As a family doctor, I have seen a dramatic shift in the range of people I work alongside every day – all for the better. When I was in training, most family doctors worked only with other family doctors and registered nurses. Today my health care team is rich with a variety of skilled people, including social workers, psychologists, chiropodists and dieticians. There are even examples of primary care teams engaging lawyers and accountants to help with health-related issues, such as housing and income.
But what’s missing – and should be an essential part of any healthcare team – is the digital expert. Here’s why.
Health care has been consistently changed by technology for decades. Historically, however, the change has been driven from within the healthcare system. PET scans, laparoscopic surgery, interventional radiology, digital imaging and electronic medical record systems are just a few examples of technological changes we now use routinely.These advances have been large scale, top down and expensive.
Now three relatively low cost, consumer owned, technological innovations are changing the game.
First, smartphones with a plethora of apps devoted to healthcare improvement, including those related to exercise, diet, chronic disease management and mental well-being, are ubiquitous among almost every demographic. Second, medical devices such as glucometers, scales and blood pressure cuffs are increasingly digitized and able to hold significant amounts of patient specific data. Finally, wearable technology, including watches, exercise bands, clothing and glasses, is exploding in popularity.
These technologies are even starting to merge as smartphones become medical devices capable of monitoring a person’s heart rate, heart rhythm, respiratory rate and oxygen saturation, among other critical health indicators.
Yet these important new technological innovations exist outside of my day to day family practice. The thousands of health related data points captured by these three types of personal technologies are not yet part of the health system. They should be.
Currently I rely on isolated data points and rough estimates. I take a blood pressure reading the day I see a patient, and I ask them how much alcohol they drank that week, what they tended to eat that month and push them to estimate how often they have exercised since our last visit. What I get are data points that reflect moments in time and the best efforts of an individual’s memory. Yet the information I need to help guide their care is often already nested in their smart phones, medical devices and wearable technologies.
But here’s the problem. Despite a steady growth in electronic medical records – and, simultaneously, patients investing in health-related personal technologies — the two worlds of technology can’t routinely talk to each other. Currently I may have a patient print out the results from their medical devices or apps and then scan the information into the medical chart as a static document.
Here’s what the future needs to look like: When patients come for their regular appointments, the first person they meet with should be a digital expert on the healthcare team. She has the ability to securely and quickly upload all the data from their various devices into the medical record in a manner that can be appropriately integrated, searched, displayed and programmed to show trends over time.
When the doctor – or any other member of the healthcare team – sees the patient a few minutes later, we now have days, weeks and months of helpful health information.
The digital expert on the team would offer far more than just synching devices at the appointment. They would be available to help link devices and apps remotely to a medical record without the patient even needing to come into the office. They could also act as a resource to help guide patients through the growing morass of choice in the wearable, digitized and app laden world of health care. They could also be key leaders in the research and evaluation of this emerging area.
Better data can improve healthcare decision-making and contribute to better quality care.
Patients already believe this, which is why they invest time and energy in collecting their health data. It’s time to take better advantage of their efforts – and a digital expert on the health team can help.
Joshua Tepper is a family physician at St. Michael’s Hospital and Associate Professor at the University of Toronto.
