Visiting the doctor’s office can be a source of anxiety for millions of patients, who often fear unknown costs, an unexpected diagnosis, or exposure risk to diseases, like COVID-19.
On the other side of the equation, business stakeholders of a community-based primary care setting are struggling to exist within the confines of 20th-century technology and strategies. The Physicians Foundation estimates that 16,000 physician practices closed during the pandemic for financial reasons. The trend is showing no signs of slowing.
The pandemic has forced us to change the way we think about long-standing practice patterns and models of care delivery. We are learning to take advantage of available technologies and patient data to deliver a more personalized, convenient experience of care. While many patients trust their providers, they are nonetheless increasingly frustrated that we don’t know them very well. As one of my patients recently pointed out, “Amazon seems to know exactly which book I’m going to buy next, but my cardiologist has no clue what happened to me last week in the hospital!”
In over 25 years of primary care practice in Springfield, Massachusetts, my partners and I have built relationships with our patients in a very meaningful way. For many, visiting the doctor is a sacred experience, whether for planned or unplanned care. Our ‘North Star’ is developing longitudinal, trusting relationships and providing high-quality medical care based on our intimate knowledge of a patient.
Yet, over time, the sheer volume of patient data has expanded and medical care is becoming increasingly specialized. As primary care physicians, we now struggle to really “know” our patients. Companies like Starbucks and Target – with access to consumer purchasing habits – have more insight into a person’s dietary habits than a primary care provider.
Locked away in an EHR is static information on patients, from medical history, laboratory values, to consultative reports. However, with advances in technology and modern data management, we should be able to anticipate patients’ health problems and act upon them in a more dynamic, preemptive way. Rather than having patients save up all of their questions, symptoms, and screening needs for a single, in-office annual physical exam visit, patients should be interacting continuously with the health care system in ways that are convenient and cost-effective.
For example, salient patient data such as blood pressure readings, mobility, and glucose levels can be done daily or weekly, automatically creating a historical log and flagging anomalies for follow-up. In a poll from Accenture, 57 percent of consumers said they were open to remote monitoring of ongoing health issues through at-home devices.
For providers who are exhausted by the volume of patient data they need to consume, emerging models of care might be perceived as daunting. However, with the right technology for collecting, analyzing, and presenting patient data, we can streamline the care experience for both providers and patients in ways that limit unnecessary in-person care. What’s more, we have already observed that expanded virtual care delivery is becoming a financially viable model for primary care providers across the country, who can scale back costly real estate rents and administrative fees. In this context, our health care workforce must also transform to create and manage the proverbial “digital front door” of care.
Not surprisingly, consumer surveys of millennial and Gen Z generations reveal that they are woefully dissatisfied with the health care experience as it currently stands. In an age when we can use a smartphone to have groceries delivered, schedule our dog grooming, and see who’s delivering a package to our home, patients still primarily communicate with health care organizations using the telephone. A patient who wants to report a new blood pressure medication is causing side effects will likely wait on hold to leave a message with a secretary and then simply hope for a timely response. That’s not good enough.
The tech giants of Silicon Valley – love them or hate them – have put incredible personal technology tools into homes and pockets of our patients and their caregivers. Now, we must activate those instruments for our own sustainability, and for our patients’ benefit.
If the neighborly primary care practice is going to survive, we must embrace a more comprehensive and connected health data usage program reassuring patients that we truly know them and are properly equipped to assess future risk. Because that daily frappuccino could be doing more harm than good – and that’s data your doctor can use.
Paul Helmuth is an internal medicine-pediatrics physician.
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