How Physicians and Patients Can Embrace Connected Care
As a physician and a caregiver, I have experienced firsthand how connected and disconnected our health care system is. Working with both oncology and transplant teams, I have seen how a coordinated team-based care approach across multiple disciplines can improve patient care. It kept us informed on patient status no matter what area we practiced, and it was easy to collaborate inside the hospital where we could actually meet.
However, this communication process often breaks down when patients leave the hospital. Care teams, patients and caregivers don’t commonly communicate as much as you think. Case in point: when I was caring for my aging mother, I received updates on her status because of professional courtesy – other physicians would call me as a peer to fill me in. It wasn’t uncommon for her various doctors, pharmacists and nurses to be in the dark as to what the other was doing for her care.
Unfortunately, my mother is hardly unique. As the health care system has grown more complex, providers and patients are often disconnected from each other. Care becomes uncoordinated. The communication process breaks down and things can slip through the cracks. As a result, members of the care team can have conflicting care plans and the patient suffers.
This fragmented system becomes a challenge particularly as care moves from the hospital to the home. Today, more than 35 million Americans are discharged annually. Many of them have at least one chronic disease, such as heart failure, COPD, or diabetes. In fact, they likely have a combination of these conditions. They’re often required to juggle several prescriptions at once and see multiple specialists. When care teams aren’t coordinating, it raises the risks of potentially harmful medication interactions, hospital readmissions and duplicate tests.
Among the solutions available to properly coordinate care is state-of-the-art wireless technology. Apps and electronic medical records have helped bridge gaps within the walls of a hospital or clinic, but what happens when patients leave the hospital? Telemedicine, telehealth, mHealth – call it what you will, is closing these gaps as much of the future of health care is delivered in a patient’s home.
Yet, it must be done right. We need systems in place to enable asynchronous communication across a care team, enabling physicians, nurses, patients and family caregivers to be able to communicate via a centralized platform. We need medical-grade, secure systems to liberate biometric data and make it liquid and interoperable with EMRs, pharmacy records and the like. We also need exception-based management that enables symptomatic or biometric data to be flagged for care team members, enabling scalable chronic care management across large populations of at-risk patients. Clinicians want the data that can specifically help them better care for patients that need the most attention.
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We’re fast discovering that in order to raise quality and lower costs, we need, in effect, to bring back the house call, but by using digital and mobile solutions. Mounting evidence suggests that care delivered at home enables patients to live longer lives and potentially better ones. Nothing is likely to accomplish that more efficiently – in tandem with in-home visits from nurses, therapists and home health aides of course – than mobile technology. Technology won’t replace nurses or physicians, but it will supplement care and enable health systems to focus resources on acute patients. mHealth is transforming how health care is delivered by allowing providers to more easily and efficiently maintain contact with each other and helping patients to better comply with medication regimens. With secure data available in near real-time, confusion will be minimized.
Other advantages will kick in, too. Gaps in care will be filled. Roles and responsibilities for providers will be better defined. Redundancies will be eliminated and accountability increased. Hospital length of stay will be shortened and admissions – and readmissions – reduced. Transitions of care will be streamlined.
More broadly, “mobilizing” health care brings the potential to make health care more efficient, accessible and affordable. Eventually – and ideally sooner rather than later – “connected” health care will be the norm. By 2020, at least 160 million Americans will be monitored and treated remotely for at least one chronic condition, according to a prediction from researchers at Johns Hopkins University.
It only works, however, if we use it. Some physicians remain reluctant to adopt such high-tech approaches for the practice of medicine. And, likewise, some patients are also skeptical. Yet the concern that technology, or non-face-to-face care, will hinder care delivery is unfounded, but nonetheless persists. As with other industries such as travel, publishing, shopping, and banking that have transitioned from analog to digital, patients and providers need to embrace the benefits of technology-enabled connected care.
This acceptance may not be an easy transition, but we will learn to leverage connected health tools to better care for our patients and manage our own health. After all, we’re already doing practically everything else through smartphones – booking travel, paying bills, shopping for our families – why not use it to improve patient care?
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