Those working in digital health should be careful not to mix up technology and innovation, speakers at the mHealth and Telehealth World Congress advised attendees in Boston this week. Technology by itself won’t affect culture change, and technology won’t achieve positive outcomes unless it’s deployed in a smart way that re-imagines care, with an emphasis on ease of use for the patient.
“Some people will tell you digitization is the thing to do,” Michael Ruiz, the Chief Digital Officer of MedStar Health, said in his opening address. “Digitization is nothing more than taking what you do today, on paper, and transferring it over to IT systems and doing it the same way. 'True digital' has nothing to do with digitization, has nothing to do with technology. It has to do with enabling experience through technology. It’s really a business strategy that says, ‘How can I more effectively engage with my patients? How can I more effectively engage with my physicians? And how can I use technology as a force multiplier in order to do my business better?’”
Ruiz drew a number of examples from outside healthcare — the Starbucks mobile app, online shopping, and price comparison tools for airfare — as examples of technology that dramatically changed user experience.
“I want it to be the Expedia, Orbitz, Kayak kind of experience and I want it right now,” he said. “How many of us are geared to do that? I would say healthcare systems today don’t have the mechanisms to do that. There is a lot of table stakes that we all have to do, whether it’s electronic health records, online scheduling, price transparency, there are a plethora of issues we have to work through. That doesn’t mean we can’t start to look at the experience where we can. Online registration for patients, online appointment, video teleconferences.”
Luis Taveras, the CIO of Barnabas Health (which recently merged with the Robert Wood Johnson Health System), said that, in the process of merging those two health systems, they’ve also tried to embark on a process of reinventing care through technology.
“We need to think about the way we deliver care,” he said. “We expect people to come to us. We have to flip that around and think about coming to them. Don’t think from the hospital out, think from the consumer in. How does that change the work? We’re engaged in a telehealth program right now where we put a smart TV in some of our patients’ homes and the idea is a patient is watching their favorite show, and we’ll break into their show and say ‘By the way, it’s time for you to take your medication’. It’s a great way to get to the patient where they are. We have to think much differently about the way we look at members, consumers, and how we deliver the best and most consistent care.”
Another example Ruiz shared was much-hyped augmented reality game Pokemon Go, which helped his own son increase his physical activity. Hospitals should look at apps like that and ask "how can we use this?", he said.
“Anyone who tells you that Pokemon Go isn’t a sticky mHealth application is telling you a story,” he said. “Augmented reality is going to become more and more of how we think about healthcare. Those are the things that will make a difference, when you can take something like Pokemon Go and think, how do I prescribe this? Could I treat obese children by prescribing Pokemon Go?”
Peter Kung, the system vice president of virtual health at SCL Health System, piggybacked on that idea while talking about how to encourage adoption of telehealth tools among different generations of patients. While Pokemon might be able to motivate the younger generation to move, other motivators might help older folks get acclimated to technology.
“Rather than approach it from a health technology standpoint, how about we train our 80-plus folks on Facetime or sending pictures of their grandchildren, then address the health piece?” Kung said. “I think there’s some promise there, so it’s not just always a health activity, we can also use different motivations for the patient, whether that be their children, or their grandchildren, then we use that as an avenue to come in.”
While there are many ways to design technology that meets healthcare consumers where they are, too often providers are very conservative, which can lead to vexing user experiences. Dr. Sunil Budhrani, Chief Medical Officer at Innovation Health, a JV from Aetna and Anova Health System, highlighted one example of a bad user experience.
“We’re inundated with portals,” he said. “I think the portal thing is a problem. Everybody has a portal, there are 100 portals, your insurance company, your health system, CVS, retail clinics, everybody’s got a portal. The more portals there are, the less likely you’re going to use them. So one thing we’re committed to is if we have a portal and we decide that any third party application is going to feed into this portal, maybe it’s telemedicine, it’s got to be a single sign on and operate in one menu your patient can get into.”
In talking about his health system's telehealth offering, Kung summed up the prevailing idea of focusing on the patient experience, and keeping the technology itself in perspective as a tool.
"The most important thing I think about is focus on the product," he said. "So when we look at convenient, affordable care, it just happens to come through a slick little app. But the business model and the patient experience is to get in touch with a physician in three minutes or less."