I am not a statistic. Okay, so in many ways, I am: I am a pretty stereotypical white, WASP-y, college-educated 23-year-old female. I live in Manhattan; I work at a hip, young healthcare startup; I wear appropriately trendy clothes, I shop at Trader Joe’s and I own an iPhone 5 (that’s got to be a record number of clichés for one person). But in reality, I’m not a statistic. I’m not a number. I have my own dreams, ambitions and priorities, just like everyone else. I also have my own health problems. In fact, for a reasonably healthy young adult, I have more chronic conditions and everyday illnesses than I probably should, given my healthy lifestyle. And sure, I know there are other people who are suffering from the same conditions, and maybe it’s selfish of me to focus on my own problems instead of the greater population’s needs. But that’s just it: I’m not a population. I’m an individual with my own personal circumstances and challenges, and when I talk to my primary care doctor I expect to be treated as such.
As an Associate at Oxeon Partners, I spend all day talking to executives about how technology is going to fix healthcare. Data is being created and captured at an unprecedented rate, and we are learning how to harness that data via advanced analytics to inform better and more efficient models of healthcare delivery. Powerful population health management technology has evolved to identify sick populations and allow us to focus resources where they are most needed. EMR, HIE, C-DSS and PPM software are all going to save us time and money, preventing costly errors by coordinating and “closing the gaps” in care. Mobile technology and cloud computing allow us to collect and share data in near real-time, and secure email and patient web portals allow us to communicate instantly with our health insurers and care providers. Truly, technology is vital to the achievement of the Triple Aim (high patient satisfaction, high quality care and lower costs).
And yet, we can’t get lost in the data. We have already seen how difficult it is to show an ROI for massive EMR implementations that have often proven to be more of a burden than a competitive advantage. Moreover, we must be careful not to overwhelm caregivers (and patients) with new systems to learn and engage with; less is more, especially when dealing with a generational divide between the tech-savvy and the older, more traditional cohort of physicians. In order to capture accurate and timely data, new technology should not be disruptive. It must integrate seamlessly into the clinical workflow in a way that improves—not distracts from—the delivery of care.
Don’t get me wrong—I don’t mean to disparage the role of technology in transforming healthcare. I am a firm believer in the power of technology to change our lives for the better, and only with technology will we be able to keep ourselves from repeating the mistakes of our last foray into managed care. Yet we have to remember that while technology can get us some of the way there, it can’t take us all the way. After all, healthcare is not about data points and models; it’s about people.
The sad reality, however, is that many of those relationships healthcare is built upon are broken. This is a systemic problem and just transforming the medium of those relationships to make them digital won’t fix it; in fact, the solution may be just the opposite, as patient-centered care is becoming a cornerstone of the new paradigm in healthcare delivery. “Patient-centered care” focuses medical attention on the individual patient's needs and concerns, rather than the doctor's, and empowers the patient to take a more active role in his or her care. The goal is to treat each patient as an individual, not just as a representative of a disease or of a greater population. To achieve this, we need to take an integrated approach that incorporates innovative technology and fosters stronger doctor-patient relationships built on mutual trust, respect and understanding. The goal of technology in this model is not to displace the doctor-patient relationship, but to enable it.
One example of this integrated approach to patient-centered care is the unique primary care model being implemented by Oxeon client Privia Health. The majority of Americans can (and should) get most of their care in the primary care setting, where preventative medicine and lifestyle adjustments can take place before a patient necessarily needs acute care. Unfortunately, family medicine is a rapidly shrinking discipline, because compensation for specialists is significantly higher and the work of a primary care physician is draining and inefficient. Small family practices often can’t afford the resources that large hospitals or health systems can, including expensive technology and an army of administrators. As a result, PCPs are often doing a lot of their own administrative work, and may not have the time or money to devote to learning new systems or managing the health of a population. And, most importantly, they may find it hard to spend time with their patients because they have to bill every possible minute of their time just to stay afloat.
In response to these issues, Privia is taking independent primary care physicians and integrating them into a high performance, clinically integrated network, providing them with population health management technology, virtual wellness teams, and a proprietary EMR and patient portal. They are doing this in a way that allows doctors to maintain their independence and their existing patient relationships, while still giving them the benefits and purchasing power of a larger network. Privia’s approach is designed to empower PCPs by offloading the bulk of their administrative work and enabling them to spend more time with each patient, building the foundations for a more patient-centered approach to care.
Another Oxeon client, WiserCare, has created a patented shared decision-making platform that combines each patient’s clinical information and preferences to then facilitate personalized decisions about treatment options and more productive discussions between doctor and patient. The platform allows patients to actually share in the decision-making process; it also optimizes doctors’ time, allowing them to focus on providing quality care and ultimately deliver outcomes with higher levels of patient satisfaction. Like Privia, WiserCare leverages technology to strengthen the doctor-patient relationship, not to replace it.
As an industry, we can't lose sight of the relationship between doctor and patient. It is only through their meaningful interactions that patient satisfaction and engagement will truly increase, in turn leading to better health outcomes and lower overall costs to the system. And so it is imperative that we focus on building infrastructure that enables and supports those connections between people, and then step aside and get out of the way.