In 2011 Sarah Churman heard her own voice for the first time. The 29-year-old Texan's reaction, captured by her husband in a home video that has been viewed more than 20 million times, is a true reflection of the power of technology and its ability to completely change patients' lives.
Churman, whose moving story was included in Microsoft's Super Bowl 2014 commercial, is only one of millions of people around the world who is experiencing the revolution that technology has been bringing to healthcare. From bionic limbs to extremely targeted treatments and forecasts of individuals' risks for various diseases, healthcare as we know it today is only possible due to vast advances in technology that is changing patients' lives.
Even Google is entering the healthcare realm. Earlier this year the company announced plans to create a smart contact lens that would measure glucose levels through tears, replacing the repeated pin pricks that the 347 million diabetes sufferers around the world have to endure to monitor their blood sugar.
As Jeffrey Bauer, PhD., an independent health futurist and medical economist, notes, "technology is providing [the world] with an unprecedented opportunity" to develop good healthcare systems. "We have the opportunity to create phenomenally better healthcare systems in terms of delivery, outcomes, and reducing costs," he stresses. But Bauer expresses concern that constraints placed on healthcare could slow down, or even stop, progress, and talks about a tug of war between the possibilities and the realities due to regulatory constraints.
However, regulations are a necessity in healthcare and a reality that several organizations have learned to adapt to and work within the constraints to bring drastic improvement to the healthcare industry. While the most talked-about advances tend to relate to medical interventions, technology is also working hard behind the scenes to improve patients' lives. Dawn Aston, TeleTech's vice president of sales, healthcare services, notes that healthcare is being transformed through tools and technologies that allow for the ability to seamlessly leverage data, personalize member outreach and engagement, and improve provider collaboration for better outcomes. In this two-part article, 1to1 Media looks at a number of improvements that have been made possible through cutting edge technology.
Telemedicine brings patients and doctors together
According to the American Telemedicine Association, more than half of the hospitals in the United States use some form of telemedicine, which the ATA describes as "the remote delivery of healthcare services and clinical information using telecommunications technology." Close to 1 million Americans are using remote cardiac monitors and the ATA notes that millions of patients around the globe use telemedicine to monitor their vital signs and reduce the need for hospital visits.
Further, mobile technology is now making it possible to have virtual access to a doctor anytime and anywhere. One example is Doctor on Demand, an iOS and Android app that allows patients to video chat with a board-certified doctor who can offer a diagnosis and even prescribe medicine for a $40 fee.
The idea of a virtual consultation has faced some criticism. Lyle Berkowitz, medical director of information technology and innovation at Northwestern Memorial Hospital's primary care group in Chicago, was quoted by Mashable describing such video visits "as glorified conference calls" with video being just a gimmick, adding that patients can almost as easily set up a call with their own doctor who knows them well and could use this insight to make a better diagnosis.
Using telemedicine to connect with a patient's own doctor could resolve a number of problems, including saving sick people the ordeal of having to travel to a clinic. As Bauer notes, not only would this help reduce the costs of commuting, but also decrease the risk of sick patients spreading contagious diseases while waiting to see their doctor. He notes that today, mobile technology is allowing patients to share very clear images of problems they might be having with their physicians. "Smartphone pictures are of diagnostic quality," he notes. Additionally, telemedicine could be potentially life-saving, not to mention extremely convenient, for patients who live hours away from the nearest hospital and require immediate help.
We're also seeing modern healthcare kiosks that provide a self-service experience with the addition of connecting patients to board-certified doctors. As Forbes contributor Stephen Wunker, who heads New Market Advisors, notes in this article, the new generation kiosks go beyond the "dusty automated blood pressure machines that have sat quietly in drug stores for years." Instead, apart from capturing patients' vital signs and connecting them with a physician, they also allow patients to use diagnostic equipment and also link to continuing follow-up programs.
HealthSpot is one provider of walk-in telehealth kiosks, launching its first in 2013. "The mission is to provide access to high quality and affordable healthcare coupled with an improved patient experience," notes Lisa Maughan, the company's vice president of marketing. The fully-enclosed kiosk is manned by a medical attendant who can help patients if they require assistance, for example using doctor-recommended diagnostic tools like a stethoscope, pulse oximiter, or otoscope, which will help the physician make a diagnosis. Maughan notes that while the company's kiosks are currently available in pilot locations that include health centers, plans are underway to extend them to retail pharmacies.
Virtual queues reduce wait times
There is little doubt that waiting to be seen by a doctor is one of the most frustrating parts of accessing healthcare. This frustration is even more proclaimed when an individual is feeling unwell and just wants to go home and crawl into bed, which is one reason why virtual consultations have their attraction. "Patients don't want to spend a long time in a waiting room and would rather wait at home," notes Alex B?er, founder and CEO of QLess.
Linda Ratner, executive director of Impact Urgent Care, agrees. Patients often had to wait for two hours to see a doctor at the health provider's two urgent care facilities in Texas, especially during the busiest period, between October and March, when the clinics are inundated with patients suffering from respiratory problems, including influenza and seasonal allergies. While Ratner was aware that most times there's little a healthcare provider can do to reduce patients' wait times, she was committed to find a way to ensure they could be more comfortable while they waited for their turn.
In April 2013, the two clinics implemented QLess' solution, which allows patients to join the queue virtually, either from their home computers or their phones. Patients are told how many other people are ahead of them and given an estimate of when they will be able to see a doctor, providing them with the opportunity to stay home until they need to get to the clinic.
Apart from reducing the frustration associated with the wait, the system is also helping to avoid overcrowding from waiting rooms and even reduce the risk of spreading germs while waiting. Ratner notes that even during the peak months, patients only have to wait for a few minutes before they are seen by a doctor. This has translated into a 20 percent improvement in patient satisfaction.
Relevant information empowers patients
A new diagnosis can be a shock for patients and their families. While the Internet is making information widely available to those impacted by medical conditions, this is not always accurate or relevant to that individual patient's situation. Further, information might raise additional questions or treatment options that patients will want to discuss with their doctors but have to wait until their next visit.
However, technology means that relevant information can be made accessible to patients while they are still in a hospital. This was the main reason why the Carolinas Healthcare System invested in interactive patient technology in nearly all patient rooms in both the Carolinas Medical Center and the Levine Children's Hospital. Dianne Novak, the hospital network's vice president of patient experience, explains that informative videos are made available to patients on bedside televisions. "It empowers patients to learn more about their care," she notes.
Novak explains that content is ordered by caregivers in accordance with an individual patient's needs. "It is very specific to that patient," she notes. For example, a patient who has just been diagnosed with heart failure will get information about his condition and medication that he has been prescribed, allowing both the patient and his family to learn more and ask questions while still at the hospital and having access to medical staff.
Aside from providing individually relevant information to patients, the system also asks patients questions about various aspects of their inpatient experience, ranging from dietary needs to pain management. Novak notes that this allows the hospital to make any changes while the patient is still receiving treatment. Further, because it allows patients to send feedback directly to the relevant department, for example informing dietary staff about a particular food they don't like, nurses no longer have to serve as the go-between and instead can focus on caring for patients.
More than 90 percent of patients are using the technology and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey has shown a 50 percent improvement in both hospitals' performances since they started using the GetWellNetwork. Further, patients have been raving about the system. One patient suffering from sickle cell said: "I learned more about my disease from your videos than I ever have before, and I have been battling this disease for the past 18 years."
The system was introduced in the two hospitals in 2013 and the Carolinas Healthcare Systems plans to extend it to eight of its other acute facilities in the next two years. Further, Novak notes that the network is also looking at extending the service to outpatients through its patient portal, allowing them to have access to information after they are discharged and also share it with their carers.
