The herd is cold. The snow is well up their legs. It is snowing still. The herd walks slowly toward the dark, carefully, unsure what is ahead. Each animal feels colder and hungrier than the rest. A single animal, at the periphery of the herd, snaps her head up and listens. Is it the sound a pack of wolves or is it a farmer bring life saving food?
The headline below from Express.co.uk expresses a similar sense of danger:
Do telemedicine solutions attack and kill health care, or are they the food that will save it? The answer, we argue below, is that telemedicine solutions can do either. If technology manages the user, it attacks and kilkls. If the users manage the technology it nourishes and saves.
Wayne Kashinsky, brilliant and inventive engineer and founder of one of the very first retail computer stores in the country has said: “No one really needs a computer.”
That remembered, and despite many computer purchases later, by us, from him, we are reminded that no one really needs technology either. So when technology rustles from the dark, what should the herd do? The animal snaps her head up as does the UK Express headline “End of The Doctor’s Surgery". The first paragraph reads: "A BID to save nearly £3 billion by slashing appointments with a doctor and treating patients via computer will put lives at risk, ministers were warned.” Translating English: Three billion pounds equals 4.8 million dollars. A “doctor’s surgery” means “doctor’s office” in British English.
A quick look at the Digital First report, either the executive summary, or the complete report, proposes to save money on British health care. While England’s National Health System is often lauded in the USA, they clearly share some of the same problems.
The report focuses on where even simple interventions such as appointment scheduling can make a difference. This NHS report also shows how other interventions add up to as C. Everett Dirksen is alleged to have said, “A billion here and a billion there, and pretty soon you’re talking real money.” This report outlines an impressive plan. The report deserves respect, but it misses the mark a bit.
A criticism, indeed a strong criticism, is that the report fails to recognize the untapped value of medical collaboration. ClickCare feels strongly that medical collaboration solves the perceived dichotomy of humanness and technology. Medical collaboration (or health care collaboration) takes the transfer of data and combines judgment, wisdom and empathy to create more than report and opinion. It move beyond objective data toward subjective support--of the patient and of the provider.
The concern expressed about the “End of the Doctor’s Surgery” is legitimate, but misguided. Patients and providers, the herd, will find food and succor if they listen to the noise in the dark and move toward it rather than away. A better outcome can be managed by the good intent of providers.
Reducing the digital divide means interposing caregivers and providers who care to collaborate on behalf of their patients.
Which brings the discussion to access. If care can be given more efficiently, should it be? Or, is the very inefficiency of care we currently have actually seem to be a help? Can the “need” for a post operative checkup be substituted by a virtual visit? Is there a cost to saving money? The provider who communicates with the patient verbally, digitally, but always empathetically neglects nothing. Conversely, when a physical visit ito a provider is hurried, non-communicative, and rushed, good care is incomplete. To us, this discussion is not a matter of the method and manner in which care occurs, but rather it is a matter of intent of why does it occur. Do we merely meet standards and quotas, but care little for the patient? Are we going through the motions, but doing it without empathy? The choice of an electronic visit or a physical visit matters little if we don’t communicate and collaborate with the patient. The patient needs to communicate too. It will take some time to find a balance, but the principles of good care never change.
Unfortunately, the National Health Service (NHS) lost its way in the forest by looking at the trees. Beyond access, the real value and savings in telemedicine is in supporting providers and patients to allow collaboration as they use data. This is the core concept of iClickCare. And we should never forget, education which is enabled by store and forward telehealth.
The member of the herd should be startled, but more than likely there is help not danger lurking at the edge of the dark. As providers, we need to be sure we hold hands and not count beans while we learn medical collaboration.
Reference and attrribution:
Digital First: http://digital.innovation.nhs.uk/pg/dashboard
C Everett Dirksen: http://www.dirksencenter.org/print_emd_billionhere.htm