Physicians vs. Patients: Finding Efficiency on Both Sides
Interactive health care technologies are falling into two categories. The first — and more common category of tools — focus on improving physician efficiency and will help to address the coming U.S. physician shortage. A second and emerging group is patient-centered, designed to empower more effective, proactive management of personal health. The question of which approach will deliver the greatest gains for our health system overall is a matter of scale and sustainability.
Many of today’s health IT ‘innovations’ measure success in seconds — shaving a few minutes a day from physician schedules. But these small incremental savings won’t solve efficiency issues, and they certainly won’t help physicians adjust to the rapidly expanding U.S. patient base.
Today, there’s just one licensed physician for every 370 people in the U.S. and resources will be stretched further in the years to come. Consider this: The American Medical Association has predicted a physician shortage of 150,000 doctors spanning the next 15 years, and the Affordable Care Act will increase the number of insured Americans seeking health care by more than 26 million. Adding to the physician burden, nearly 70 million aging Baby Boomers are on a crash course with the under-staffed industry.
Taking these elements into account, it’s clear this crisis won’t be solved, or avoided, by improving physician efficiency alone. Effective solutions have to start with the patient.
Barriers to Patient Involvement: The Impact of Low Health Literacy and Non-Adherence
Low health literacy is a rampant issue amongst U.S. adults and accounts for $106 to $238 billion in wasted resources every year. The limited health care that can be delivered to patients is often not effectively consumed and carried out – resulting in costs related to readmitted patients and improper adherence to medications, which alone results in approximately 140 million unfilled prescriptions – valued at $2.8 billion annually.
The issue of non-adherence is crippling – averaging close to $310 billion annually and representing approximately 14% of total health care costs. It not only increases avoidable spending, but also significantly impacts nearly 40% of doctors in their ability to deliver optimal care.
Healthier patients start with access to better, more digestible information. We need to directly address this gap to create a community of patients that aren’t forced to rely on physicians at every turn.
Improving literacy though specialized patient tools is the first step in how technology can sustainably impact the reach and efficacy of care.
Activating Patients and Breaking Through the Digital Barrier
But empowerment isn’t the only benefit of leveraging patent-centered technologies — they also increase engagement, giving physicians access to better, more complete information regarding their patients’ behavior.
In 2011, Dr. Timothy Bickmore found that patients had more favorable outcomes after interacting with a computer simulated nurse than a live doctor. Specifically, patients more accurately reported their health information to the virtual character, preferred the virtual character because they didn’t feel rushed or talked down to, and were more likely to know their diagnoses and make follow-up appointments with their doctors. A non-judgmental source, with the ability to communicate to different literacy levels, created an environment that promoted better patient outcomes.
The proliferation of smart devices has created a unique opportunity to take these machine-driven conversations to the everyday patient — the perfect delivery method for patient-centered technologies.
This is where the virtual health assistant fills a critical gap.
For health care providers, interactions become the most personal, relevant, and timely that they have ever been. Through the use of VHAs, health care providers, payers, and physicians can increase patient adherence through a virtual assistant’s natural two-way conversation.
VHAs provide patients with guideline driven information, allowing them to stay on track with medications and overall personal health.
Patient tools, like VHAs can execute on straightforward requests, like reminding a 50 year old with MS what to do when she forgets her heart pill, but they have the capacity to handle much more complicated environments as well. For example, a VHA can help an Asian patient with diabetes and deep vein thrombosis, who also has a six year old with Celiac disease, decide what to cook for dinner — on a budget.
The personalization and proximity to patients is unparalleled in today’s technology landscape and amazingly, the idea is not something being dreamed up for some distant future. It is possible now.
They bring limitless options to the table. Retail pharmacies can reach out to people not taking their prescribed medication on a recommended basis. Hospitals and physicians can deeply engage patients. Providers can proactively recommend preventive health screenings for cancer.
For patients, physicians, and the entire health care community, VHAs are our best opportunity to take advantage of a technology that can truly impact the long-term wellbeing of patients and extend the reach and ability of physicians to deliver care.
Thomas James Morrow, MD, has 30 years experience across the health care industry, in clinical practice, as a managed care executive, and as a pharmaceutical medical director. He currently serves as an advisor to Next IT.