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What’s a Patient?

Posted on May 10, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

For quite a while I’ve been pushing the idea that healthcare needs to move beyond treating patients. Said another way, we need to move beyond just helping people who have health problems which are causing them to complain and move into treating patients that otherwise feel healthy.

Said another way, Wanda Health once told me “The definition of a healthy patient is someone who’s not been studied long enough.”

If you look long enough and hard enough, we all have health issues or we’re at risk for health issues. There’s always something that could be done to help all of us be healthier. That’s a principle that healthcare hasn’t embraced because our reimbursement models are focused on treating a patients’ chief complaint.

In another conversation with NantHealth, they suggested the idea that we should work towards knowing the patient so well that you know the treatment they need before you even physically see the patient.

These two ideas go naturally together and redefine our current definition of patient. In the above context, all of us would be considered patients since I have little doubt that all of us have health issues that could be addressed if we only knew the current state of our health better.

While NantHealth’s taken a number of stock hits lately for overpromising and under delivering, the concept I heard them describe is one that will become a reality. It could be fair to say that their company was too early for such a big vision, but it’s inspiring to think about creating technology and collecting enough data on a patient that you already know how to help the patient before they even come into the office. That would completely change the office visit paradox that we know today.

This is an ambitious vision, but it doesn’t seem like a massive stretch of the imagination either. That’s what makes it so exciting to me. Now imagine trying to do something like this in the previous paper chart world. Yeah, it’s pretty funny to just even think about it. Same goes with what we call clinical decision support today.

When Will Digital Health Concepts Reach the Doctor?

Posted on I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The always insightful Joseph Kvedar, MD, has a great post up where Joe gets a wake-up call from one of his advisors:

“Joe, when are we going to take all of these digital health concepts from the 30,000 foot level and get them into that 10 minute window that the doctor has with the patient?” It is not hyperbole to say that this put the last 20+ years of my career in a whole different perspective.

This is a good wake-up call for all of us in the space. Pushing digital health solutions down to the 10 min window a doctor has with a patient is the nirvana of what we’re doing and is incredibly challenging.

Dr. Kvedar suggested that we’ve already started to do this when he shared an example of how his PCP offered an eVisit option for follow-up to his in-person visit. I think that is a good example, but his insights into the 2nd phase offered a great look into where all of this is headed [emphasis added]:

Phase two will be the integration of tools like remote monitoring of diabetes and blood pressure. This is more tricky. The front-end work of monitoring remotely-derived values is done by either a non-physician clinician or, in some cases, a software algorithm. The doctor gets involved only when there is a complex medical judgment required. When deployed at scale, this approach extends the doctor across many more patients due to the one-to-many nature of the intervention.

Taking the recent interaction with my PCP as an example, remote monitoring would be considered a whole new channel of work, which doesn’t easily fit in to his workflow like an evisit does. It is hard to estimate its value, hard to predict how much impact it will have and hard to envision how to integrate it into clinical practice.

There are some real gems in this quote. My favorite is “The doctor gets involved only when there is a complex medical judgment required.” The future of healthcare IT is going to be built on this concept. When does a doctor need to get involved and when can another staff member or software algorithm address the situation? It will take us at least a decade or more to figure out this balance. Not to mention the workflow that will make sense.