Digital health is the future, but are we ready for it?

February 8, 2019

If we are not smart about how we implement digital health, we may have results similar to the EHR.

Editor’s Note: Physicians Practice’s blog features contributions from members of the medical community. These blogs are an opportunity for professionals to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. 

I was recently waiting in line at the airport, and my mind began to wander. It finally settled on a crucially important question-what wasPhoebe’s sister’s name on Friends*? My mind gave me hazy hints- it was something like Minerva or Indira. After several seconds of intense concentration passed, I considered pulling my phone out of my backpack so I could Google the answer. (I didn’t as these types of mental exercises are increasingly important for me to engage in as I proceed through my 40s.) That made me consider what I would’ve done years ago when I didn’t have a smartphone continuously connected to the internet. What would I have done? Asked somebody, maybe. Or waited until the next time I watched the show and smacked my head in frustration when it finally came to me. 

You may be checking the webpage address wondering what this has to do with the practice of medicine. My organization is exploring our future forays into digital health. In theory, there are so many benefits to enhanced connectivity between our patients and their caregivers. Digital health will provide us with access to information we currently don’t have or would need our patients need to come into the clinic to provide. It will be quicker and more convenient for caregivers and patients alike. Once healthcare reimbursement catches up, it should theoretically reduce overall cost of care. This all may be true, but I wonder how my organization will predict the other changes in usability that may accompany digital connectivity in healthcare. 

We are all aware that the EHR, while providing us with many benefits, has not saved time or reduced the length or improved the quality of clinical notes, and has directly led to physician burnout.  Similarly, when my organization started our patient portal, there were promises of decreased phone volume and more efficient care provided between visits. This too has not been proven in practice. 

Just like my example at the beginning of this blog, easy connectivity and accessibility can lead to over- or inappropriate utilization of the resource. I am sure Google is thrilled that I think of them when I am wrestling with the answer to an important piece of trivia. However, since our healthcare organizations remain largely set up to have people respond to these digital inquiries, I doubt we’d be thrilled with the healthcare equivalent of Google. 

Google spends a lot of money, time, and talent developing algorithms to help me find the answer to pop culture trivia questions in seconds. The medical equivalent does not currently exist-if my patient messages me about a cough, we do not have the computer “smarts” to apply digital triage, likelihood algorithms, or even robust clinical decision support. Essentially, the current system digitalizes inefficient processes, which serves to increase the volume of patient requests, and, in trying to mimic the ease and accessibility of email or the Google search engine, we frustrate patients who have grown accustomed to quick and accurate answers and solutions at their fingertips.

Digital health is the future-of this I have no doubts. However, this will have results similar to the EHR if we are not smart about how it is implemented. 

*Answer: Ursula

Jennifer Frank, MD, is a family physician and physician leader in Northeastern Wisconsin and finds medicine still to be the best gig out there. Married with four kids, she is engaged in intensive study and pursuit of work-life balance.