of the same components as traditional healthcare delivery systems but does so in an entirely new way — recognizing that rather than treating any one disease or condition, it’s best to treat patients as individuals who need to be treated for many problems, not all of which are medically relevant for each individual patient.
- Misconception: The idea of personalized medicine is pure science fiction. Reality: It’s actually happening right now!
This is a comprehensive list of topics in healthcare, starting with an introduction and then a set of general questions about the healthcare system.
What are the main issues around health literacy? What do we understand by “health literacy”? How do we measure it? Is there any framework for its measurement? What is the role of the physician and what are its implications for health literacy?
How can we make healthcare more consumer-oriented? Which form(s) of payment do we need to rethink in order to address this challenge, if any at all?
What does it mean to be “patient oriented”, and how can we redesign our healthcare systems so that patients are as well-informed as possible about their own health needs and those of their loved ones, as well as those of their communities and the world around them?
What is meant by patient-centered care? How can we design new models of care (such as data-informed care) that allow us to increase both patient safety and access to affordable care while improving quality and lowering costs? What are some examples of these approaches (such as “shared decision making”)?
How can researchers inform public policy regarding health care costs, financing, access, quality, and outcomes after adjusting for population demographics such as age, gender, race/ethnicity, geographic location (urban vs rural), etc.? What do these adjustments tell us about the potential for cost reduction through better prevention/alternative treatments versus pharmacotherapy/surgery or other treatments (e.g., diet)?
What is meant by “consumer driven health” vs. “white coat medicine” or pathologized medicine(s)? How might consumer driven health practices be improved or changed through technology such as telemedicine and electronic health records (EHRs)? How could EHRs support patients who struggle with accessing needed services due to barriers such as language barriers or lack of computer skills or access to internet connection? What is medical tourism ? For whom would medical tourism be most beneficial — financially or otherwise — since it is usually not only relatively expensive but may also carry some risk along with it? For example: In some cases where adequate diagnosis/treatment cannot be obtained outside the United States because physicians cannot obtain necessary licensure there; in cases where insurance companies refuse coverage; in cases where pharmaceutical companies refuse to sell generics in certain countries due to price discrimination; in cases where a patient’s
Ogan talked about the Healthcare paradigms, and how in 20 years we’ve moved from a sick-care system to an evidence-based system where prevention has become more important.This is the paradigm that created the environment for what he calls consumer centric medicine, where people become the owners of their health and healthcare, and act as active participants in their own care.”
Watch Episode #52 of Digital Health & Wearables Series