ClickCare Café

Doing Embarrassing Manual Workarounds Instead of Using Tech? You’re Not Alone

Posted by Lawrence Kerr on Thu, Jul 11, 2019 @ 06:00 AM

clark-young-fQxMGkYXqFU-unsplashI run a technology company. So people are sometimes surprised when I choose decidedly low-tech solutions in my life or work. For instance, in my hobby of woodworking, I don’t use any electric tools — just hand saws, chisels, and the like.

I know that many people approach technology in their work and medical practice similarly. There may be a higher tech way of doing things, but many of us have either habits or very good reasons for doing things manually.

So when is technology the wise route? And when can that have hidden downsides that we’ll only realize once it’s too late?

A new report looks at the choices that Operations Executives make when it comes to technology and digitization. 

There are many automated tools for data visualizations and analysis that many COOs need. It would make sense for these executives to adopt the technologies — they limit mistakes and save time. The reality?  62% of operations executives say that their core systems make it hard to digitize processes. Often, the choose manual processes and manual workarounds instead — but the results are outstandingly negative: 

When processes are manual, operations execs report major risks to businesses: 

  • 62% say it slows down performance
  • 48% say it increases costs
  • 38% say it increases compliance risks

Usually, these manual workarounds are desperate attempts after having tried other tech solutions and being backed into a corner. Many executives try "off the shelf" solutions but report other big business issues: 

  • 36% said it couldn’t meet their mobile requirements
  • 21% said it required additional professional services
  • 31% said it couldn’t deliver the customization they needed

We've run into this over and over again with hospitals and medical practices. They think they "should" use technology for medical collaboration or telemedicine. They try some comprehensive, expensive, hardware-heavy solution. And the results are very similar to the above: the systems don't fit into their providers' workflows, they don't work across different hardware (e.g., mobile), and they're not adaptable in different situations and over time. 

As this author shares, "Operations executives need a software solution that enables them to easily build and modify applications that address their unique processes and systems. Furthermore, they need to be able to do so quickly, cost effectively, and without compromise." 

Honestly, that's precisely why we made iClickCare so low-cost, adaptable on any hardware, and endlessly flexible for different workflows. Ironically, some hospitals and executives have balked at iClickCare being so affordable and adaptable — perhaps looking for a "big splash" implementation. 

I believe that you should use the technology that's most appropriate for your situation and your goals. For my woodworking hobby, that means no electric tools — less injury, more craft, and a better experience. For many providers looking for telemedicine or medical collaboration technology, that means a flexible, low-overhead tool like iClickCare. Don't fall into the trap of reverting to old manual processes or tools that aren't really working — and don't fall into the trap of the "big splash" implementation. Be courageous enough to insist on technology that's appropriate for you, and for your patients. 

 

You can try iClickCare today, with a free download: 

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Tags: telemedicine solutions, telemedicine technology, medical collaboration tool

5 Big Insights from a (Yes, Really) Tele-ICU Program

Posted by Lawrence Kerr on Thu, Jun 20, 2019 @ 06:00 AM

luis-melendez-530478-unsplash (1)Telemedicine has its limits. There will never be a completely virtual replacement for in-person visits and care. 

Where that limit really is, though, I don't know. I find I hear about more and more unbelievable telemedicine programs every day. The most recent? A tele-ICU program that actually seems to be working. 

Honestly, I'm not positive whether this program is ultimately "good medicine" or whether it's a shortcut that shouldn't be taken. But I do think that the very extremeness of the the program gives us some insights about telemedicine and medical collaboration more broadly (not all of which are positive.)

Recently, Lou Silverman of the telemedicine company Advanced ICU Care sat down with Fierce Healthcare to share thoughts about his program and about telemedicine more generally. 

And these are 5 insights about telemedicine and telehealth that that came out of that conversation:

  • Good care is what matters -- not whether it has "tele" in front of it.
    We've always said that if you put the individual patient first, the means for caring for them will follow. For instance, you get a telemedicine consult via iClickCare because the patient's case demands it -- not because it's routine. As Mr. Silverman says, "The industry has done itself a disservice by continuing to imply that 'health' is distinct from 'telehealth' or that 'medicine' is distinguishable from 'telemedicine.'  My view is that we are all part of a singular ecosystem with uniform goals and a unified vision around improving care for patients and delivering the care where and when it is needed in a manner that is both clinically and cost effective."
  • Medical collaboration gives us the best answer, regardless of who contributed it. 
    Most people in medicine are altruistic; but egos can also creep in. That's why Mr. Silverman's reminder about team collaboration is crucial: "Success is achieved by the team, that performance counts and politics do not. Our attitude is that the best answer always wins. Period. It doesn’t matter who had the idea or how we got there."
  • Expensive technology does not make a program "important."
    We've had hospitals turn down iClickCare because it doesn't require any expensive hardware -- it's shocking how much people connect expense, novelty, and quality. But Mr. Silverman is right: "Great healthcare delivery is a fusion of data, expertise, experience and empathy. Viewing technology as a facilitator—and not a shiny new toy unto itself—is also an important part of the mindset. Healthcare is about people helping people. Twenty-first century healthcare is about helping the most people possible achieve outcomes that they did not think were possible."
  • Broad telemedicine adoption is on its way. 
    It's so heartening to know that telemedicine is finally finding broad support. "Today, there are very favorable tailwinds regarding government policy in telemedicine. Individual states and the federal government are making tangible progress in advancing telemedicine initiatives," Lou Silverman confirms. 
  • Just because something is possible, doesn't mean it's desirable. 
    The fact that a tele-ICU program is even possible is reflective of just what an amazing time we live in. That said, the fact that it's possible doesn't necessarily mean it's the best way to provide care. The truth is that I am not completely familiar with the realities of this program. But I do think it's crucial to always look beyond ROI to what makes an impact on the patient. 

