Complimentary approaches to achieving health technology’s potential to improve patient outcomes and care affordability were on display at the Institute for Healthcare Technology Transformation’s annual meeting in San Francisco last week (iHT2). Here’s what you missed:
Dr. Wesley Valdes, Keynote speaker at iHT2 and Medical Director of Telehealth Services & Virtual Medicine at Intermountain Health, demonstrated the extent to which disruptive technology has changed healthcare. According to Dr. Valdes, technology is empowering patients by providing choices that maximize convenience and affordability.
Employer-supported virtual physician visits were among the most disruptive technologies noted by Dr. Valdes at the iHT2 keynote. These secure video teleconferencing visits involve an average waiting time of nine minutes and a cost to the patient of $5 for a fifteen minute face-to-face visit. They have very high patient and physician satisfaction ratings, reduce lost work time by more than thirty percent, and have resulted in zero malpractice suits so far, according to Valdes.
Visits to pharmacy “minute clinics” that offer primary care (provided by a nurse practitioner or physician assistant in the pharmacy) are expected to account for forty percent (40%) of all primary care visits in the US within the next two years. In addition to maximizing patient convenience, pharmacies expect to leverage information gained from a patient’s store purchases to improve health…imagine a diabetic patient receiving real-time text messages at the check-out counter that ask the patient to reconsider the purchase of a candy bar, or remind the patient to fill overdue prescriptions.
Perhaps the most thought providing comment of the event was Dr. Valdes’ controversial suggestion: “Within the next five years there will be only three major health systems in America, CVS, Walgreens, and Walmart.”
David Kaelber, MD, PhD, MPH, CMIO at Case Western Reserve University’s MetroHealth System in Cleveland, Ohio, was recognized by the audience as a leader in the use of technology to deliver practical value to patients. His health system has achieved significant improvements in patient outcome metrics in economically challenged patients using relatively low-tech innovations.
When asked where technology has delivered the most good for his patients, Dr. Kaelber said, “We use a series of technology-related messaging programs that are highly effective, and include texts to patients or parents of patients, automated phone calls, and even automated sending of postcards or letters. We send reminders about appointments and immunizations for both children and adults.”
Kaelber says he designed his clinic’s EHR to recognize and report events that need follow-up. For example, if ordered lab tests have not been done within three weeks after the order then reminders automatically go to patients. This has increased completion for lab testing from an average of five (5%) percent to 15% three weeks out.
“In order to do this we needed a system-wide integrated EHR,” Kaelber says.”Getting 70,000 of our 200,000 patients to use our patient portal for communication has also been a big accomplishment. We’ve learned, especially because of our economic patient base, that patients access mHealth if their mobile device is a smartphone. Every effort is made to authenticate patients and sign them up before leaving the clinic.”
Disruptive innovation is rapidly changing the healthcare landscape. The drivers of disruptive health IT include innovators, entrepreneurs, academic and private venture capital organizations, insurers, the pharmaceutical industry, hospital systems, physicians and other clinicians, and patients. Low-tech solutions that facilitate proven effective workflows (e.g. immunization reminders) and increase patient engagement (e.g. smartphone apps) are being employed by innovative physicians to improve patient outcomes and reduce cost. More time and study is needed to demonstrate which high tech innovations will prove equally or more effective.
Dr. Hochron co-founded and is the Chief Medical Officer of Practice Unite, a mobile solution that improves healthcare communications and provides healthcare systems with a platform for their mobile strategy. His approach to coordinating care using customized, integrated mHealth tools has been featured in the Wall Street Journal, the New York Times, HIMSS Media, the Journal of the Healthcare Financial Management Association, MedCityNews, MedTechBoston, and by American College of Healthcare Executives and the New York eHealth Collaborative. Dr. Hochron’s approaches to mHealth integration are used throughout the care continuum to coordinate acute care, post-discharge care, and to monitor and manage long-term care.Hochron has more than 25 years of experience advising and working with healthcare systems and providers in his roles as a practicing physician and healthcare attorney. He received his MD degree from New York Medical College, and his JD degree from Rutgers Law School. He is a Clinical Professor in the Department of Medicine at UMDNJ-Rutgers medical school.
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