Did you ever walk into a doctor’s office and then have to fill out a long paper intake form with the same information you’ve filled out multiple times before (name, date of birth, insurance etc)? Or notice that your doctor is writing notes on pieces of paper that remind you of your days in school? Did you ever see someone carry a pager around? Was that person wearing a white coat?
You can bank and pay for your Etsy/Amazon/Target/Apple “gotta have that now” stuff online. You can Skype with your family who lives thousands of miles away. You can order a pizza & know the exact moment it comes out of the oven. You can interact with @Oreo, @TacoBell @Grumpycat online.
So why can’t you easily see your health charges online? Why can’t you get a quick text or email that you’ll be seen by your doctor in 10 minutes? Why can’t you Skype with your doctor?
1. Until recently, your doctor has probably had little to no training or exposure to the world of digital health.
If you do a quick and dirty poll and ask the MD’s in your life what it is, you’ll likely get a ?-mark look or an answer related to apps, electronic medical records, or meaningful use. How can that be? Don’t most doctors have smartphones & tablets? Yes, a lot do but their use in a professional capacity isn’t 100% yet.
Until recently, there were no courses in med school or noon lectures in residency related to health information technology, wearables, personalized medicine, medical apps etc
It’s hard to use something or integrate it into your daily life if you’ve never heard of or really used it before.
2. Time is an issue.
Doctors focus on taking care of patients. I’m thinking more about your symptoms and how you feel than the medium I’m using to document your visit.
Then for docs that are tech-inclined, there are literally thousands of apps and products out there & it’s time consuming to mine all of them. Plus, patients are individuals and some things are not one size fits all.
Do you remember when video game consoles first came out? They weren’t in color & there were very simple & basic things you could do, and not much else? Fast forward to the consoles & games of today which provide an Imax or in some cases a virtual reality experience. Big difference, right? Medicine is slowly making its way from version 1.0 to version 2.0.
Remember how pricey version 1.0 of any tech is? Then 5 years later version 5.0 is as pricey but 20x better. That’s kinda how it is too. Thing is though, version 1.0 is deeply entrenched & is usually pricey to remove and you have to train people to use the new product & there will definitely be speed bumps along the way.
4. So-so to bad first time experiences
Have you ever tried on a dress or a suit that clearly was made for someone else but you tried to make it work anyway? Well…certain kinds of tech weren’t originally made for doctors (actually made for billers) and so the initial experience wasn’t so great.
Or another way of putting things is, if you took a bite out of something & it was not what you expected, bitter even, would you be more or less likely to take a second bite?
5. Your individual doctor may not be the main decision maker when it comes to choosing & using tech.
Doctors use the tech tools that are available to them. As a student, doctor-in-training, or even as a supervising physician, you tend to use the technology that is already in your clinic, hospital, center and don’t really play an active role in choosing the tech.
6. Classic battle of innovation vs. regulation
The actions of doctors, healthcare providers, which include nurses, physician assistants, medical assistants etc, (only wrote doctors cuz I am one & for the alliteration) affect lives. We tend to favor things that have been tested & researched & that don’t do gross harm. Thing is, innovation pretty much implies the unknown.
7. Inertia (Thankfully this doesn’t apply to everyone)
It exists. Healthcare is a complex system with many layers and many players. I once read that it takes 15-20 years to make big changes happen.
My two-sense: We are rooted in tradition, yes, but the main tradition we uphold is caring for patients. This entails providing the best care possible and embracing new technologies, thought frameworks, workflows that will give the people (we swore an oath to care for) the best possible care experience.
Ok…so these are the issues. Now for some good news.
Times are changing. I’ve seen initiatives in regards to digital education, collaborative innovation, and health policy changes (government push to go digital). In addition, chips are getting smaller and faster and technology is becoming evermore accessible cost-wise. Organizations and startups are taking a hard look at what hasn’t worked & where a lot of the friction/pain points are, in order to come up with solutions that make the healthcare experience better.
Last, there has been a push by patients, by the general public, for change to happen & trust me, it will. It’s just a matter of time.
Charlene Ngamwajasat, MD (@doctorcharlene) is the author of the Just Curious Blog, where this post originally appeared.
Thank you. I am excited about the progress that has been made thus far and I too believe that there will be accelerated change, especially within the next 3-5 years.
This is an excellent overview of the sub-optimal growth of the healthcare field. I am, however, excited about things like telemedicine, teletraining, and the new physicians social networks like Doximity. My gut feeling is that the rate of change will soon pick up as doctors struggle to remain competitive.
Too many generalizations here. Way more complicated than developed here.
There ARE many of us who have been getting it and doing it right for years.
Though the Costs have been high in a lot of ways.
Thanks for reading. Yes costs have been high. The article is meant to be a conversation piece & to a certain extent I wrote it for providers & curious members of the general public who may not even know what digital health is (notice lack of acronyms like MU, API, back end, front end, etc), per se, but do interact with tech somewhat in their professional lives. The article has definitely resonated with people. I’m aware that the issues are complicated & that there are quite a few providers who were early adopters of tech & who pretty much are almost fully digital, though they tend to be the exception rather than the rule for now.
The problem is privacy. Laws (HIPAA) prohibit sharing of any “personal health information” through a non- secured medium, which includes email, text, twitter, any other popular social media, and most apps. Physicians have to use proprietary software for all of it, which is often not user friendly.
Thank you for your comment. Perhaps I’m an optimist, but I believe that this will change (version 2.0) I also think that HIPAA will evolve as technology changes, or at least there will be Acts/Amendments.
Great point Bobby. I am in total agreement. Acquisition getting easier, but the use part (UX/UI, workflow, and overall design need work).
“Make the right thing easy to do.”
“Easy,” to me, includes easy to acquire and use when it comes to IT.