In a previous Physician Practice blog post, I provided a list of considerations designed to help you ensure a seamless deployment of new technology at the point of care. The end goal being that you have guardrails in place to help you properly identify and integrate technology that will more effectively enhance clinical environments and the care provided to patients.
Within ambulatory care, there is a growing need for connected technology and devices. Much of this is being driven by the consumerization of healthcare. Patients are demanding to be connected with their healthcare in the same way they are connected within other aspects of their lives. Look no further than fitness tracking devices or apps that help patients manage chronic conditions or connect directly with physicians.
This greater connectivity is paving the way for the digitization of the point of care ecosystem; which in turn promises to bring more accurate and in-depth data to the patient visit, transforming the delivery of care.
Data is the lifeblood of good medicine. Virtually all the tools physicians use in medicine (e.g., labs, imaging, physical exams, etc.) are essentially simple data-gathering tools. They help build the foundation for intervention decisions and care planning.
I vividly recall a moment when I was practicing medicine where data and paying attention to the
patient was essential to delivering good care. A mother came in with her baby, who I had delivered about 6 weeks earlier. She seemed worried and quickly started saying 'something is wrong with my baby'.. I did an exam and found nothing wrong... the baby seemed sleepy but that wasn't unusual.
But, trusting the mother, I obliged on 'getting some labs, just to be sure'. About an hour later, the lab called saying there was a critical value. The baby's sodium level was dangerously low, a level I thought would be incompatible with life. Not believing the result, I insisted on a stat repeat and it came back exactly the same. I rushed the child to the hospital and, after a few days of intensive workup, we found a genetic flaw that needed special medicine. That baby is alive and well today because of 'data' - without it, I am sure we would have lost that child.
While data sources have improved immensely since that time (e.g., higher resolution imaging, genomic labs, portable ultrasounds), most remain independently siloed data sets with limited potential. Connected technologies promise to eliminate those silos, bringing together the data to expand the physician’s ability to know and understand each patient as a unique individual and determine an appropriate clinical plan.
For instance, advanced digital analytic tools, artificial intelligence and machine learning introduce a means for the data to take on a whole new level of capability – predicting disease progression, identifying patients who may be at risk or identifying the best choices for intervention. When the disparate data sources are combined and paired with modern smart analytics, the “data snapshot” of the patient basically goes from a blurry two dimensional picture to a high-resolution three dimensional image.
Of course, just having more data at the point of care is not enough. It must be accurate, relevant and actionable. Too often, the data available at the point of care is flawed. Medication lists are not accurate, which can lead to adverse medication selection or patient confusion. Past medical history is not complete or is poorly prioritized, causing the data to lose its informational value. A blood pressure reading may be suspect, forcing the physician to repeat the test or ignore it completely.
Combining partial data, unfamiliar data or questionable data within next-generation systems is dangerous as the inferences gained may lead a clinician down the wrong path or waste valuable time. In order to accurately and efficiently capture the value of the data, we first must shore up the individual tests to make them as accurate as possible. This includes making them as digital as possible to avoid human error. We must ensure that the data is obtained correctly and transmitted correctly...integrity of the information is essential.
As healthcare organizations look to set up their digital ecosystem, it is important they do so in a manner that helps achieve data clarity so physicians can make better care decisions at the point of care. Here are four things to keep in mind:
· Care team members can (and should) do all they can to augment the provider’s precious time in the exam room to predict and populate the right data to help improve decision-making at the immediate encounter level.
· Clinical teams need to align and create protocols for each encounter or disease type to ensure the right data is present at the point of care the first time. They need to ensure consistent evidence-based guidelines are followed for clinical decision making. Most care situations have consistent data requirements from established accepted protocols. This greatly simplifies the “what data is needed?” question and empowers care teams to design systems to achieve it.
· Technology should be integrated wherever possible to eliminate human intervention, reduce human transcription errors and auto-populate dashboards and templates to eliminate unnecessary data handling. Every technological innovation that eliminates human touch helps improve efficiency and drive consistency.
· Consider how you can eliminate downstream workload. Can you review a lab during the patient visit, rather than on the phone later in the week? Can you get that diagnostic study done right now to use it for advanced decision-making? Can you prepare the patient with his/her own data to allow for more self-guided next steps, such as using wearables and self-guided apps to manage chronic conditions?
Greater connectivity at the point of care is important for realizing better care experiences and outcomes. Being able to put accurate, actionable and relevant data at the physician’s fingertips is perhaps the most important benefit to integrating new technology. Not only will it help improve outcomes, it will also allow physicians to more effectively use their valuable time with patients at the point of care.
Tom Schwieterman, MD, practiced family medicine for 12 years before joining the team at Midmark. As vice president of clinical affairs and chief medical officer, he leads the company’s focus on innovative technology and new approaches that enrich experiences between caregivers and their patients at the point of care.