Category: Healthcare Technology

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???

Trouble Online

Check this out. What you will see will not shock you in terms of substance. Sure, hacking can be done. No surprise there. 

BUT. This piece may surprise you in terms of the order of magnitude of the problems encountered with patient data platforms. One login permits access to 4 million patient records. Cybercriminals scoring $21B with ransomware in 2020. Etc.

Bottom Line. Hidden between the lines here seems to be an interesting, if not surprising, piece of information. The more standardization and interoperability that gets built into systems, the more they are vulnerable to being hacked. Which is unfortunate since standardization is generally seen as a good thing in platform development.

Another realization underscored here is that the more companies yield to patient demand to have access to their own data, the more vulnerable patient information becomes to security breaches.  Translated, if a platform is set up to make it easy for patients to use, it’s likely going to be easy for hackers to use as well. 

AND. Wrapped around all of this is the message that this situation is likely to keep getting worse in the foreseeable future unless somebody wearing a white hat has an epiphany on how cybersecurity related to healthcare records really needs to be handled.

Fingers crossed!

Telehealth Use Up, Patient Satisfaction Down!!!

Check this out. What you will see is common sense as it applies to telehealth. Quite simply, the pandemic hastened the proliferation of telehealth platforms and of physicians ready, willing and able to use them. The fact that third-party payers, in many cases for the first time, compensated doctors for telehealth visits was a significant driving factor here. Just so, patients seeking safety and convenience stood ready to try telehealth visits during the pandemic.

BUT. Challenges in actually using the telehealth technology reduced patient satisfaction, as did confusion about treatment costs and lack of a “provider details.” Also, rather common sensical is the fact that telehealth is seen as being more satisfactory by the relatively well than by those in poorer health, who are looking for more support from their physician interactions. 

Bottom Line. All of these J.D. Power findings line up rather nicely with the results of my On Doctors’ MindsSM conversations, wherein doctors are telling me month after month that it is the less complicated, follow up patients, and those demanding special handling in terms of safety and convenience, who are now the only ones getting serviced through telehealth platforms. Especially for specialists, the loss of direct physical examination and patient relationship management inherent in telehealth visits causes most doctors to far prefer in-office patient visits. 

Digital Therapeutics

Check this out. What you will see is the announcement of the launch of the first FDA-approved video game designed for the treatment of ADHD. Being marketed through, you guessed it, digital media. 

Go to their website and watch the trailer

One wonders how many more videogames will come onto the market, FDA approved, requiring an Rx and costing $100 per month, to compete with this initial offering. Or will this be a monopoly? 

Lots of other questions come to mind. What will the receptivity of healthcare practitioners be for this offering in particular, digital therapies in general? Will parents pony up the $100 a month for three months of initial therapy? How effective will the therapy be? Will parents reup after the initial trial? 

Bottom Line. Don’t you just love it when something genuinely new like this comes along? All the new research avenues that one gets to pursue! 

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?

Death By Charting

Check this out. What you will see is an unfortunate visual. The visual of a parent/physician, seven days before Christmas, trapped in front of the computer, pecking away. So what? So, lots? Patients are feeling unattended to as their doctor must prioritize paperwork over care. The kids pictured above are doubtless feeling deprioritized as the parent/physician is hidden away, pecking away. And the physician has an emotion too. Anger. Understandable! Bottom Line. My first thought about all of this? Being a physician means never getting out of school. To clarify, I don’t mean that doctors are subject to life-long learning. Of course they are, and well they should be.  No, what I mean is that doctors never escape the horrors of the scholastic “all-nighter,” not one dedicated to nocturnal patient care but rather one wasted on the mental masturbation of busy work.   How unfortunate!

Virtual/Augmented Reality And Empathy

You may remember that a week or so ago, I did a riff on empathy. I discussed the fact that psychologists speak of three forms of empathy. I can cognitively understand what you are going through, or I can actually experience the emotions that you are experiencing, or I can actually be moved to help you with your issues. Or all of the above. 