Other healthcare organizations are leveraging the web to deliver information to their patients or members. Paul Ignasinski, managing director for client development at Root, notes that a number of insurance providers are leveraging the Web and mobile to keep customers up to date with changes in the insurance landscape and explain complicated issues, for example how the Affordable Care Act could impact them. He uses the example of Blue Cross Blue Shield Michigan, which created a Website to help both its own members and other U.S. residents navigate the complicated changes. Ignasinski notes that because the organization didn't have a lot of experience dealing with individual members rather than large employers, it wasn't sure what questions consumers would ask. The site was meant as a resource to simplify the changes, an information tool that broke down a very complicated issue into information that was easy to digest. The added bonus is that providing prospective members with information helps avoid long phone calls asking for the same details that are available online. "It saves healthcare advisers a lot of time," Ignasinski notes.
Additionally, data about individual institutions is providing patients the information they need to make informed decisions about their healthcare. As Mark Pitts, senior vice president of analytics at SourceHOV, notes, data is providing an increased level of transparency, making available information about individual providers' performances, which hospital or clinic offers the best treatment, and even disclosing risks of infection in hospitals. "This is putting the consumer in the driver's seat and allowing him to determine where to seek treatment," Pitts notes.
Precision medicine personalizes care
In May 2013 actress Angelina Jolie made the news for a different reason than her movie career or her fashion sense. In a candid op-ed in the New York Times Jolie revealed that she had undergone a preventative double mastectomy after finding out she carried the BRCA1 gene, which exponentially increases her risk of breast and ovarian cancers.
Jolie's experience shone a spotlight on genetic testing which, nowadays, is not only used to identify an individual's risk of a particular disease, but also to develop a tailored treatment regimen. The Human Genome Project leveraged data to identify the genetic roots of disease and develop treatments. As Bauer notes, the project, which would not have been possible without advanced technology, allowed researchers to understand that certain diseases, like cancer, have a varying makeup and require specifically targeted treatment. For example, not all types of breast cancer are alike and therefore don't respond to the same treatment. Further, as in the case of Jolie, the presence of a particular gene puts a person at a higher risk of the disease, allowing for increased monitoring or preventative surgery.
Aside from determining which treatment is most suitable for individual patients, this knowledge is also allowing clinicians to better understand whether a particular disease is curable. Bauer notes that a percentage of cancers are not lethal and don't require the costly treatment which often has a negative impact on quality of life. Similarly, why should patients suffering from a disease that's incurable go through painful and uncomfortable treatments instead of making the most of their lives? "Technology is allowing us to determine which treatment makes the most sense for an individual patient," Bauer stresses.
A recent Wall Street Journal article noted that the personalized strategies used in the treatment of breast cancers are also now being used for prostate cancers, with research showing that while certain men with "a high-risk form of the disease" would benefit from more aggressive treatment, others might need less treatment.
Selecting the right treatment obviously has an impact on the patient but it also helps to improve the ROI of medicine by spending money on the most appropriate interventions that are expected to have the best results.
As technology continues to advance at lightning speed, we should expect more breakthroughs that will improve health-related customer experience. Ideas that sound like they're coming straight out of a science fiction movie are already being floated, including Bathroom GP, a futuristic product-service bundle mentioned in Customers in 2030, a report by product-testing and consumer campaigning charity Which?. The system takes biological readings and screens for illnesses while consumers are using the bathroom, measuring, for example, kidney function and glucose levels, and works in conjunction with a microchip embedded in a wristband or even the consumer's own body that monitors vital signs, including the heart rate.
Does this sound too far-fetched? Maybe it is, but just a few decades ago few would have expected that almost every individual in the developed world would own a touchscreen smart device that provides anytime and anywhere connectivity. Technology has already changed the world and is expected to continue doing so. As Bauer notes, the possibilities provided by technology are phenomenal.
Read more about technology's impact on customer experience within the healthcare sector in Part 2 of this article out March 24.