¿Qué haría que todos los médicos usaran la salud digital?

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Here on The Medical Futurist site we often show snippets of the future we imagine for healthcare. In this vision that we often dub as a utopia, we envision healthcare to be invisible, seamless and preventive. COVID-19 brought us much closer to what we had foreseen (from telemed solutions and robots to A.I.), and these changes also made doctors feel the need to change. But, of course, it’s not as easy as that.

Digital health is really quite simple: it’s healthcare through technology to both patients and medical professionals. Simplified as it can so be, it actually covers a growing field of science from wearables to patient data, robots and genomics. As we put it in a peer-reviewed paper back in 2017, “under the term ‘digital health’, advanced medical technologies, disruptive innovations and digital communication have gradually become inseparable from providing best practice healthcare.” To be able to catch up with technological advancements, the structure of healthcare must change. It’s an entire cultural and physical transformation of the whole healthcare sector. (Click to see our infographic on the future of healthcare.) But you knew that already.

Get the big picture here

The AMA Report

The American Medical Association first conducted a study on physicians’ motivations and expectations for the adaptation of digital clinical tools in 2016, then repeated it in 2019.

Every measured category showed a clear rise in digital health modalities – and it was before COVID-19. The study concluded that physicians seem to be overcoming their resistance to using digital health tools. One of the conclusions was that “nearly half of all physicians are enthusiastic about new digital solutions.” Whatever that might mean.

By 2019 (remember, this was before COVID hit the globe!), more than 87% of physicians claimed they see at least some advantage in digital health tools. An increasing number (40%) of PCPs saw a definite advantage – whereas only 33% of specialists said so. Reasons for enthusiasm have also changed. “Allows me to provide care remotely” in 2016 was a niche need. In 2019 it became a secondary driver. “Helps reduce stress/burn-out” received a similar choice and became one of the key motivators in the use of digital technologies. 

Telehealth and remote care instances began to grow already before COVID – in fact this area showed the biggest growth among all digital tools. Almost every third doctor used a telehealth solution in some form, doubled from the 14% of just 3 years before. https://www.youtube.com/embed/dQ-rjGz15yM?feature=oembed&enablejsapi=1&origin=https%3A%2F%2Fmedicalfuturist.com The shortest definition on telemedicine, ever.

#Wearenotwaiting

But patients were not stood there waiting on the sidelines. They started to get matters in their own hands. One of the most striking examples of how participatory activism can be successful is how the diabetes community organised itself at the beginning of this digital transformation. They started developing platforms, apps, and other on- and offline solutions and gathered under the #wearenotwaiting flag. Others were keen to follow, and today pioneers like ePatient Dave or Lucien Engelen are leading the patient movement.

After patients became active participants of their cure, companies, too, realised they need to act upon. Digital health solutions (wearables, artificial organs, medical tricorders and many, many more from science fiction to science) started gaining momentum – and funding. And as patients couldn’t wait, companies didn’t, either. 

Infographic on the development of key trends and innovations in the process of delivering care

Even regulators followed the flow. The US Health Insurance Portability and Accountability Act (HIPAA) was signed into law as early as in 1996. This established the policies and procedures for privacy and security regarding personal health data. And the first device, a non-invasive, automatic glucose monitoring system, the GlukoWatch was approved by the FDA in 2001.

Barriers To The Digital Switchover In Healthcare

Doctors’ work dramatically changed by the end of the 20th century. Medical professionals now spend way too much time with paperwork. And on crap electronic interfaces. In comparison, they have way too little time for the patient. But all the responsibility is theirs. These aren’t the working conditions one dreams about.

And there’s more. Fundamentally, no technological innovation is made just for them. Or if it is, it is expensive, difficult to implement (like AR), and hard to use. And even if the concept is good, only a handful of skilled and well-funded doctors would have the chance of using them. (At TMF we strongly believe in these technologies though. That’s why we collected an entire set of possibilities with AR in this article.)

A.R. vs. V.R.

So what’s really needed for doctors to hop on?

What will be interesting is how the same AMA report would look like if conducted in 2021. Despite the rise of remote care solutions, doctors, in some ways, have missed the connection. But it wasn’t their fault. They have, for example, never been prepared to get on at all.

It’s important to note the obstacles doctors face when considering the application or the use of digital tools. Firstly (and most importantly), that they were not prepared for this. There are only about 10 (!!!) courses around the whole world that aim at getting medical personnel ready for digital change. This includes my own course on the subject. https://www.youtube.com/embed/sK-b79G9NKg?start=13&feature=oembed&enablejsapi=1&origin=https%3A%2F%2Fmedicalfuturist.com Medical Education of the 21st Century

Our Top Incentive Options

Based on the study results, the AMA recognised the expressed needs of support and has set up a set of key steps and best practices for physicians on their website. However, besides a support system, there are other incentives that can, will and should support the digital shift in healthcare. Here are our five cents on the subject.

1. Push From The Rise Of Empowered Patients

We believe that patient empowerment, the spread of digital health, the digital approach, and the fact that digital medicine ceased to be a faraway concept lead to a new role for physicians. Thereby the job will be just as well more rewarding as more creative and physicians would have the chance to practice the art of medicine like never before. It’s easier in fields where the relationship is close, like in primary care.

What’s needed to achieve this?
Real-world examples and partnership. The experiences of digital doctors (like my own GP, Dr. Réka Vernes or Bryan Vartabedian) set a great example for the others. Good cooperation between doctors and patients where e-patients don’t demand but assist the transition. 

2. Government Incentives Through Healthcare Policies

Direct support from the governments is incredibly important in taking healthcare to the 21st century. Take a look at the Danish digital health strategy, for example. Theirs is one of the most forward-looking examples of a government-supported objective, transforming patients’ and doctors’ lives for the better. Their citizens have full access to their health data – and all medical data is handled by the government (which, not inseparably, enjoys one of the highest levels of citizen trust in the world).

What’s needed to achieve this?
Incentives by each government to help physicians in the shift.

Danish digital health
Source: www.emaze.com

3. Guidance From Medical Associations As Motivation

Medical organisations like the AMA play a huge role in professional motivation. For example, their guidelines on the use of A.I. for physicians also set a gold standard for doctors. With this, among other objectives, the AMA wanted doctors to get involved in the development of healthcare A.I. and encourage patient and physician education on the potentials and limitations of A.I., bearing in mind that the emerging, carefully designed A.I. tools and solutions are user friendly and safe for all.

What’s needed to achieve this?
Evidence. Publications, guidelines from professional organisations or governmental bodies will mean motivation.

4. Significantly Improve Working Conditions

Typing memos about patient-doctor encounters is extremely time-consuming. Doctors spend a great amount of time with administration tasks, but digital technology can change that, too. Artificial intelligence-based voice to text technology can help. While the doctor and the patient speak, this voice assistant puts down the interpreted text into the relevant columns in the EHRs. With less time on paperwork, doctors will have a better, more rewarding workday. They will be able to provide better quality care, have more time with patients and even share responsibility. And, most importantly, they could concentrate on what they are most qualified for: healing patients with care and empathy.

Fuente: The Medical Futurist: https://medicalfuturist.com/what-would-make-every-doctor-use-digital-health/

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