Commentary — August 2015
By Amit N. Keswani, MD
With the continued evolution of medicine and the application of business principles that transformed the automotive and electronic industries in the 1980s, it was only a matter of time before that technology began to infiltrate health care. The development of lean production systems, the application of six sigma principles, and supply chain management have put us in a digital revolution in medicine and data analysis.
We live in a data-driven culture and are able to access data at a rapid pace, whether it be emails, texts, photos, books, or video searches. A 2010 report from the Centers for Disease Control and Prevention (CDC) states more than 80 percent of Americans have looked up health-related questions on the Internet, and more than 20 percent of adults have posted on a health care online forum.
This digital revolution of medicine — where medical knowledge is readily accessible from digital devices — means patients now demand more autonomy of their health care. This is positive not only for the patient but also for the practitioner.
I often see my older attending physicians grumbling when patients talk about researching a disease on the Internet and then ask questions. I, however, am glad patients are embracing their problems and trying to improve their fundamental understanding of the disease process. More importantly, I look at that as an opportunity to shape where their information comes from and to have conversations about what active roles they can take in improving their well-being.
It is not uncommon to have patients in our clinics who track their measureable data, such as blood pressure, heart rate, weight, or daily steps. I encourage my patients to embrace the wireless accelerometers and pedometers available, as long as the devices inspire additional cardiovascular fitness. It makes sense to use these devices to help manage chronic diseases, which a 2009 CDC report estimates account for more than 75 percent of all health care expenditures.
Unfortunately, there remain practitioners averse to embracing these advancements, and shockingly, there still exist practitioners who do not use electronic health records (EHRs). Health care systems often switch EHR systems in an attempt to add functionality. But doing so compromises physician satisfaction. EHRs will continue to change with the implementation of ICD-10 this fall, as medical billing becomes even more complicated.
As technology continues to develop and adapt, parts of health care will continue to become more remote and decentralized. If we follow the tenets of keeping it simple and focusing on patient care, navigating the digital revolution in medicine will only be to our advantage as practitioners.
When we hear words like quality, process improvement, and data management, instead of shuddering in fear, we should learn more about this jargon, as it will continue to infiltrate the health care industry. Physician leaders can help use data and improve patient care by deciding which data are useful and which are not.
We must all learn to embrace change and not avoid it. Our success as physicians will only be retained if we help our patients adapt to and manage the immense, complex data accessible to them. An empowered, knowledgeable patient is our ally, as long as we can help that patient navigate data properly and safely.
Amit N. Keswani, MD, is an interventional cardiology fellow at The University of Texas Health Science Center at Houston. He will start a career in academic medicine this fall.