Category: Healthcare Innovation

Digital Health and Cultural Appropriateness

Check this out. I am going to offer you a choice today. You can either take away one very simple but important thought, set forth in the “Bottom Line” below, or you can spend almost an hour of your time watching the video you will be sent to via today’s URL. Be a sport and watch the video. I am sure that you will find it to be worthwhile.

Frankly, this one caught me by surprise. An absolute “DUH! Why didn’t I realize that?” experience. The panel discussion presented here centers around attaining three realizations. First, it is well recognized that in our race to eliminate inequity in healthcare, it is extremely important to have minority patients treated by practitioners who are “culturally sensitive” to their subgroup. Second, it is often impossible to have practitioners with the right language skills, cultural orientation, etc. available on site everywhere to meet this requirement. Third and finally, telehealth can be used to manage this challenge by providing access to “diverse providers,” and doing so efficiently. 

Put all of this together and you have a great opportunity going hand in hand with an interesting challenge. The opportunity lies in being able to culturally “match” providers and patients. If a Black female patient wants to be treated by a Black female physician, that can be made to happen via telehealth. The challenge lies in figuring out what organization is going to set up the system that is going to make this all happen.

Spend an hour of your time listening to this panel discussion, and you might start to get an idea as to how all of this might work. 

Bottom Line. A potentially significant application of telehealth is the ability to provide patients with access to culturally “diverse providers,” thus permitting better practitioner/patient interaction and better healthcare outcomes.

What role should the pharmaceutical industry play in making this happen???

Tackling Racial Disparity in Cancer Care

Check this out. What you will see is a necessarily long article on a complicated topic. Article after article I perused in the last week speaks to different aspects of racial inequality encountered in healthcare. I read one by a Black ER doctor describing the myriad different kinds of racism he faces daily in his job. Another article cried out for racial bias reduction training in medical schools. Etc. Etc.

But this article grabbed me because of its specificity to the treatment of cancer patients. This piece doesn’t talk about undoing prejudice that is deeply rooted in history. Not exactly a quick fix. Nope! It talks about the importance of attaining a singular pragmatic endpoint, completion of therapy, and the benefits of interventions like providing patients, like the woman pictured above, with transportation to get to the therapy site, and nurse navigators and computer systems being employed to help in the effort. 

Bottom Line. Over the past several years that I have been examining paths toward racial equity in healthcare, I have become increasingly impressed with pragmatic interventions like this that can make a real difference and do it now! Sure, there are loftier goals, like eliminating racial prejudice. But think about it this way. Which is the more certain path, with quicker benefits? Eliminating racism to eliminate healthcare disparity or reducing healthcare disparity and having the effects of that pragmatic shift start to whittle away at prejudicial attitudes? 

As this article clearly points out, option B is going to start to save cancer patients’ lives far more quickly. Let’s learn from studies like this one, which identified practical barriers getting in the way of health equity in cancer care, and start to eliminate them! Now!!!

Moderna Hitches A Ride With Uber

I love out of the box thinking like this. Check this out. What you will see is that Moderna has formed a partnership with Uber. Why? Two wrinkles here. First, messaging embedded in the Uber app to increase confidence in the COVID vaccine. Second, providing ride services to vaccination sites.  

Bottom Line. Could this be an important next step in “Warp Speed?”  

Alexa Goes HIPAA Compliant

Check this out. What you will see is an announcement that Alexa is now HIPAA compliant, and is being employed by several healthcare systems to allow patients to make appointments, check on prescriptions, etc. using voice technology.  

Key here is the piece’s use of the terminology “nascent” to describe the current state of the application of voice technology to healthcare, potentially being used by patients and clinicians alike. Everything from supporting patient compliance programs to scribing for physicians can enjoy enhanced effectiveness and efficiency by using voice technology based applications.

Bottom Line. Here is the really interesting part of this. I have absolutely no belief that the Bezos gang is pursuing these apps for apps sake. Nope. What they are doing here is developing a marvelous platform that will let them get into pharmacy and even clinical practice, all connected and accessed through Alexa. And once they do, they will become a formidable competitor for the healthcare dollar. Perhaps an unbeatable competitor. They can develop what amounts to a closed system. They are being very circumscribed and judicious in offering development kits here. Their competitors won’t likely get one, or if they do, they will be paying a significant royalty just like everybody else does that runs their business through Amazon.

Exciting possibilities here. For Amazon. For healthcare.  

Question. What should pharmaceutical companies be doing at this point to make sure that they are on this train when it leaves the station?

Hospital Innovation In The “New Normal”

Check this out. What you will see is a description of three areas in which hospital innovation has been accelerated by COVID-19. These include “Alignment of Incentives.” With the pandemic putting significant strains on the finances of many hospitals, the movement toward value-based medicine has been significantly accelerated. Concepts like “Command Center Management” have evolved to accelerate decision making and increase efficiency. Whether this will help the hospitals’ bottom lines remains unclear.

