When our founder, Cheryl, went to medical school, there were only 5 women in her medical school class. (Actually our medical school class since both of us were in the same medical school class and shared a cadaver.)

Things have certainly changed since then, in some ways for better and in some ways, for worse.

Although Cheryl’s medical school class only had 5 women in it, in 2017’s incoming medical school classes, women made up just over 50% of students. As this is Women’s History Month, that seems a milestone worth noting. 

Surely, allowing the makeup of our doctors’ demographics to reflect the demographics of the talented people in our country is good for everyone. So the equity in representation of the genders in medical school classes is likely a step forward.

That said, I was, quite honestly, saddened and surprised to hear that female doctors earn 27.7% less than their male counterparts (an average of $105,000 less.) This number actually has increased since 2016.

The pay gap, of course, is a serious issue across all industries and physician pay aligns with the pay gap that is seen in other professions. And truthfully, the pay gap for lower-waged workers is probably more significant of a problem for those experiencing it.

But my concern about this pay gap in medicine goes beyond gender equity or salaries. My concern is greater because I believe this persistent — and growing — pay gap is representative of our tendency in medicine to devalue the contributions of some medical providers relative to others.

This instance is especially stark because the job being performed is exactly the same. So we're very obviously undervaluing the contributions of female doctors relative to male doctors.

But we do this across the medical team. We each have such unique contributions to a patient's case. When we refuse to use existing tools to do medical collaboration, we are effectively saying, "my opinion on this case is the only one that is relevant."  When we refuse to ask colleagues to collaborate, when we disregard the perspectives and input of others on the team, or when we neglect to consult on a case, we're devaluing those perspectives and the patient suffers. 

Stark data is always a chance to see where we find the same dynamics in our life or practice. So as Women's History Month comes to a close, I hope we can use it as a moment to reflect on how we might value, reward, and listen to all of the voices on the medical team, regardless of gender or title. 

We’ve heard key investors say that the biggest startups over the next 10 years will be those that follow the model, “machine learning + _____________.” In other words, the future’s biggest companies will be innovating at the intersection of computer’s intelligence and human reality and wisdom.

Similarly, many people who look to the future of medicine see healthcare being increasingly supported — perhaps in profound or even dominant ways by computer diagnosis.

iClickCare, of course, is medicine supported by technology, also. And a big part of our work is finding the right balance and interaction between people and the technology. Our interface is meant to minimize the feel of using technology while maximizing the “behind the scenes” work that the technology is doing to support the collaboration and coordination. It’s sophisticated, patent pending technology that feels deeply simple to the healthcare providers that use it to collaborate.

This week, we were both saddened and inspired to hear about the recent passing of Catherine Wolf, a scientist who focused her work on the interactions between computers and humans. She was a forerunner in her field, working at IBM’s Thomas J. Watson Research Center and helping develop voice-recognition systems as well as early “picture phones” and cellphones.

She also was diagnosed with ALS 22 years ago, giving her firsthand experience of using computers to communicate when her mobility was limited to an eyebrow raise. She continued to work, innovate, and to write, learning to use technology as adaptations to allow her to continue to thrive.

Her story reminds us of the profound potential of the “collaboration” between humans and computers. We’re reminded of how much we’ve progressed in the last few decades and we imagine how much more potential there is.

We’re inspired by the potential for deeper humanity, creativity, and contribution, as exemplified both by Wolf’s work as well as her life.

For an in-depth look at why we choose the technology we did for iClickCare, and how it "gets out of the way" of the people using it, download our free Quick Guide: 

I love listening to a podcast called Rework. They talk about work and business in interesting ways -- and although they're certainly not in the medical field, many of the insights apply. 

Last week's episode really stuck with me as important and made me realize just how far behind the healthcare field is. The episode, Interruption is Not Collaboration, looked at the cost of interruptions in the workplace.

If you're like most healthcare providers, the thought of even talking about "interruptions" seems ridiculous. In a medical setting, the day is one long interruption. There's so many things scheduled and happening simultaneously, that we become used to the situation, not noticing the cost. 

In fact, as is cited in Rework's episode, when we are interrupted, it takes about 23 minutes to recover from that interruption, in terms of productivity and the quality of your focus. In other industries, business leaders have started putting in place systems and tools that limit interruptions. Not for emotional reasons, but because the interruptions are "expensive" in their impact on work, in productivity, quality of insight, and errors made. But in the world of healthcare, we accept interruptions as normal and do little to try to minimize them.

I believe that many of my colleagues have little interest in medical collaboration because when they hear "collaboration" they think of interruptions in the form of: 

• Text messages
• Phone calls (or calls they have to return) 
• Videoconferencing appointments
• More meetings to attend. 

Of course this is what providers envision when they think of collaboration -- because these are the common forms that collaboration ends up taking. But these forms of collaboration come at such a high cost in terms of the provider having to interrupt or step away from the rest of their work -- that the collaboration becomes very much not worth the trouble. The other challenge with collaboration taking this form is that because the medium is so ephemeral, the conversation is not archived or accessible over time. Once the question is answered (like so much in our virtual world), it ceases to exist.

