Healthcare’s integration challenges: Digital transformation’s ‘growing pains’
Just like adolescents working their way through the awkward teenage years, digital tools struggle to achieve maturity in improving care.
Teenagers are awkward … and so is the current state of healthcare as it graduates from its elementary days of EHR implementation and moves to a state of optimization and the forthcoming adult world of artificial intelligence and other widely publicized transformative innovations.
Drawing on this vivid analogy, Mitchell Josephson of Health Data Management, and Joshua Reischer, MD, CEO and founder of Health Note, sat down to discuss this current state of healthcare technology and its "awkward teenage years" — a period marked by rapid development and frequent missteps, but also tremendous potential for growth and maturation.
The awkward stage of technology
Reischer’s metaphor of healthcare’s digital transformation being in its teenage years captures the essence of the current state of the industry. Like teenagers, healthcare technology is full of promise but also fraught with challenges and inconsistencies.
"It's on its way to success," he explained, "but it's not quite there yet." Marked by advancements in integration and user experience, it’s still catching up to the vision of seamless, efficient care delivery.
Personal experience: A microcosm of issues
To illustrate the current state of healthcare technology, Reischer shared a personal experience that resonates with many patients and providers. During a visit to an ear, nose and throat (ENT) clinic, he encountered a series of redundant and disjointed processes that exemplify the "teenage" awkwardness of healthcare technology. Despite completing pre-visit forms online, he was required to fill out the same information on a tablet upon arrival and then again through an app at the clinic. Even after all this, the physician had no access to the pre-submitted data, requiring Reischer to repeat his information and manually provide a sleep study report he had already uploaded.
This experience isn’t uncommon; rather it seems to be more the norm as current integration of technology in healthcare often leads to inefficiencies and frustrations rather than streamlined care. The repetitive nature of data entry and the lack of seamless integration between systems highlight the need for better workflow integration and user-centric design.
The importance of integration and workflow
One of the key takeaways from Reischer’s insights is the importance of integrating technology into existing workflows effectively. He emphasized that merely integrating new technologies with legacy systems is insufficient. Instead, these technologies must be thoughtfully woven into the everyday operations of healthcare providers. This involves understanding the upstream and downstream effects of new technologies on different stakeholders, from front desk staff to medical assistants and physicians.
Effective integration requires a holistic approach that considers the needs and experiences of all users. This means involving end-users in the design and testing phases to ensure that the technology addresses real-world challenges. As Reischer noted, without this level of involvement, it’s easy to create solutions that miss the mark, leading to further inefficiencies and user frustration.
User experience: A crucial factor
User experience (UX) plays a crucial role in the successful adoption of healthcare technologies. Reischer pointed out that nearly half of all outpatient visits in the U.S. involve Medicare-eligible individuals who may have different technological needs and preferences, compared with younger patients. Designing technology that accommodates these differences is essential to ensure widespread usability and satisfaction.
For instance, user interfaces need to be intuitive and accessible, with considerations for those who may not be as tech-savvy. This could mean incorporating larger text options, simplifying navigation and ensuring that support is readily available for those who encounter difficulties. By focusing on UX, healthcare technology can become more inclusive and effective.
The role of large language models and AI
The recent surge in interest and development of large language models, such as ChatGPT, has sparked a renewed enthusiasm for digital innovation in healthcare. Reischer highlighted that these advancements have made people more willing to explore and adopt new technologies.
However, he cautioned that the successful implementation of these technologies depends on their integration into workflows and their ability to enhance, rather than complicate, the work of healthcare providers.
Artificial intelligence (AI) and machine learning (ML) hold significant promise for improving healthcare delivery by automating routine tasks, analyzing large datasets, and providing decision support. However, their success hinges on their ability to seamlessly integrate with existing systems and enhance the work of healthcare professionals without adding to their burden.
Overcoming integration challenges
The integration of technology into healthcare is fraught with challenges. One common issue is the reconciliation of information. Reischer explained that while it’s possible to collect data from patients and integrate it into their medical records, the process of reconciling this data can be cumbersome.
Decisions about whether information needs to be reviewed manually or can be automatically integrated must be made carefully to balance usability with accuracy and security.
Additionally, the format in which data is stored can impact its usability. Information entered as structured data may be more useful for certain applications, while PDFs or other formats may be necessary for different contexts. Understanding these nuances and designing systems that accommodate them is essential for effective technology integration.
The path forward: Principles of success
To move beyond the awkward teenage years and achieve a mature, optimized digital healthcare environment, several principles of success must be adopted.
Holistic integration. Technology must be integrated not only with existing systems but also into the workflows of all users. This requires a deep understanding of the day-to-day operations and challenges faced by healthcare providers.
User-centric design. The needs and preferences of all users, especially those who may be less familiar with technology, must be considered in the design and implementation of healthcare technologies.
Iterative testing and feedback. Continuous testing and iteration with input from end users are crucial to ensure that the technology meets real-world needs and adapts to evolving challenges.
Leveraging AI and ML. These technologies should be used to enhance efficiency and decision making in healthcare. Their integration should aim to reduce the administrative burden on providers and improve patient outcomes.
Focus on data security and privacy. As technology becomes more integrated into healthcare, ensuring the security and privacy of patient data is paramount. This involves robust data governance policies and practices.