“Market Competition” is another area where hospital innovation has been accelerated. Telehealth, for example, is a capacity that every hospital now must offer. In fact, excellence in telehealth is rapidly moving from being a differentiating factor to becoming “table stakes.”  

“Consumerism” is the final area where Covid-19 has accelerated innovation. Patient demands on healthcare have radically changed with the pandemic. For example, patients are increasingly evaluating institutions based on the accessibility and features of their “digital front door.” 

Bottom Line. The common theme here? Innovations that hospitals were moving toward pre-COVID have been greatly accelerated by the pandemic. Over the course of the rest of 2020, it will be important for us to keep our eyes on what else is going to change in the hospital environment. 

Death By A Thousand Clicks

Check this out. What you will see is a URL with one of the longest riffs that I have ever sent you to. I am sorry about that. But it is also an important piece. And you don’t have to read the whole thing to get its simple message. Here it is. EHR’s are not perfect. AND. Their imperfections can kill people.  

The article starts with the story of a young attorney who died because an EHR failed to transmit an order for a diagnostic test which would have found the aneurysm that was killing her. AND. As the story evolves, we find that a significant percentage of patients find errors in their personal EHR’s. 

Watch the embedded video. The irony here is that the Federal Government promised, including through Presidential proclamation, that EHR’s would greatly improve healthcare. The Fed’s felt strongly enough about this that they provided financial incentives, and eventually a mandate, for practitioners to move from paper records to EHR’s. And doubtless they were correct. EHR’s make sense. But they are not perfect.  

Bottom Line. And the moral of the story? Good intentions and well-reasoned solutions can carry with them a dollop of problems. Don’t overlook them!

Can Patients Be Their Own Scribes???

Here is a novel idea from an ER physician who prides himself on being the “Efficient MD.” Rather than have patients sitting for hours aimlessly pouring through old magazines while they wait to be seen, have them use online software to start to fill in their own charts. Having shared with us this interesting notion, the blogging physician then goes on to list several reasons why that might not work. Little things like the cost of the technology, patient confidentiality, etc.  

Bottom Line. While this idea might need a little fine tuning, I think that this doctor might be on to something here. In the pharmaceutical industry and in the halls of medicine, we talk a lot about “patient engagement.” Picture how disengaging it is for a patient to have to sit mindlessly for several hours waiting for care. What could a little technological empowerment do to make better use of patients’ time, perhaps taking a little of the workload off the doctor and starting, rather than thwarting, the process of patient engagement?

Think about it!

Learning Continuity Of Care

Here is something I hadn’t really thought a lot about. According to this blogging medical student’s astute observation, medical school is a largely fractured experience. One month of intense study in one rotation, then on to the next. How does a student learn continuity of care as she flits from Oncology to Pediatrics? Good question.  

And in this post, we see a good answer. Forward-thinking medical schools like Stanford have special “Continuity Clinics” that teach medical students important skills like how to develop long term relationships with patients, how a specific mentor deals with a multitude of different medical problems with a consistent style, etc.

Bottom Line. There is a very important general point being made here. Learning to be a “good” doctor involves more than just learning clinical skills. What other soft skills need to be incorporated in medical school training? How about skills that help the budding young doctors learn to plan their careers, avoid burnout, etc.?  

Yes, Damn It! Design Is Very Important In Health Care!!!

Check this out. Amazing. About 10 years ago, a wave of articles and books appeared that seemed to indicate that “design” was finally getting recognized as an important concept in healthcare. Wanting to keep up with the trend, I started to run around and meet with professional designers who I thought might bring value to our work with clients. But then it got very quiet. Finally, as the referenced article shows, design is starting to get a lot of serious attention in health care. Harvard and Penn are starting to get heavily into the act, and $ Billions are being spent against the design initiative. Most importantly, as this article points out, clinicians are now working with designers, which makes a lot of sense. Bottom Line. Hopefully, this time, the notion that the discipline of design has a lot to bring to health care will be allowed to be fully developed.  Read about it, think about it. There is a lot of potential here!

More Medical Robots

A few days ago, we talked about a robot that draws blood. While this might be a helpful piece of technology, it is not likely to be a life saver. But check this out. While CPR is challenging even under controlled circumstances, this video demonstrates rather conclusively that it is really dicey in many of the situations in which patients and their rescuers find themselves. The general principle here is that trying to do CPR while in motion can be hazardous to patient and rescuer alike. BUT. Enter robotic CPR. Seems like this piece of technology would be a boon to both patient and rescuer. Bottom Line. This is yet another indication that it will be fascinating to watch as more and more robots enter into the healthcare field. What attributes will separate out the must-haves from the can live-withouts?