“Are we seeking to transform or are we just coping?” A poignantly asked question by Christopher J. Ross, CIO Mayo Clinic, in one of the opening keynotes of the 2019 HIMSS conference in Orlando, back in the second week of February.
It is a fair question, given the possibilities from digital technologies and communication advances to both support and transform. Ross alluded to the different stages of digital transformation in healthcare and the transformative powers that unfold, as it triggers a shift from mainly curing the sick to a wider concept of healthcare. The latter being one that includes a more expansive understanding of the diverse constituents of health, as well as how to predict and prevent medical conditions.
CIC has written much about this broader approach to healthcare, which readers are able to download from our website.
However, in reviewing what was presented at HIMSS 2019, Orlando, two important talking points present themselves for further examination and offer a pointer to the shape of healthcare in 2019 and beyond. The first is social determinants and a broader view of health, while the second is the view that patient engagement is correlated with trust.
Social determinants and a broader view of health
“Health is more than healthcare. […] We need more than electronic medical records (EMRs) as a system of reference”, a point stressed by Dr Karen DeSalvo, MD, MPH, and a former Acting Assistant Secretary for Health under the Obama administration, during a panel discussion after the HIMSS keynote. It is a point that epitomises the notion that the determinants of health and wellbeing are far more than just the information collected in a medical setting. DeSalvo urged the audience to take into consideration other aspects, such as our behaviour, the location we live or the air quality, when it comes to factors influencing our health. This insight is based on the understanding, once again emphasised by DeSalvo, that “the majority of our healthcare outcomes is driven by non-medical factors. Our next journey is [about] freeing the data from the EMR and insurance claims and taking it into a broader environment to determine the fundamentals of health.”
Such an approach expands our understanding of the determinants of well-being and helps us to look at the activities of people outside healthcare facilities with fresh eyes – “We need to include social data to understand the patient”.
It is a strategy that is shared by the idea of precision medicine with the goal of understanding how a person’s genetics, environment, and lifestyle can help determine the best approach to prevent or treat diseases.
Understanding the importance of social determinants on people’s health has been a growing school of thought, helped by the heightened availability of both consumer-generated and environmental data, greater means for interoperation, correlation and analysis of the data.
Patient engagement is correlated with trust
The topic of how to better interact with patients and engage them into taking more responsibility for their own care has been growing in importance. During the Patient Engagement & Experience Summit, that preceded the actual HIMSS conference, a genuine commitment to collaborate with patients was palpable. Adrienne Boissy, MD, MA, Chief Experience Officer at the Cleveland Clinic, who moderated the event, stressed that “patient engagement is about individual conversations and shared decision making.” She urged nurses and clinicians to ask patients how they want to be engaged.
A comprehensive best practice manual on patient engagement has yet to be written, although CIC has a number of reports available in its library on some aspects of this, especially with respect to: Progressing the patient experience in IoT and connected healthcare. However, two important features come to mind in the drive to improving the engagement of patients:
1. Simplicity of language
There are a number of points that should be taken on board when looking to create better patient experiences. Importantly, the type of language used for documenting needs some rethinking; is it clear and adequate? Does the language used for describing the diagnosis evoke trust in the patient? Might there be better wording than saying “problem” when referring to specific symptoms? Are the diagnosis and the treatment plan spelled out clearly to the patient? What are the next steps and which diet and physical activities would be beneficial for the patient?
Simplifying the language used around medication is crucial, especially when considering that, for example, in California, the third largest state in the US, 44% of inhabitants do not speak English (at least as a first language). Also, the reading proficiency of around 44 million Americans is below that of an eighth grader. That said, even more proficient English speakers can have a hard time to understand the package leaflet for medicines, which is an important part of ensuring medication adherence.
2. Support from technology
Technology can play a major role in enhancing the care experience. Robert G. Louis, MD, Neurosurgeon at Hoag Memorial Hospital, started using virtual reality (VR), not only to plan and rehearse surgery, but also to educate patients on how their upcoming brain surgery will be performed by “flying them through their own brain”. Compared to the black-and-white images generated by MRI and CT scans, the use of VR lets patients better understand their treatment. “We experience life in three dimensions, why should medical care not do the same?”, Louis wonders.
A new chapter in healthcare?
Neither talking point topics are new considerations for the healthcare sector; they have been discussed in depth over recent years. What is different, is that there is greater consistency in focus and alignment across the global regions as to where greater effort is needed.
The journey to improved healthcare outcomes is evolving along the focus on the patient, the clinical workflows, the environment and other important non-medical factors. There is growing consensus in the underlying challenges and big issues driving the industry, and it is one that transcends regional boundaries. Of course, there are still regional differences and much work to be done in order to standardise and advance the delivery of healthcare consistently across the globe. Technology – digital, information and communication – is clearly a crucial enabler and means for effective and efficient delivery.
An uplifting aspect of the healthcare market in 2019 and one that perhaps heralds a new section, if not a new chapter, in its evolution, is the vital recognition that care delivery and improved healthcare outcomes rests on a triumvirate that consists of patient, clinical practitioner and partner ecosystem. It is one in which technology and the secure transition of data where and when it is needed without hindrance is an important underpinning link. Without this, crucial and timely insights that may impact the care outcome will not be achieved.
Many get this and are driving the necessary conversations that need to occur within and between the clinical and social welfare practitioner community to better serve the needs of patients. Any push towards embracing technological awareness, education and cross industry practices within the context of the healthcare ecosystem will show that the discussion has progressed to action.
Creative Intellect Consulting is an analyst research, advisory and consulting firm founded by Bola Rotibi, an experienced and renowned expert analyst in the field of software development, delivery and lifecycle management processes, technologies and tools.
The blog was written by Bola Rotibi, Research Director and Cornelia Wels-Maug, Principal Healthcare Analyst, CiC. It was first published by Creative Intellect Consulting and is reused here with permission.