New Technology
New technology in healthcare is kind of a weird thing. On one hand we keep coming up with new technology for diagnostic reasons that cost way too much, and on the other hand, we never get rid of old technology. But let’s talk about telecommunication with patients. A Physicians Practice 2018 Mobile Health Survey of 187 total respondents showed:
- 75.9 percent say they use mobile health (mHealth) in their practice on a weekly basis.
- However, half of the respondents who use mHealth say they only use it 0-5 hours per week.
- More than 22 percent of practices use it 6-10 hours
- While only 27.2 percent of practices use it more than 10 hours.
- Those who are still not using mHealth say the main reason why is because of concerns over HIPAA compliance (31.6 percent), although more than 20 percent say they just don’t have the time.
- Other findings from the survey include:
- Staff Communication (69 percent) is the number one use for mHealth among practices. Patient communication (51.1 percent) is the second most common use.
- Nearly half of the practices using mHealth (48.9 percent) are doing so with the iPhone. A much smaller percentage are using Android phones, iPads, and other tablets.
- Only 14.5 percent of practices are accepting patient data from wearable devices.
A few observations that I see is that HIPAA still impedes us terribly. I use AtlasMD and the communication via email and texting is awesome and all captured on the chart. My second thought of the above information is that the doctor-patient communication is so slow and bogged down via portals that it never gets answered in an appropriate time. Also, in a system where doctors are not getting paid for these communications there really is no incentive to do things via email or texting. The Direct Primary Care model takes care of this hurdle.
The biggest joke in healthcare today is that we are the ONLY profession that still uses pagers and faxes. C’mon. Really? We are stuck in the early 90s on this. Getting information, for example, from other hospitals goes from an EMR to paper to fax to paper to a scan and then into another EMR. Are you kidding me?
We can do better.
Beepers are great. I’d rather page someone and know it’s rude not to wait by the phone for a brief time and they know it’s more efficient to call promptly. With cell phones I leave a voice mail that will take them a while to listen to and not know if they decided it’s something they don’t want to respond to or if me telling them I’m getting in my car in 20 minutes for 15 minutes is too onerous for them to work around. Should I leave patient identifying data so they can check their computer first, or will they decide that’s too much work and never call? Do I leave my office number because they’ll call soon while I’m seeing patients and my MA will interupt me, or my cell knowing the office phones will be closed for lunch in an hour, and then have to carry it into every patient encounter and answer sales calls all day? And sometimes my iPhone just doesn’t ring, and a voice mail comes in hours later. Now when I take a half day for desk and paperwork and make a few calls, everyone calls back at the same time hours later, or not at all. Even direct lines for physicians to call at businesses that want our business seem to think phone tag is just fine.
I respectfully disagree with RSW. Faxes are the worst. Confidential medical information can be seen by anyone passing by. That is, if the fax is not illegible, or busy, or out of paper. And the time lag in the process described by Doug can be extreme.
Technology is an instrument, a means to do things. It has been continuously revolutionizing medicine along with clinical knowledge. Technology, in medicine, is like the sea for the fish. You don’t have to patronize a fish to swim in the ocean, if it’s appropriate for the fish. You don’t have to patronize doctors to have them use technology.
Technology must answer one simple question – “How does this REDUCE the amount of time spent on low-value things?” Laparoscopy has replaced open surgery, as it makes for smaller procedures and quicker recovery. Those are intrinsic goals of the surgeon. Laparoscopic equipment allows the surgeon more rapid satisfaction of her/his goals.
The EMR is not good technology. It is a thing that can do a thing, IF THE HUMAN CONFORMS TO THE NEEDS OF THE MACHINE. That is a very bad thing to have happen. It’s not up to the laparoscope to tell the surgeon what to do. If the freshwater trout would only conform to its release into the salty ocean, it would not die immediately. If the machine insists upon doing the undoable, nothing will be done. Finding blame is irrelevant.
Nope.
E-mails and texts are a terrible way to communicate about anything of importance, prone to typos, omissions, misinterpretations, etc. For anything more complicated than confirming the time of an appointment, they’re inadequate and dangerous. And I sure don’t want those becoming part of the patient’s permanent medical record. The push to use them is entirely about convenience, not better medical care.
A phone line, a fax, and a well-trained staff work just great.