• doctorpatientfighting

    (ED NOTE: Came across this article while ricocheting ’round the net, and believe that it hits at the crux of one of the sore points of the digtilization of healthcare; the doctor-patient visit.  Many docs are resentful of the homework a patient brings to the visit, and 3G doc, along with , and of are helping this sore point)

    August 16, 2012

    Although I wasn’t at CES 2012 in Las Vegas a silver lining to some hectic flying schedules means I’ve now managed to watch most of the video presentations from the Digital Health Summit.

    My favorite by far was a small panel contribution made by Alexandra Von Plato (EVP, Chief Creative Officer,  & ) in the following “Is technology changing the Doctor-Patient relationship?” panel:

    one of the most wonderful things that has happened with the advent of digital technology in particular is that people’s impression of the healthcare system has declined right? We all think it sucks a lot worse now than it did when we were kids. and that sense of decline really comes from that sense of a lack of access – another thing Gene [Gene Frantz, TI Principal Fellow, Texas Instruments] said he spends hours with his Doctor – nobody spends hours with their Doctor anymore. Nobodies Doctor knows them from an Apple from a hole in the ground. They spend ten or fifteen minutes, ‘a quality consult is fifteen minutes’, you’re lucky if you get that, the average pediatrician has 4000 patients, so the idea that you have a lack of access and this is driving your anxiety about what exactly is the quality of the care you’re getting at the same time entered the internet. So just as managed markets were causing capitation and all these access issues for us as individuals in came digital media and opened up a wealth of information that we can now garner and use to help us become the first opinion. And this idea that we’re in charge and we’re in control by the way isn’t something that we patients are embracing with great gusto. we’re scared, we’re resentful, it’s not getting cheaper, so one of the things I think is that we in fact do not have a technology problem

    I think we have two other kinds of of problems:

    One is an objective dilemma. For a lot of technology in healthcare the objective is data capture it’s about getting the data into records into file formats that can be shared what is that doing to the Doctor and Patient exchange? because what happens when you go to the Doctor when the objective of technology is is to make the Doctor a data entry guy! or make the Nurse a data entry nurse! So they’re sitting there and you’re sitting there with all your problems and your heart on your sleeve and the Doctor is looking into a screen typing away making sure all the fields are filled out. That’s completely disrupted that relationship so yes we’re deploying technology but only in service it seems to me right now to get the data capture gain fixed.

    The other thing we have is an attitude problem. I describe patients coming in having put real calories in the game now spending maybe a couple of hours maybe more than that if it’s your kid or your husband or your mum trying to figure out what that rash was what that pain might be caused from and you bring a file folder in and i think there is real intelligence in that file folder from somebody who really cares… the patient, the caregiver. And this is what the Doctor does: “puts your little charts away”. And this is what the patient does: “I’ve printed this stuff out from the internet… will youuuuu…” because they are ashamed and they feel like they have to apologise! and the Doctor makes them feel ashamed by saying “put that stuff away, I have to start over with my data capture process”.

    So here we are in a time when technology is doing so many amazing things for so many areas of our lives but I agree with  it’s really 10 years behind what technology has done for the travel industry, the financial services industry, for the you name it… healthcare is at least a decade behind.

    Really we should be looking at the opportunity for technology to improve experiences to not just improve accuracy, and yes accuracy is of utmost importance in healthcare, but the experience is what happens between a Doctor and a patient and it’s something we’re not even operating on yet as entrepreneurs, as technologists, as designers. The user experience and if we can get it – those patients to feel incentivated, included, part of the system not the objective of the system, not the problem that the system has to solve but actually an included part of the system that’s going to solve the problems and close some of the gaps by taking responsibility because they feel confident and able to do it and they feel valued…. then we’ll have some real breakthroughs

    (31:40 – 36 min)

    Whilst I think we (patients) have always been the first opinion () the common sense shared by Alexandra here was the most useful thing mentioned at the entire event.

    It has been from a similar appreciation of these fundamental data input and attitude issues combined with our appreciation of the need for patients to discuss online health information () that have driven us to design  so that:

    1) Every patient can give their entire history without time pressures or the need for a Doctor BEFORE the consultation begins

    2) Every patient can share digital content (eg. URL’s, text from a community discussion thread, YouTube Videos, etc) with their Doctor BEFORE the consultation begins

    3) Consulting Doctors can review all the patient provided information BEFORE they reach out to connect with their patient

    4) Shortly after the end of the Mobile Video Consultation with the Doctor the patient is provided with a Consultation Report that contains the history and additional information the patient shared plus the details added by the Doctor that include her advice, recommendations and any links to online sources of extra relevant information.

    Unfortunately the benefits of this really need to be experienced first hand as a patient to be appreciated but after more than 5 years experience with  we’re now convinced that the biggest disruptive change that’s going to occur in the Doctor-Patient relationship will not actually result from the ability of patients to bring digital information to a consultation (they already try their best to do this but their efforts are typically being discouraged/rejected) but the change that will happen when Doctors wake up to the potential they have to GIVE digital information to their patients.

    You’ll get all this the minute your Doctor gives you an URL… …until then it’s worth bearing in mind that at  we try our best to give at least 3 with every single consultation.


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