Digital health tools can help providers improve the quality of the care they deliver, but only if they think about healthcare design and keep in mind how these tools affect patients' experiences, said speakers at the Healthcare Experience Design conference, held in Boston on March 25.
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Physicians are dealing with an unprecedented amount of change. Many are implementing EHR systems to qualify for meaningful use incentives. At the same time, health reform provisions are encouraging them to deliver care in teams and to do more to prevent hospital readmissions. Many physicians could find all these changes daunting, but presenters said new delivery models and IT tools actually provide an opportunity to improve care quality.
Taking a bad health experience and making it digital doesn't turn it into a good experience. It just makes it a bad digital one.
life sciences chief strategist, IDEO
For example, Jacob Reider, M.D., chief medical officer at the Office of the National Coordinator for Health IT, talked about how IT tools, combined with a rethinking of how healthcare providers operate, can cut the number of unnecessary prescriptions doctors write for patients. In today's hospitals, patients typically are treated as consumers, he said, and because of this patients often get what they ask for. In the case of common respiratory infections, doctors frequently prescribe antibiotics because patients want medication for their illness, even though most clinical evidence shows that antibiotics don't treat respiratory infections effectively.
Implementing decision support systems can give physicians access to this kind of evidence, but doctors also have to be open to changing the way they interact with patients, Reider said. "Design isn't 'give the customer what they asked for.' It's 'give them what they need,'" he said.
Reider said the meaningful use program is a primary component of the technology-driven redesign of the healthcare delivery system. He pointed to several criteria that encourage physicians to put patients at the center of care, but he cautioned that for these changes to work, doctors have to do more than check off boxes on the meaningful use attestation website. Providers must take time to reexamine their workflows to ensure that changes actually improve care in some way.
Even relatively simple changes in the way physicians use technology could lead to improvements. Amy Cueva, founder and healthcare principal at experience design firm Mad*Pow, which sponsored the conference, said in her opening keynote that just turning a computer screen around so patients can follow physicians as they enter information can lead to better engagement.
Since the meaningful use program launched, physicians have complained about the amount of time they must spend entering information. Many feel the computer screen acts a new barrier between them and their patients. But Cueva said physicians shouldn't feel like they are being turned into data entry specialists. Instead, they should embrace the opportunity to share their computer screen with their patients as they record data, as this may help engage patients in the care process.
At the same time, providers need to avoid adopting IT tools without a clear idea of how they will be used to improve patient care. Rodrigo Martinez, life sciences chief strategist at consulting firm IDEO, said the concept of digital health has received a lot of attention, but "means absolutely nothing." This is because most providers are just using digital tools to do the same things they formerly did on paper. But the true benefits of converting to digital happen only when the provider adjusts its workflow to make the most efficient use of the tool, rather than making the tool fit its existing workflow.
"Taking a bad health experience and making it digital doesn't turn it into a good experience. It just makes it a bad digital one," Martinez said.
One of the primary ways digital tools can improve care is by keeping patients connected to doctors outside of the office. Martinez pointed out that the vast majority of a patient's experience with an illness happens outside their doctor's office. Digital tools can allow physicians to support patients with chronic illnesses, but only if physicians are open to offering this kind of service.