News travels fast; change happens slowly.
That is the trend in healthcare when it comes to novel connected care technology and measurable benefits to patients, providers, or clinics. The tension is strong in part because the internet enables stories to travel so quickly and so widely, but the practical challenges of incorporating anything new into the clinical routine have not been similarly expedited.
It isn’t just the internet worsening the disconnect. The “disrupt everything” mentality made so popular by Silicon Valley types has made its way into healthcare. Or at least, to the periphery of healthcare: wearables, fitness apps, and other IT novelties associate themselves with health and wellness, but tend to move more in the consumer market than in hospitals. Fears about HIPAA, data security, the accuracy and reliability of a crowded wearable device field, and constant nagging pressure to balance volume with quality all conspire to keep doctors working with familiar technologies. It is hard for something new to gain a foothold.
Promising Signs for New Health Tech
Even so, buzz-worthy technology is infiltrating the clinical space.
Ever the darling of futurists and breathless prognosticators predicting the end of traditional manufacturing, 3D printing has shown some promise in turning radiologic imaging into a more precise, instructive resource for surgeons and physicians. Not all new technologies can make the claim of 3D printing for diagnostic applications: it can take flat images and turn them into models, giving surgeons and physicians unprecedented interactivity and understanding of their patients. It is an upgrade to the output of existing image technologies, from X-rays and CAT scans to MRIs and more.
The long-anticipated deployment of telehealth is also having its day. The government is getting on board (including greater use of telehealth by and through the Veteran’s Administration), reimbursement and insurer acceptance is on the rise, and of course for all of this to be true, providers must also be engaging with patients using the technology.
Actually, provider use of telehealth is almost a one-two punch of change and development in healthcare. On the heels of the Affordable Care Act (Obamacare), nurse practitioners are operating with greater autonomy, providing primary care and family care as the lead caregiver. With a rise in telehealth tech support and insurer coverage, nurse practitioners are finding themselves often the go-to caregivers for these remote encounters. Telehealth has managed to pass the smell-test for nurses and become one of the core health technologies nurses use most.
Wearables take so many different forms, serve so many different (and sometimes limited) needs, and so often aim for marketplace popularity over clinical reliability, that they don’t seem quite ready for prime time in hospitals yet. But if these other technologies are any indication, the barrier to adoption is shrinking as the public gets more enthusiastic about the new possibilities they see.
The Downsides of Health-Tech Disruption
It only takes a few success cases like telemedicine to broadly raise expectations among patients and consumers. Compounded by social media sharing and other online storytelling powers, the possibilities of new technology can seem decades ahead of a health system that appears positively backwards by comparison. Why the hesitation to adopt new tools and embrace technology breakthroughs?
The foremost concern is security. Widespread adoption of EHRs still doesn’t have the IT staffing levels or skill levels needed to keep systems secure from external threats or internal errors. Both security gaps can cause entire systems to go down, be held for ransom, or silently leak data to thieves and fraudsters.
The more technology is integrated into caregiving, the more pathways and weak spots inevitably crop up. Fraud and progress seem to go hand in hand; while we may be waiting to see the full benefit of new tech in healthcare, we don’t have to wait as long to see complications, diversions, and mistakes caused by overreach and substituting optimism for due diligence.
The retail industry got a lot of press for implementing on-demand customer service channels through their websites, injecting some cutting-edge artificial intelligence, and deploying chatbots to address common customer queries and complaints.
Only later did it become apparent that all this tech-centric interactivity was being compromised by hackers using their own chatbots to steal personal information and facilitate fraudulent activities. If chatbot fraud is already undermining retail and social media, with their limited use and access of hypersensitive personal data, what chance does healthcare have? Healthcare can hardly keep static EHRs secure; bringing automated interactive data exchange into the mix seems predictably disastrous for security. Mix this autonomy with mobile and wearable devices as the Internet of Things moves in on clinical spaces, and the security challenges virtually explode.
Between Fear and Optimism: Progress
The winning balance comes with some trial and error. Expectations will necessarily be tempered by experience, risk-accounting, and good old-fashioned research. Public pressure and consumer sentiment cannot be entirely ignored, but that is more an opportunity for discourse than the delivery of bad news. Caregivers are seasoned experts when it comes to evidence-based practices; if we can find avenues to blend new technology with what we know are best practices, the tech belongs at the bedside. If we can’t, consumers should be relieved that their providers are practicing at the forefront of clinical knowledge and research.
Transparency doesn’t always have to depend on technological mobility and accessibility. For the public health system, news and hype cycles can be mitigated by doctor-patient engagement. Who knows? We might just find talking to one another is still the best treatment after all.