When I started practicing medicine, the office staff used a paper-based ledger system to manage patient accounts and billing. The name of each patient seen and the amount collected at the visit was written on a carbon copy duplicate, and provided as a receipt.
Sounds archaic when compared to today’s e-prescribing tools, remote care monitoring platforms, and Internet of Things (IoT) devices that automatically transmit everything from NICU patient vital sign changes to a patient’s pacemaker data. But it really wasn’t all that long ago that we functioned with minimal technology. Most of it clinical.
Fast forward 25 years and the relationship between technology and healthcare is now inextricably linked to better care and outcomes, greater administrative efficiency, and an improved patient experience. Here are a few healthcare industry changes that would be impossible without technology.
1. Slow, manual transactions are now faster and more accurate
Twenty years ago, it took thirty days or more for a mailed-in paper insurance claim to be returned to a physician or hospital as rejected, often for something simple such as the incorrect spelling of the patient’s name or transposed social security number. Today, a front-end edit report in an organization’s billing system checks for these errors - and many others - before a claim batch is even sent to the payor. Errors are identified in seconds and quickly fixed.
This is just one example of how information technology has catapulted us from paper claims, phone calls, and manual data entry to massively more efficient processing of everything from claim adjudication and pre-authorization to benefit-specific cost estimators and payment remittance.
2. Clinicians have incredible amounts of data in the palm of their hand
Thick reference books and manually performing hundreds of clinical calculations have been replaced with apps and platforms accessible on mobile devices, tablets, and laptops. ePocrates, Medscape, and Calculate are just a few recognized brands in a sea of thousands of options. And, what started as access to reference data has evolved to connectivity with real-time, granular details about a patient’s condition, prescriptions, or medical record. For example, e-prescribing. Transmitting a patient’s prescription to the pharmacy, often before the patient leaves the physician’s office, speeds the entire process and improves patient satisfaction too. What used to be a piece of paper that was easily lost is now a digital transaction that is recorded, logged, and reportable.
E-prescribing has laid the data foundation new medication platforms, such as Meds360, which displays a 12-month view of a patient’s medication pick up history, dosage changes, and discontinued medicines on an iPhone. Such data provides insight into a patient’s adherence behavior as well as an accurate account of the medications being taken.
3. Patients can access and interact with their own medical record
Digitizing the record - from chart notes to lab results to images - and putting it into the cloud has opened a new world of access and interactivity potential. Not only can patients access their lab, medication, and certain clinical data. Many also now register or pay their bill online, and make or request an office visit appointment electronically. And as the electronic record evolves, data from embedded medical devices such as pacemakers, or wearables like the Apple Watch, will become integrated and used to launch any number of as-yet-not invented tools.
4. Clinicians and care providers are able to connect with patients post-op, post-discharge, and in between visits
It was unheard of in the early 2000s to think that we could capture meaningful clinical data from patients if they weren’t physically in front of us. The only option was the phone, and you can’t really collect quantitative data that way.
Remote care monitoring tools have enabled self-reported data capture and data streams that deliver data about patients when they are outside of the office and hospital walls. And, live telehealth video videos let us evaluate and treat a variety of conditions that used to require an in-person visit. It’s remarkable when you consider that most of this change has happened over the last ten to fifteen years.
5. Medical devices are smarter, smaller, and less costly
Faster bandwidth, smaller/smarter silicon chips, robotics, new materials, artificial intelligence, higher definition video. All of these things and more have led to the ability to create medical devices that reduce recovery time and length of stay, and improve clinical outcomes because they keep getting smarter and smaller and more cost efficient. From daVinci robots in cardiovascular care to cameras embedded into “pills” that videotape what’s going on inside a patient’s gastrointestinal tract, the combination of these technological advances pushes the healthcare industry to design better more effective devices for improving care, curing disease, and saving lives.
6. Healthcare technology has created a lot of new jobs
The symbiotic relationship between healthcare and technology has created a proliferation of sub-industries, from consumer health apps to wearables to quantified self data gathering, that need engineers, physicians, data scientists, marketers, administrators, content developers, clinicians, and others. Many of these jobs pay well and are focused on solving interesting health care problems and addressing public health issues that have an impact on humanity, connect patients to their medical data, improve safety, and save lives. The truth is that many folks who enter this industry do so because they want to make a difference and solve old problems in new innovative ways.
7. A double-edged sword
I’d be remiss if I didn’t raise the issue of data access and convenience vs. the need for privacy and security. With greater connectivity comes greater responsibility to be a steward of people’s clinical and financial data. We know this. But as evidenced by the number of healthcare data breaches over the last several years, we aren’t there yet. Every clinical and healthcare executive worth his or her salt cares about this issue, and in my circles we put it front and center in our product development and strategic discussions. But until we find the right balance between convenience and security, we'll continue to grapple with a double-edged sword.