de 2016 por la Gabriel Paz Larach
To what degree will telehealth remain a dominant force in health care after the pandemic ends? That will significantly depend on how care providers invest in existing and emerging digital tools that will allow physicians and patients to build and maintain trusting relationships.
While virtual visits accounted for roughly 70% of total visits in the United States during the early stages of the outbreak, their levels dropped to about 30% towards the end of fall. That said, it’s safe to assume that telehealth won’t return to its pre-pandemic level, when only 8% of Americans used it. That’s because even though barriers to adoption — such as regulation, insurance coverage, and conditions requiring in-person care — will remain, provider and patient behaviors and expectations are shifting. But the degree to which they do so will depend on how the experience for both groups improves.
It will require provider organizations to invest in tools that are sensitive to human emotion. This is certainly possible. In fact, some providers have already started doing so, and startups offering solutions have begun to emerge. Here are three ways telehealth technologies can humanize the virtual care experience for both providers and patients.
Create a Strong First Impression
It’s no secret that first impressions matter. It takes milliseconds for us to make snap judgments. We also tend to resist novelty the older we get. Naturally, we can assume that physicians and patients — particularly those who haven’t used telehealth before — will be skeptical about adopting it. So the more compelling the first impression these tools create, the likelier patients and physicians are to engage with them.
When using technology, first impressions are informed by the effort it requires to execute tasks (compared to that of alternatives) and the instant gratification it provides. Models in cognitive psychology, neuroscience, and economics indicate that humans like to avoid effort. Studies such as Mischel’s marshmallow experiment have also shown that we’re likelier to choose instant, over delayed, gratification.
Picture a platform that welcomes physicians with a warm message about their upcoming appointment with a particular patient. The message could include key insights about the patient’s record and reason for her visit. As they start the visit, a digital tip sheet could pop up to outline friendly reminders on virtual care best practices (e.g., maintain eye contact, ask personal questions to get to know the patient) and the types and methods of diagnoses that can be performed to execute a successful visit. Once they meet a certain benchmark of successful telehealth visits, they could be rewarded with an invitation to an exclusive seminar.
Making the scheduling process personalized and informative could make a great initial impression on patients. Having them complete a short app-based quiz to understand their needs and concerns before scheduling a visit would ease the friction of finding the right doctor. Providing a simple, clear online estimate of what their insurance would cover and what their responsibility would be before scheduling a visit would give them the gratification of making financially-informed health care decisions.
Care provider organizations and startups alike have already developed tools like these. One Medical’s 1Life technology ecosystem, for example, provides physicians with summary of a patient’s care history and context-based suggestions for their care as well as access to her full electronic health record. At NYU Langone, where I work, virtual appointments are booked through Epic’s online patient portal, MyChart, which gives physicians access to a patient’s entire clinical information. Bright.md provides a “virtual physician assistant” platform that helps patients find the right care in under two minutes by answering a thorough clinical questionnaire that bases the questions it poses on the individual patient’s responses. Waystar uses predictive analytics and other advanced software to help patients understand how much their insurance plans would cover and how much their out-of-pocket expenses would be prior to their appointments.
Build Active Engagement and Meaningful Connection
Technology streamlines the way we live our lives and engage with one another. But it seldom replicates the nuances and beauty of human connection, and that deficiency is a significant problem in health care. Providers care deeply about their patients and delivering the best care possible to them. Patients want to be listened to, understood, and comforted.
It’s therefore important to have tools that facilitate high quality delivery of care and help patients feel they’re being treated as people, not statistics. There are two prongs to understand in achieving this: active engagement and meaningful connection. The former requires the tools to prompt patients to take actions that improve the way they manage their own care and prompt providers to deliver care in a more effective way. The latter requires the tools to be able to understand and anticipate the needs of these groups so they can help strengthen the patient-provider relationship beyond a transactional service.
Active engagement for patients could be, for instance, app-based prompts to confirm their symptoms and communicate concerns to providers the day of the visit, or a friendly text message with a link to join the visit minutes before starting. For providers it might look like a virtual assistant that reminds physicians to follow up with patients depending on what the outcome and treatment plan of a particular visit was.
Meaningful connection can be achieved with artificial-intelligence-based software. For example, AI-based speech-recognition software could monitor a patient’s speech during a visit to identify potential conditions that affect the human voice, like asthma, before the physician or patient even know it.
Kencor Health’s SAMi digital assistant is one example of a solution that reminds patients to measure their vitals regularly and keeps them engaged with their treatment plans and automatically shares data with their care team. Healthymize is an AI-based, voice-monitoring solution that turns smart devices into remote patient-monitoring devices for diseases such as asthma and pneumonia.
Instill Confidence and Ensure Safety
Insecurity and fear are primal emotions. We’re averse to ambiguity and tend to favor what we know over what we don’t. We’re also afraid of suffering a loss and assess risk based on perceived control we think we have over outcomes. Clinicians want to know with certainty that their diagnoses, prognoses, and treatments are rooted in evidence-based practices. Patients want to be confident in their providers’ expertise, that their advice will heal and not endanger them, and that they will keep their information confidential.
Telehealth tools have the potential to address such concerns. For example, virtual assistants could listen to the provider-patient dialogue and search digital clinical guideline libraries for the latest evidence-based practices pertinent to the patients’ conditions and summarize key findings to assist providers in delivering well-informed advice. By not requiring providers to do this research manually, it would allow them to focus on their interactions with the patient.
The use of remote and wearable devices could help physicians measure their patients’ health metrics. Following visits, virtual assistants could prepare simple, comprehensive summaries of what was discussed, recommended treatments, and relevant research articles for physicians to review. Once physicians had reviewed this material, patients could receive this content via an encrypted messaging system, which would give them the reassurance that they’re receiving expert care and that their information is protected.
Some startups are already venturing into these activities. For instance, Notable uses wearable technology to collect patient-reported outcomes. Zignifica is a software system that analyzes and interprets information and data presented in medical papers to provide physicians with evidence-based practices. Heal sends a HIPAA-compliant summary of the services to patients within 24 hours of service.
Telehealth, of course, can never replace in-person interactions between patients and caregivers. But as experiences during the pandemic have proven, it has the potential to improve the convenience and quality of care. Its future adoption, however, heavily depends on its ability to support a trusting relationship between patients and physicians. As provider organizations choose telehealth technologies and digital health companies develop new tools, they must keep the core human needs of both patients and physicians front and center.