This is why we believe so firmly that healthcare collaboration needs to take the shape of Hybrid Store-and-Forward® telemedicine. It's absolutely crucial that care coordination and healthcare collaboration be sustainable, and supportive of the rest of the provider's workflow. Providers need to be able to ask and answer questions on their schedule, in their own time. With this form of collaboration, questions and answers don't interrupt the rest of your work, you can answer in a way that works with the rest of your schedule, and the case is archived for future review. That means that all of your patients get the most focus you can provide, and that you get the satisfaction of finishing one thing before starting another.

Your work matters too much to allow interruption to be the way things happen. Demand more for yourself -- and demand more for your patients.

To learn more about Hybrid Store-and-Forward telemedicine, download our free quick guide: 

Most healthcare providers don't have a lot of mental or physical space during their work day. Whether it's to make a phone call, have a bite of lunch, or a private conversation with a colleague.

I always used to find respite in the surgeon's lounge, both the respite of a quiet moment, and the respite of an inspiring or helpful conversation with a colleague.

Today's medical context is simultaneously more isolating and more exposed that it ever was before.

We're almost never left to quiet and solitude to reflect on a patient -- but we're also very much disconnected from our colleagues when it comes to collaborating on a case.

So I was curious to hear a radio story that looked to the origins of the "open offices" so popular now in corporate America. It's now quite mainstream to have an open, playful, flexible office, but when the advertising agency Chiat-Day created one, it was incredibly unique.

As Planet Money describes the office: "There was also a ping-pong table, a giant staircase to nowhere and the piece de resistance, the floor - poured plastic resin… The desks in this office were all on wheels, and the chairs were plastic with coiled springs for legs." It was gorgeous, it was bold, it was brash -- and everyone had to be moving and talking to each other all of the time. There was no room for anyone to have a private conversation, to store their things, or take some isolated time to think.

In fact, the architect that created it, Gaetano Pesce, still believes the design he came up with (pictures here) is transformative and is a boon for creativity.

Was the design a success or a failure? Well, it certainly depends who you ask. But many people who worked at Chiat-Day when they had the open office say that it was very cool but that it simply didn't work for everyone. For the more reflective, or the more introverted, or for those who simply needed to work in a different way, the office dictated a certain way of working -- rather than supported the unique way that each person wanted to work.

So on the one hand, I find the study fascinating because I think that in medicine, there is a very specific need to find a balance between connection and solitude. So much of what we talk about with iClickCare is that it connects you. We use telemedicine to facilitate healthcare collaboration -- connection among you and other providers. 

But iClickCare also has another important role -- it protects you. Rather than the video-conferencing scheduling nightmare, or the million-and-one consult phone calls, or the barrage of emails that most of us face, iClickCare is specifically designed to work on your schedule, in your way. Hybrid store-and-forward telemedicine is asynchronous -- which means that you don't need to be answering consults, or requesting consults on any particular schedule -- you can do it in the way and at the time that works for you. 

So we are always on the lookout for tools, spaces, designs, and cultures that are designed with people in mind -- all people. 

Collaboration is good, but has to be on individuals' terms.

This is our guide to all the details, pros, and cons of hybrid store-and-forward telemedicine. You can download it here, for free:

The American Telemedicine Association reports an amazing change in regulations: 49 of 50 states now have Medicaid programs that cover telemedicine for low income beneficiaries. (The single outlier? Hint: the smallest state in the nation.)

This report also notes that Missouri is a new member of an exclusive but growing group of states on the cusp of expanding coverage to store and forward Technologies. Store and Forward means non-videoconferencing, but instead communication with pictures and words in an email-timeframe. At this time, Missouri joins New York by specifically including -- and covering -- providers of all types and across the continuum of care.  

These legislative trends are at the convergence of several trends that are obliterating the barriers to telemedicine. Modern technology that assists in the everyday care of patients -- telemedicine and telehealth -- is no longer an experimental, conceptual idea. It is no longer about pilots, trials, and demonstration projects. In fact, telemedicine isn't even that cool or new anymore -- it is a mainstream, valuable, everyday tool.

With this change in telemedicine's place in society comes a change in providers, and a change in supporters. No longer is the only telemedicine model that of a central expert "helping" dispersed or lesser-resourced/educated/connected outposts. Now, and especially with store and forward telemedicine, these tools can help all providers support, challenge, educate, and collaborate with each other. And it's a good thing, too. Sometimes the most influential provider in the room is the one with the least number of degrees, but the closest contact with the patient. Sometimes, it is the patients themselves.

Missouri and New York, while pioneers, are enabling what we at ClickCare have been espousing and creating since our early grant days in the 1990s. They are enabling patients' access to care. They are ensuring that everyone, including the patient, should be involved in care at the right time and the right place. And most importantly, they are allowing collaboration to happen -- which means better care for each patient. 

So we call for more pioneers to join Missouri and New York in cultivating and enabling access, collaboration, and (don’t forget) education.

Still learning the basics of Hybrid Store-and-Forward® telemedicine? This guide can help: