In my previous post I discussed what I believe to be the most important paths to patient engagement without technology. I would like to now discuss how technology can promote patient engagement. This technology might be in the form of a health/medical app, a patient portal, information derived and transmitted via sensor or other type of digital health technology.
1. Technology is always to be used as an adjunct tool, not the sole solution. This is probably the most fundamental consideration. I chuckle when I hear of a technology presented as a "solution." Solutions do not occur in a vacuum. Technology must always be incorporated into some process, whether it's limited to the user or spans a network of individuals. Much data might be generated, but if it resides in a magic silo without being filtered and translated into a meaningful actionable message, it's useless. It's also useless if the following four issues are not addressed.
2. It must be used with consideration of health literacy, ethnicity and language. The patient experience is a phrase getting much attention these days. While there is little in the way of data correlation between quality and patient satisfaction, one can't argue that intuitively if cultural, ethnic and language barriers are addressed with technology tools, the potential for reduced medical errors, better patient satisfaction and perhaps even better outcomes might result. In searching for such a tool, I found a unique and interesting technology called SpeechMed, which incorporates language translation into connected platforms. Improving language literacy will undoubtedly improve health literacy. Platforms should also take into account ethnic and cultural differences that might imply using a different user interface for selected populations (as well as ages).
3. It must include the caregiver. Any technology aimed at self-management needs to take into consideration the caregiver. The importance of technology in assisting caregivers is discussed in a review titled Family Caregiving and Transitional Care by the Family Caregiver Alliance. The role of technology and the caregiver has also been discussed in a previous post by me.
4. It must be connected. I believe that the patient portal is the single most important key to patient self-management. It can serve as a repository for medical records including videos, PDF files, medical apps and other content. For this piece of the puzzle to be most effective, it must permit connectivity from diverse technological sources. Barriers to this are economic and political, not technological. As the patient portal market and health information exchanges mature (Stage 2 of meaningful use dictates the use of patient portals but only requires that 5 percent of patients have them), I see connectivity becoming less of an issue. The development of open-sourced platforms will also help in this regard. The patient portal can thus become the source of convergence of many different digital health technologies.
5. It must be endorsed, not despised by healthcare providers. Technological advances in therapies are expected and even anticipated by many healthcare providers. They are seen as symbols of progressive and modern medicine. Yet due in large part by their experience with EHRs, many providers are pushing back other types of digital technologies. If technologies are easy to use, are accepted by the patient and caregiver, provide demonstrated benefit and deal with data in a filtered and algorithmic manner, attitudes would change. As a former practicing clinician who speaks with former colleagues daily, this is not a small barrier.
I look forward to hearing thoughts from readers about these points. Patient engagement is going to be a cornerstone of healthcare in the future. We must find the best ways in which to achieve it, with both humanistic and technological factors considered.
David Lee Scher is a former cardiac electrophysiologist and is an independent consultant and owner/director at DLS Healthcare Consulting, LLC, concentrating in advising digital health companies and their partnering institutions, providers and businesses. A pioneer adopter of remote cardiac monitoring, he lectures worldwide promoting the benefits of digital health technologies. Twitter: @dlschermd. He also blogs at http://davidleescher.com. He was cited as one of the 10 cardiologists to follow on Twitter and one of the top ten blogs on healthcare technology.