Building New Healthcare Pathways

By Matt Fisher, General Counsel, Carium
Twitter: @matt_r_fisher
Twitter: @cariumcares
Host of Healthcare de Jure#HCdeJure

Healthcare is experiencing a lot of turmoil over the best way to interact with patients and provide access to care. The tension centers around sticking to traditional models against going full steam into a fully technology-enabled world. The arguable fight over the culture of healthcare may have distracted attention from finding a sweet spot (at least for now) for the intersection of healthcare and medicine.

The Traditional Way

The traditional model is bring every patient into an office, clinic, hospital, or other physical location. Going back to before fully interactive technology existed (which wasn’t that long ago), the only way to provide care was by seeing someone physically in-person. The physical exam and being able to put hands on a patient was the only model contemplated.

There is nothing wrong with the approach of needing to see a patient in person. There are any number of issues that can only be discovered that way because the opportunity to actually touch something or see something in the same room can produce unexpected findings. I suspect that most physicians have multiple stories of having a patient come in for one innocuous reason, but because of something that was observed or something that was touched incidentally a bigger unrelated issue was found.

The power of those interactions created a justifiable mystique around the in-person patient visit. Beyond the acknowledged impact within the healthcare industry, popular imagery also developed around a patient going to a medical office for a visit or receiving treatment at a hospital. The reinforcement of that imagery ingrained certain clear perceptions around how medicine “should” operate.

Explosion of Technology

Seemingly almost out of nowhere, the power of technology accelerated and created the ability to engage in remote, real-time interactions. It wasn’t so long ago that internet connections occurred by dial-up or video streamed seemingly frame by frame. Now, the speed of connections makes interaction seamless and almost like being in-person (clearly nothing will replace being physically next to someone, but everyone has learned that a lot can happen remotely).

Alongside the clarity that can happen in live video streams, there is also a whole host of new tools that can collect granular data and transmit both automatically and constantly. While the accuracy and impact of the data are not fully clear, it does create a completely new picture of a patient.

The new technology created a perception that technology could solve the problems of healthcare. As solutions and tools arose, a push began (which still exists) to make care fully virtual. Full virtual care means starting all patient interactions remotely and through the use of technology. Some suggest that no in-person component is necessary because of all the tools that are available. It is arguably the full opposing pendulum swing from the traditional model that existed for years.

Illusion of New Care Delivery

As the technology based tools were developed the idea arose of how to weave it into the delivery of care. Using a broad brush, the concept was to combine traditional methods of in-person care with robust technology driven interactions. A number of those companies experienced a lot of early success using a lot of high-touch interactions and the appearance of bleeding-edge technology. The narrative became that patients would get care in advance through technology and then would only come in when needed.

As time advanced though, it became apparent that the technology being used wasn’t necessarily as advanced as touted. After digging into the background, the technology wasn’t actually all of the new tools being developed, but just pieces of those new tools. The model still relived heavily on people reaching out to patients and entering data. It was not full integration of the opportunity presented by technology.

Evolution of a Continuum and Balance

After seeing the pendulum swing from one extreme to another (whether in reality or in hype), a better balance is starting to emerge. The balance is a recognition that a new continuum of care must be created centered around a couple of concepts: (i) human touch and tech touch and (ii) right care at the right time in the right place. The confluence of those two concepts is all about developing a new continuum that takes elements from all of the modalities.

A component of enabling the continuum is having the right technology infrastructure. The technology can’t just be trying to recreate in-person interactions or processes virtually. The technology ideally should drive new ways of running healthcare and open eyes as to new opportunities. That means breaking some things and iterating without causing harm.

Part of getting to a full integration and seamless workflow may be finding technology that is not just a solution for one aspect of the process. Piecing together a multitude of systems can just encourage fragmentation. Assembling different pieces takes a lot of time and effort as well as potential switching between systems. Instead, a more comprehensive, flexible platform that satisfies a variety of needs while also being open enough to connect with the missing pieces makes more sense. The power of such comprehensive platforms seems to be growing along with an acknowledgement that electronic medical record systems are not that platform.

The real platforms are premised on strong engagement for patients, clinical teams, and more. A broader approach reflects the growing focus on proactive, preventive care to foster sustained health. Sustaining health before a problem arises or becomes worse calls for the continuum of care that interweaves all modalities. That is why care teams and patients need a platform that supports that flow and enables all of the interaction.

When Will the Future Arrive?

The specific arrival of the future of healthcare will likely happen without any big announcement. Instead, one day everyone will wake up and realize that a fundamental shift occurred without one event demarcating that shift. The wave is clearly building and hopefully the break occurs soon.

This article was originally published on The Pulse blog and is republished here with permission.