How IT factors into the physician-patient relationship

Without a doubt, IT is a core component in the evolution of patient-centered care. Nonetheless, finding the right balance between patient engagement and new IT initiatives can be challenging.

"Focusing specifically on the physician-patient relationship – it's behind the rest of the world," said Steve Wigginton, CEO of Medley Health, a medical practice marketing and communication services company. "But there are a lot of benefits to be had. More information is readily available to physicians as a result of IT, and therefore, it's easier for them to keep track of what's going on with their patients."

"IT has, in some ways, made it possible for patients to be more self-serviced around transactional types of interchanges with their doctor," Wigginton continued. This includes scheduling appointments, reviewing bills, etc. “Those are just some of the main ways we're seeing IT have an impact so far," he added.

Wigginton outlined the following five keys to understanding IT and the patient-physician relationship.

1. Patient-centered IT initiatives hold multiple benefits for the physician. Small physician practices in particular, Wigginton said, need to adopt the same features as their competitors. And, it's important to note their competitors are no longer just their fellow physician practices down the street. "As Walmart and Walgreens and CVS expand into transactional, low-cost primary care, there's a competitive pressure to be able to add these features," Wigginton said.  And although a competitive edge is important, he said maintaining closer and more convenient relationships with patients has incredible value. "Your inability to communicate with them in modern terms is a big hindrance," he said. "My financial planner, my physician trainer – all the people in my life who are important to me, I can communicate with through e-mail and other channels. It makes it easier to achieve the best health outcomes when a physician practice adopts this [approach]."

2. Challenges exist when it comes to reimbursement models. The disconnect between physician practices and IT initiatives almost always involves the business model, Wigginton said, and the value of the technology. "There are some challenges that aren't widely addressed but are brought to light by both physicians and patients with the advances in IT," he said. The biggest of which is the advancements in IT – e-mailing, texting and video conferencing – coming without payment. "There's no good reimbursement model, and most of those reimbursement models are rooted in the traditional office visit," Wigginton said. "So it puts pressure on the physician to do more for less – not the same, but less. It's a double-whammy because there's a higher service load on the physician and higher expectations from the patients, given these tools. There are only a few instances where the business models align."

3. Patient-centered IT practices continue to vary.  While larger-volume practices are using e-mail and patient portals to optimize patient input, lower-volume, more patient-centric practices are using e-mail, text, video and mobile apps, said Wigginton. "They're doing it to create more of an impact across a broader spectrum of their patients' health; they're helping them manage it not only when they're sick, but also [through] interactive wellness programs." The most important part of employing these technologies, he continued, is to find what works best for the patient. "If I'm a texter, I'll text; if e-mail is my thing, I'll do that; and if I want to come to your office, I can," said Wigginton. "I want my physician to be highly knowledgeable about me and communicate with me and have a relationship with me."

4. It's about meeting patients’ expectations. "We have patients who maybe don't think about themselves as patients, but as consumers," said Wigginton. "They have different expectations of how they connect with the people around them and access information." For example, younger patients prefer to direct message a physician, as opposed to e-mail or texting. "Other industries do this exceptionally well," Wigginton added. "Other industries apply IT to support interaction between them and their consumers, and they have very smart consumer-oriented solutions." It's important to learn from these approaches whenever possible, he said, not only to avoid "reinvention," but to also understand how these approaches translate into healthcare. "Whether they're driven from the regulatory environment, like HIPAA, or the reimbursement environment," he said. "You can't have services that essentially eradicate half of your service visits – you'll bankrupt your practice."

5. We're not finished "experiencing innovation. "If there's one thing we know for sure, said Wiggington, it's that the industry is nowhere near close to limiting the ways people communicate with one another. "We're not stopping face time," he said. "There's something after face time and there's something after tweeting and Facebook pages. We will continue to see innovation in the ways people get and process information." The future includes not only more innovation around reaching out to patients, he added, but also more convenience on the provider side. "The best of those services will offer consolidation," he said. "So for the physician, there will be an easy way to manage a patient panel who has different preferences." The consolidation, he predicts, will be the essential feature of physician/patient services. "There's difficulty in coordinating all that, and making sure those things come back together is very critical."

Follow Michelle McNickle on Twitter, @Michelle_writes

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