It wasn’t long ago that a robot navigating the halls of a hospital, topped with the talking head of a doctor on a video screen doing patient rounds, made national news. How quaint.
Technology has always taken a leading role in shaking up medicine and patient care. Most of that historically has been for high-end diagnostics and treatment in-hospital. That continues, but there’s a technological upheaval underway in all aspects of healthcare delivery, from basic patient services and integrated delivery networks to business management and profit generation.
New models of care delivery are arising from unexpected places, such as walk-in clinics and telemedicine kiosks at drug stores, where you can now get shots for flu, shingles and pneumococcal pneumonia. Consumer convenience is a big driving factor; so is getting a slice of the healthcare piggy bank.
One trend is gaining enormous velocity due to a confluence of forces – virtually delivered primary care. Doctor and patient engage via secure communication networks, increasingly with video. Ideally all the patient medical history is available, as well, for online reference and show-and-tell discussion. Consider the degree of system integration and data accessibility, as well the capacity for real-time diagnostics and treatment regimens that must be available to bring about truly successful outcomes for both patient and practice.
By 2018, 40 percent of primary care encounters in the U.S. will be delivered virtually, according to a forecast from Gartner Inc. (1) It is not hard to understand why.
- The number of primary care physicians is stagnant, while mandated healthcare insurance has increased the number of covered individuals by approximately 30 million; there already were too many patients and too few doctors.
- The average waiting room time to see a doctor is more than 20 minutes, while the average face time is seven minutes.
- It’s common in many areas of the country to wait 18 days for an appointment. In Boston, which has the highest number of doctors per capita, the wait exceeds 40 days.
- Seventy percent of all doctor visits are for information only or to address issues that can be handled over the phone.
- Tech-enabled and highly mobile consumers are increasingly demanding new solutions tailored to them.
- The general population is getting older on average, leading to a greater demand for physician appointments
- The healthcare information technology industry is focused on virtual medicine and developing products such as HIPAA-compliant video conference software, interactive patient kiosks and other enabling applications and tools.
The trend is beneficial to the medical community on several fronts. Partners Healthcare and its affiliates found this to be true through research, and now says on its website that “Partners is pleased to provide an increasing number of options for patients to communicate with their physicians.” Ronald Dixon, MD, the director of the Virtual Practice Project at Massachusetts General Hospital, and associate medical director at MGH Beacon Hill, talks about the project, his use of video medicine, and the collaboration necessary to implement it in a video posted on Partners’ website.
Another leader pointing the way is Kaiser Permanente, claiming that more than 50 percent of primary care encounters are virtual.(2) Not only have in-office visits decreased significantly, the total number of patients seen has increased appreciably with improved patient outcomes in some areas such as stroke and heart attacks.
Successful implementation of virtual medicine shares many of the same challenges that other industries face embracing seminal technology advancements in this Age of the Customer … breaking down silos and bringing business and IT leadership together to effect transformational change in virtually all roles and aspects of operations. Another is finding the time and resources to get it done while still running a business.
Gartner offers a half-dozen recommendations to healthcare leadership regarding this topic in its recent report, “Predicts 2015: Healthcare Delivery Organizations Will Stand on IT to Climb Bigger Mountains,” which also is referenced elsewhere in this article. But, one recommendation in particular captures the scope of influence virtual medicine will reach within healthcare delivery organizations:
“The chief medical officer (CMO) should engage with internal legal/risk management and any appropriate third parties (including governmental and private healthcare payers) to evaluate legal liability, privacy, licensing, accreditation and reimbursement issues (as well as clinician incentives) that may impact virtual care delivery. Also, specific policies relative to storage and documentation of brief encounters, email and texts with patients, etc., must be established or refreshed.”
It should be noted that Gartner’s forecast is not that all this will happen in 2015; that would certainly lend credence to the origin of “May you live in interesting times” being a Chinese curse (which it is not). 2018 is their forecast window, which still is not a lot of time. However, this confluence of forces mentioned at the beginning of this article will be a source of enormous energy to bring about this transition, perhaps not to complete fruition but certainly far along its path. The amazing thing is that it is only but one of many happening simultaneously. We do indeed live in interesting times.
(1)(2) Gartner, Inc., “Predicts 2015: Healthcare Delivery Organizations Will Stand on IT to Climb Bigger Mountains,” 2 December 2014, Analyst(s): Vi Shaffer, Thomas J. Handler, M.D., Laura Craft, Melanie A. Meyer, Barry Runyon, Zafar Chaudry, M.D.