Let’s take that discussion one step further. Check this out. What you will see and hear in this 3-minute video is Will Garner of Tipping Point Media discussing how Virtual Reality and Augmented Reality can be used to create empathy, tightening the bond between representative and physician and between physician and patient. 

Sort of a fascinating discussion, actually. Got me thinking about the post I did on empathy. Got me asking myself the question as to what kinds of empathy VR and AR are actually trying to raise, how successful they will be in doing so and what behaviors might change as a result. My best guess is that while these technologies will attract interest and engagement, which in and of itself is a good thing, they are not likely to increase physician empathy. I am guessing that most Rheumatologists already understand the pain experienced by a rheumatoid arthritis patient and are anxious to help if they can. Similarly, most Ophthalmologists likely “get” the negative impact of macular degeneration and are frankly quite frustrated that there is often not a lot that they can do to help. Does either specialty really “feel” the pain of the patient? No, but that is probably okay.

Bottom Line. As with every potential application of technology, one is left to answer the question “To what end?”  While VR and AR, like many new technologies, are genuinely whiz bang, I increasingly ask questions about where are we going with all this? Clearly, Will’s presentation focuses on the technologies’ ability to increase empathy. But inquiring minds want to know … Then what???

The Best Apps For Physicians???

Check this out.  What you will see is a list that purports to hold forth some of the best apps available for doctors. Don’t spend a lot of time looking at this. You will just get a headache. As I did a quick review of this list, a couple of things occurred to me. They include:

  • Many of these apps seem like they would make better books than apps. I can’t quite get in touch with learning to treat Heart Failure by looking at my iPhone.
  • I also cannot quite picture being able to find a requisite app on the phone of the average doctor. If she starts to populate her smart phone with an app for every medical purpose, the cafeteria of choices would rapidly become rather unwieldy.

This article got me to thinking. What role(s) should apps play in the hands of medical professionals? I’m thinking that apps for HCP’s should put information into their hands, and maybe computational abilities, that they need to access quickly. And frequently. Does the average doctor need an app that helps him to interpret x-rays? I am going with nope! How about one that teaches her how to help patients to quit smoking? Sorry, but nope again!

Bottom Line. If such a plethora of “apps for doctors” gets built, my guess is that most physicians will start to tune out on the whole genre. Perhaps we should cut this tidal wave off at the pass?

Perhaps it is already too late!

Your Smart Phone Dermatologist

Check this out. What you will see is the review of an app that helps the user to diagnose and keep track of moles that might be cancerous. Interesting stuff. I have two reactions. First, as the article rightfully comments, I am sure that there are a gazillion people out there who NEVER get their skin checked by a Dermatologist. Never thought about it, too inconvenient, too scary, etc. Would this app be better than nothing for such people? Quite possibly. BUT. Note the picture above. This woman sees a lesion, and knows to point the camera at it. However, the trick is seeing the damn thing in the first place. A recent personal experience. TMI, but exemplary. Living in South Carolina, I once again yesterday laughed out loud when my PCP asked if I was “staying out of the sun?” Doctor, I moved here to be in the sun! Why did she ask? A recent check by my Dermatologist had discovered a very shallow melanoma under my left sideburn. I am off for Mohs surgery at the Medical University of South Carolina on Valentine’s Day. I had one on my left shoulder a year ago, and had that removed immediately. My point? My PCP was amazed that my Dermatologist was so diligent that she found this little spot under my hair. I certainly wasn’t aware that it was there. The PA that spotted the one on the back of my shoulder last year asked how long it had been there. I had never even seen it!!! SO. How could I have turned a camera on these little spots? Bottom Line. I have gotten to the point that every time I see something like this, I ponder its potential unintended consequences. While I am sure that this app will find some lesions and save some lives, I worry that it might actually stop some people from going to the Dermatologist with potentially tragic results.  I hope I am wrong!