Marshall B. Rovner, M.D., Medical Director, Ogilvy CommonHealth Worldwide, a WPP Health & Wellness Company
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Annual physicals may be a low priority for many in today’s workforce, interacting with the healthcare system only when ill. Digital tools can strengthen the physician-patient relationship, improving patient engagement and care, but it will require a closer collaboration among all healthcare participants.
Healthcare-Collected Records and Patient-Collected Data
Digital tools can be separated into two categories — healthcare-collected records and patient-collected data. Healthcare-collected records include electronic health records (EHRs), the official patient record within a healthcare network.
Payers, healthcare networks, and industry analysts study EHR data to evaluate outcomes, and identify behavior patterns that can be used to evaluate physician performance or potentially to personalize treatments. Patient-collected data includes sources such as wearables, connected devices in patients’ homes or associated digital health apps such as the popular Fitbit or Vivofit, and an emerging field called digital therapeutics or digiceuticals.1
Meaningful use criteria attached to Medicare reforms like MACRA (Medicare Access and CHIP Reauthorization Act) resulted in physicians replacing paper charts with EHR systems. These EHR systems are cumbersome, redundant and have converted the formerly hallowed bedside encounter or in-person office visit to one of faceless data collection, devoid of eye contact, eclipsed by a computer monitor. Physicians have become documenters instead of healers in an increasingly digital world. However, there is hope. Patient-collected data can assist physicians in personalizing treatments.
Patient Controlled Health
Patients want control of their health as proven by the widespread adoption of digital health apps. At present, over 318,000 health apps and over 340 consumer wearable devices are available worldwide.1 Patients can monitor their caloric intake, activity levels, and a myriad of other activities with the assistance of wearables and apps; in some cases, there are apps that serve as remote echocardiograms, or evaluate for hyperkalemia based on heart rhythms.
Contemporary healthcare apps and technologies can help physicians treat patients with real-time data, complementing diagnostic laboratory tests.
Rock Health, a healthcare-focused venture fund group,2 reported that 87% of surveyed patients would like to use digital healthcare services, provided that those services meet their needs and provide the level of quality they expect.
Furthermore, the expanding telemedicine industry proves that a physician-patient relationship can exist remotely. Patients already monitor their health through digital apps, but knowing that their information is secure and clinically useful can increase engagement.3 Patients are not seeking disruption — they want to partner with their physicians, they want to be part of the clinical process, taking ownership of their health, and they want efficiency. Digital health apps can be the bridge. Integrating patient-collected data into EHR systems will require that those systems be designed to flag outlier patient data, allowing physicians to respond quickly. Integrating patient-collected data in a meaningful way will reduce the need for intake surveys in the office, redundant data collection during the visit, and most importantly empower physicians and patients to share in the clinical management process.
First-line approaches are lifestyle modifications for a variety of conditions that can now be tracked through these technologies. Patient-collected data can be deposited and stored in the EHR and reviewed by the physician. In today’s busy world, not everyone has access to transportation or the flexibility to visit the physician for a follow-up. Patient-reported symptoms can be collected remotely.
However, the data must improve physicians’ workflow, decreasing time spent collecting data, increasing the time spent discussing solutions and care with patients. Digital connectivity restores mutual collaboration between the physician and patient, moving the relationship beyond a transaction during times of acute illness. Integrating patient-collected data and EHR systems will not replace the office visit, it will enrich the communications between patients and their physicians. In an era of increasing obesity, mortality, and opioid abuse, we must act and restore the physician-patient relationship.
The Physician-Patient Relationship is More Than Transactional
The pharmaceutical industry must build partnerships among all healthcare stakeholders that enhance the physician-patient relationship. Marketers and industry partners must work with physicians and healthcare networks to elevate and integrate digital technologies within the EHR systems to assist physicians in using data in clinical decision-making. The physician-patient relationship is more than transactional — it is a partnership through wellness and illness.
Pharmaceutical companies and marketers have responsibilities to patients along that healthcare continuum and must act to correct this situation.
Pharmaceutical companies cannot expect physicians to respond to marketing tactics if clinical time is siphoned into charting; most importantly companies must realize that streamlining EHR systems improves the delivery of their medicines to patients, decreasing errors, and improving patient safety. This transcends marketing; it is the modernization of our healthcare system in the digital age, where only a few key players have the resources to act: failure to do so will be a failure in patient care.(PV)
Editor’s Notes: 1 Aitken, M., Clancy, B., Nass, D., (2017). The Growing Value of Digital Health: Evidence and Impact on Human Health and The Healthcare System. Retrieved August 28, 2018, from IQVIA Institute for Human data Science: https://www.iqvia.com/institute/reports/the-growing-value-of-digital-health; 2 https://rockhealth.com/reports/healthcare-consumers-in-a-digital-transition/; 3 Beisdorf, S., Niederman, F., (2014). Healthcare’s Digital Future. Retrieved August 27, 2018 from McKinsey and Company: https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/healthcares-digital-future
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