Doctors "know instinctively that the human side of medicine -- the attentive listening, the visual cues, the continued eye contact, and the careful history and physical exam -- is critical..." Dr. Val Jones, CEO of Better Health, wrote in a commentary piece last week. "The problem we have with EMRs is that they often interrupt the sensitive and intuitive parts of what we do. EMRs and other digital 'tools' designed to make our work more efficient, may do so at the expense of the human connectedness our patients deserve and need."
Jones' commentary is a must-read for anyone interested in new technology's impact on the patient-doctor relationship. As she notes, a more efficient practice is not necessarily a more effective one.
"Digital tools designed to make work more efficient" certainly would include the many wireless-enabled point-of-care services coming to market, but first a quick note on EMRs: The notion that EMRs will boost a practice's efficiency has not yet been proven, according to one industry thought leader:
"This lack of coherence and lack of any integration right now is what's facing EMR and it's the same story with PHRs," Dr. Eric Topol told mobihealthnews in a recent interview. "It's like the Tower of Babel - most [EHRs] can't communicate with each other and it's really a problem. When are we going to get out of that? I don't see it in the near future. Even billions of dollars from the federal government isn't likely to turn this around."
Granted: Sacrificing the sensitive and intuitive aspects of the patient-doctor relationship in order to enter data into a medical record that will probably end up in a digitized filing cabinet (as opposed to a paper-filled one) may be a fool's errand. However, using wireless point-of-care devices is certainly a horse of a different color.
As Dr. Natalie Hodge explained, her concierge medical practice, which is almost entirely run through her iPhone, allowed her to increase the personal side of her care. Hodge said she formed deeper and more impactful relationships with her patients by spending an hour with them during her six house calls each day, instead of the 35 ten minute appointments she had with patients under the office-based model. Becoming untethered from her office with mobile point-of-care services allowed her to become more sensitive to her patients' needs.
Dr. Jack Forbrush, who heads up the Osteopathic Center for Family Medicine in Bangor, ME, has found his iPhone to be an indispensable tool for connecting with his patients. Forbrush routinely visits three or four assisted living facilities before arriving at the center in the morning, and the applications on his iPhone allow him to make deeper connections with his patients during his rounds. Forbrush shares information about his patients' health with them right from his iPhone's screen. The older the patient, the more interested they are in the device's capabilities, Forbrush said. The use of the iPhone has increased his knowledge sharing with patients, which has led to more personal relationships with them.
Finally, Stanford University Doctor Andrew Newman has stated that using Epocrates' iPhone application in his practice has been "transformative" for the patient-doctor relationship.
In the end, Dr. Val's conclusion is spot on: Younger and/or tech-savvy doctors, like Hodge, Newman and Forbrush, need to step up and educate the technophobic ones on how to integrate these new technologies into their daily practice of medicine. In turn, all doctors, nurses and caregivers should educate their patients about the point-of-care tools they are using.
"Evidence-based, outcomes-driven data at the point-of-care is the goal," UCLA Wireless Health Institute's Dr. Patrick Soon-Shiong said recently. "Those few words have a deep meaning to them -- evidence-based outcomes based point-of-care. That is the holy grail for healthcare transformation."
We can all agree with Dr. Soon-Shiong that those words have a deep meaning. Once put into practice, though, they could create deeper, more meaningful relationships between doctors and patients, too.
