The digital revolution of health care – how to change the role of doctors
The numerous and promising digital/technological solutions in health care – whether e-health, m-health or other digital/medico/technological solutions – challenge in several ways, e.g. 1) implementation, 2) culture and 3) role of doctors – and their tasks – and other health care professionals.
How do we engage doctors in the use of approved digital/technological solutions when the perspective is “less work/tasks for doctors” and “all the common thing you do today as a Doc may be solved by others (other health care professionals assisted by digital solutions) in the future?” – how can we make doctors adapt to and engage in “the future digital era”?
Participant comments on The digital revolution of health care – how to change the role of doctors
Doctors, or at least this doctor, want to spend more time interacting with patients, talking to them, examining them, making a diagnosis, establishing a course of treatment – instead of entering information into a computer. Doctors will embrace technology if it helps them do their desired tasks better or more effectively, and they will resist when technology takes them further away from the patient.
Camilla, great questions regarding healthcare´s digital transformation.
It is my belief that doctors might be reluctant to embrace the power of digital transformation due to the lack of a comprehensive and robust strategic and cultural roadmap supporting these technologies.
Most hospitals are delivering a fragmented and siloed technology that fails to add value to patients; costs keep rising, value is not achieved. Moreover, healthcare´s heavy regulation has traditionally acted as an impediment to disrutive innovation within the sector.
Integrating these technologies in the hospital´s overall strategy, explaining how digital transformation will create value by reducing costs and improving clinical outcomes, devising a gradual implementation scheme are just some factors that might help.
The problem is that physicians don’t trust the assumption of “less work/tasks for doctors”. The whole digital revolution so far has increased workload. Many physicians complain on using EMR systems. They have less time to interact with patients and treat them and are spending much time typing data into a computer or reporting in what ever way. Furthermore, reimbursement systems (at least in the Netherlands) do not pay for patient contacts via e-mail, patient-portals, apps or whatever new solution with which you could keep a patient out of hospital.
Last but not least and there I agree fully with Pelayo, in our hospital (and we are not an exception) we seems to lack an overarching mission and strategy how we want to communicatie with our patients and how we want to deliver how healthcare using modern digital options. I strongly believe that a shared vision will help people to embrace new technologies.
Apart from creating a strong culture in the hospital around these techniques, it is of importance to create an incubator for young HCP to play around with new ideas/innovations and provide some small funds to try out good ideas
There is more data…Big Data…as they say. The issue I currently see is that we are generating so much data that has little to no bearing on patients, practice growth, or quality. Taking a look at the typical EMR in the US, data is shared electronically between physicians 15% of the time. Data is still being exchanged verbally and even “faxed” between Drs. most often. The reason I believe, is that the systems are data capture machines and not useful for communication. Until that changes, we will be generating “big data” that is not particularly useful to is or our patients.
Digital health-care revolution, will create winners and losers. This is because three groups are fighting a war for control of the health-care value chain. One group comprises, traditional innovator, pharmaceutical firms, hospitals and medical technology. The threat to the traditional innovators is that as medical records are digitized and new kinds of patient data arrive from difference sources and social media, insurers and governments can get much better insight into which treatments work.
For example an app or a wearable device that persuades people to walk a certain distance every day would be far cheaper for insurers and governments to provide than years of visits to doctors, hospitals and drugs. More data will not only identify those drugs that do not work, but will also give rise to new services that might involve taking no drugs at all and eliminate visits to the doctors.
The big question that all us should ask is who will be the big loser, the drug companies, the hospitals or the doctors? And what impact will this have to the role of doctors in the healthcare value chain?
Obviously, the EMR has been one of the biggest dissatisfiers for physicians due to frustrating systems and time spent away from engaging with the patient. Now that EMRs are the given, if we focus on tech solutions that will enhance the efficiency of physician and add to engagement rather than detract. I think at this point doctors are hungry for great tech solutions as opposed to our initial bad experiences with EMRs.
Very interesting topic. Technology hasn’t yet solved many of the problems in the existing system. Unless the system changes, health care professionals will have issue adopting/deploying the full potential of technology in health delivery. Arcane regulatory, billing requirements and lack of system thinking has stymied the deployment of technology and improvement in health care.
I think above all use, for technology to be successful in hospital settings and even adjacent settings of care delivery, the providers need to be engaged in the development/implementation of the solutions itself. Even though it does take time away from caring for/spending face time with patients in the short-term, in the long run it means that products are being developed with the stakeholder themselves. I think this can be done successfully both with internal innovation hubs, as well as with third party vendors who have appropriately engaged physicians champions and included them in R&D process to make sure a solution is created that is truly trying to address a problem at hand. However to date, most frustrations come from turnkey solutions being handed down from administration which can cause frustration and confusion as to who/what/how a technology is supposed to address.
Technology needs to improve workflow, work efficiency, reduce error, improve safety and patient/physician experience. Sadly most technology used in hospital have not been able to do that. Hospital IT and EMR are very expensive, and often not developed or implemented to solve these issues holistically. My personal suspicion in that the IT specialist and people in the hospital who end up using these systems are not always speaking the same language and the users are not always appropriately engaged or consulted during development phase. And when implemented, the systems are too inflexible or too expansive to make tweaks and adjustments.
Tough issue. If there are some low hanging fruit, you should use and emphasize them. For example tele-medicine makes the life of psychiatrists much easier, and they will adopt it. Digital solutions that engage patient more in his treatment can make the appointments easier for the doctors. When a new system is built, in optimal case you should be able to take something away. Doctors will adopt it if the total count of clicks goes down. Of cource most of the steps “in the way to digital era” dont have these elements…
Good comments – thanks to everyone; I agree a whole lot especially with the lack of strategy and roadmap to support the way we choose the different digital end electronic solutions and how to implement them so HCP acknowledge them and see them as advantages. And the importance of a reimbursement system that actually support new technologies and new ways of working.
As healthcare moves to a new digital era the role of doctors as true care providers will be significantly enhanced, provided they embrace technology.
There are a small group that are apprehensive, but that is more because of poor education or fear of being replace by a robot some day !
Doctors need to be taught how to embrace the benefits of mhealh/ ehealth/ tele-medicine by what ever name it is called.
Ultimately the goals of digital health are no different from the doctors own goals i.e improve outcomes, lower the cost of care, improve patient access, improve patient experience, improve physician productivity, expand doctor reach, enable better work-life balance for doctors etc.
Training doctors to embrace the new technology is important, for ensuring their buy in.
In any IT /EMR/ tele-medicine implementation, it is also important to make sure that the doctor is not reduced to a data entry operator and seen wasting time hammering away at a key board, but his knowledge and time should be spent “facing” /treating the patient.
I think one of the biggest barriers of many physicians adopting more technology, myself included, is that it hasn’t been able to improve workflow and in many cases it is slowing things down. In many ways this will end up being one of 2 paths; a forced discontent while waiting for a generational change of normalcy or in some cases we see institutions working to customize the technology more (even though a higher up front cost may take place) allowing the individuals to employ the technology effectively and more likely to adopt additional changes.
Camilla from what I hear this is a global issue. Most of the time doctors don’t have the willingness of “wasting their time” with technology even when it’s for the better of the organization or the patient. I agree with Pelayo and I stick to one point he mentioned, work close to the doctors and show them the benefits of that technology implementation. Even if in the beginning it might bring more work for them, after a while it will become natural and the outcomes for the patient will be better and clear.