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December 17, 2010

Trusting Relationships with Technology and Its Importance in Healthcare

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Bobby Gladd recently pointed out this interesting YouTube video of Dr. Joseph Kvedar speaking at the 2010 Connected Health Symposium. In the video Dr. Kvedar makes some interesting observations about humans and their relationships with devices and how that applies in healthcare. He calls it emotional automation. Check out the video if you have a few minutes.

I find this concept really intriguing. At a very practical level (since my heart is very practical), I couldn’t help but draw the parallel from what Joseph Kvedar said and the idea of the online doctor’s visit. There’s so many reasons that this should be successful and so many situations where an in person visit doesn’t matter.

I’ll share a quick personal experience. Being around doctors and working with doctors as much as I do, I’ve had occasion where I was feeling sick and didn’t have the time to go and see my regular doctor. In one instance, I was leaving for Hawaii the next morning and it was 4 PM the day before. Basically, no time to get to my doctor.

As it so happened, I was in the office of a doctor that I worked with. I mentioned the issue and told him my symptoms. He then asked if I wanted him to write me a script. I was a bit taken a back by the request. I certainly wanted his help, but shouldn’t we have gone in and done the routine. You know the routine. The one where the doctor listens to your breathing and heart (or whatever they’re really listening to). Feels around your neck. Looks in your mouth and ears.

Instead, this doctor went straight to the script. Turns out I’ve since learned that in many cases that doctor routine just isn’t really needed. In fact, many times it’s just done for the sake of the patient and not part of the diagnosis at all. Oh the dirty little secrets of healthcare. If you’re a doctor you already know all about this I’m sure. And certainly I’m not advocating removing the patient visit all together. Just in many cases it’s just not needed.

Of course, my point isn’t necessarily advocating a certain treatment method of not. I’m not a doctor and I don’t claim to be. I’m just sharing what I’ve heard other doctors say. What I am suggesting is that for this change to happen, there’s going to have to be a change of mentality by the patient as much as the doctor.

Dr. Kvedar describes well in the video above that we’re capable of relationships with technology. We can change our behavior and adapt to these types of changes. It will just need the right amount of education and technology to make it happen. I know some EMR vendors have patient portals, but I haven’t seen many that have dove in head first to the online visit model. Probably because the reimbursement model for online visits is still lagging behind.

Lots of really interesting things to chew on in this discussion. I’ve really just begun the conversation. I have a feeling the comments on this post are going to be intense.

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    4 responses to "Trusting Relationships with Technology and Its Importance in Healthcare"

    1. # Brian commented on December 17th, 2010:

      What you didn’t realize about your non-visit is that the doctor performed an exam of most of your organ systems: he watched you walk (gives tons of information about your neurologic status), listened to your voice, watched your respiratory rate, assessed your ability to concentrate and describe your symptoms, recognized any deviations from your usual demeanor and psychiatric stability, and observed your skin for any sign of diaphoresis or pallor. Voila, a level 3 exam without touching the patient.

    2. # John commented on December 17th, 2010:

      Good point Brian.

      I also forgot to mention in the post how something like Skype, FaceTime or other online video option could offer a lot of what you describe too. All from the comfort of my home.

    3. # Mike Koriwchak commented on December 20th, 2010:

      Brian nailed it. Right on the money.

      The other part to consider is that you already had a personal, face-to-face, nontechnological relationship with that physician. It wasn’t a doctor-patient relationship per se but it substituted well.

      I think the online concept would function well as a multiplier/extender for a doctor-patient relationship that already exists. I don’t think (at least for the next 10 years or so) that it can fully substitute.

    4. # John commented on December 20th, 2010:

      Mike,
      I agree that having a relationship with the doctor is a valuable thing to from both perspectives. I also agree that it won’t be a full substitute (I’d say at least 20 years and maybe more).

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