Well, cement trucks and health care used to have a lot in common. Now all of that has changed.
Cement plants have a market that is determined by the time it takes for special trucks to transport wet cement and get it in place before it sets. We see those cement trucks out on the roads with their spinning cargo bins — and all of them are bound to a local, pre-defined geography.
It was also once true that health care was delivered in much the same way as cement in trucks within a limited radius of transport. But digital technology has begun to change all of that.
The first big change came in radiology. Back in the day of actual films, groups of radiologists could hold local markets captive. Film transport was cumbersome, and considerable resources in real estate and personnel were devoted to storage, cataloging, and retrieval.
It all changed with digital images. These electronic packets of data could be routed anywhere for reading and called up instantaneously at the point of service by those ordering the test. Reading rooms shrank in size, film storage areas vanished and rotating image carousels — once a great innovation — were relegated to recycling centers and medical museums.
And it’s far from over with radiology. The original digital invasion is now being followed by a new wave of machine learning and artificial intelligence poised to upend radiology workflows in even more radical ways. Handheld devices guided by intelligent algorithms can put imaging into the hands of more clinicians at the point of service, while automated image analysis, guided by computer learning on millions of images, accelerates interpretation.
Much of health care delivery, though, still is stuck largely in the cement-truck era. While a local radius of care will always require the presence of providers in face-to-face interactions with our patients, at least a third of care delivery workflows can be transferred onto a digital platform and no longer be bound by a fixed geography.
Medical knowledge and expertise are valuable assets that now can be freed up and moved anywhere they are needed, regardless of the location. Digital outreach enables advanced clinical expertise to get to the right place at the right time, facilitating clinical interactions from provider to provider and provider to patient. Machine learning and artificial intelligence are also moving in, promising to bring the accumulated wisdom of medicine more reliably and rapidly to the point of care.
There are legitimate fears that technology might diminish the value of relationships in favor of a transactional model of medical care. Used wisely, technology can help us to support these essential relationships by enabling easier access and interaction and by decluttering the space of rote work and box checking to offline virtual venues, allowing more time to focus on actual care and strengthen relationships. Medicine will always be a hands-on profession that requires us to be physically and emotionally present with our patients. But much of our work can be accomplished and improved leveraging digital workflows.
Enlightened health care organizations embracing these digital changes and incorporating them into the logistics of care delivery will be the ones who succeed. Those banking on the constraints of wet cement to maintain the status quo will struggle and find their worlds disrupted by others. Like our colleagues in radiology, we can learn much from the lessons of cement trucks and health care.
C. Todd Staub is senior vice-president, physician relations, OptumCare.
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