 

Telemedicine is an exciting and important tool. But as the insights above illustrate -- it's not an end unto itself. It's about finding the best tool for the best care. And that's for each provider and hospital to decide. 

Curious about using telemedicine for medical collaboration in your setting? You can get started here. 

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Tags: good medicine, telemedicine technology

Disturbing but True Facts About Technology and Doctors

Posted by Lawrence Kerr on Fri, May 03, 2019 @ 06:00 AM

 

glenn-carstens-peters-282287-unsplashIt’s one of the conundrums of modern life that time-saving technology sometimes takes more time than it saves us.

For instance, email is quicker than a phone call, and yet office workers spend an average of 4 hours a day checking their email. We're somehow spending so much time managing the technology of connection that we have less time to actually... connect.

And medicine is no different — healthcare providers are spending dramatically increased times interacting with EHRs/EMRs and plummeting hours with patients. 

It’s disturbing but true: a study of first-year residents shows that 43% of their time is spent interacting with electronic medical records — that’s 3 times more than they spend interacting with patients. In fact, according to JAMA, they spend nearly 90% of their time away from patients.

The problem with this time split isn't so much that it's not efficient. The problem is that healthcare's most valuable assets  the human beings who are our healthcare providers  aren't being used to their "highest and best" potential. That matters for the output that we see from them (in terms of quality of care and innovation) as well as for the long-term sustainability of healthcare (considering the sky-high rates of healthcare provider burnout.) 

It's easy to look at this and bemoan the use of technology in medicine. Perhaps technology is inherently distracting, alienating, and time-consuming?

Personally, I don't think so. Technology can detract from our time with patients or it can add to it. What makes the difference is whether the technology we are using has been thoughtfully designed, intuitively structured, and whether it integrates into our workflow. The answer to all three of those questions for most Electronic Health Records is a resounding "no," which is why EHRs have become such a time-sink and distraction for doctors.

The truth is that we can’t go backward to an era of black doctors’ bags and paper medical records. But we can go forward to an era of holistic, integrated technology. And I think that as leaders in medicine, it's our responsibility to demand technology that supports human engagement, the art of medicine, connection and collaboration with our colleagues, and the highest and best use of our time. This demand of our technology is far from frivolous; it's key to our ability to uphold our commitment to our patients.

Thankfully, I think that there are subtle signs that healthcare is beginning to swing its huge pendulum back toward human interaction and human-scale healthcare. As Dr. Zimlichman wrote recently, even hospitals themselves are becoming a "technology" that is unwieldy and shows signs of shrinking in significance: 

“The hospital as we know it—a medical center crammed full of patients, beds, equipment, medical staff and service workers, and much more—is an expense society can't really afford anymore... Other industries—retail, banking, finance and others—have long used digital tools to enable clients and businesses to collaborate and connect, anytime and anywhere. Those tools are now available to the medical industry—and given the constantly ballooning costs of care, the hospital is a perfect candidate for its own digital revolution.”

In other words, its possible that we are actually at the peak of technology's negative impact on medicine. And that as technologies mature and healthcare evolves, technology may actually begin to bring medicine back into a more sane, human-centered way of working. As healthcare providers, we can usher that new way of working into reality  or we can resist it by holding tight to "the devil we know."  I suggest the latter.

 

Curious how a simple technology like iClickCare actually works? Watch a 1-minute video to learn more: 

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Tags: EHR, EMR, telemedicine technology

Why Developing Countries Beat the US in Medical Technology

Posted by Lawrence Kerr on Tue, Apr 23, 2019 @ 06:00 AM

annie-spratt-210845-unsplashThose of us who live in the US tend to think of our medical system as the most cutting-edge in the world.

And there is a lot of truth to that — medical innovation is certainly an area of strength for us and we can be proud of our contributions. 

That said, a recent New York Times article put a spotlight on the ways developing countries can show a special kind of rapid innovation with technology that sometimes leapfrogs our slow, deeply challenged adoption patterns.

Any new technology presented to the US medical community has to beat a gauntlet of obstacles to be adopted. Between regulatory issues, compatibility troubles, concerns about compensation, and political drama, the adoption of any new technology is a minefield.

Sometimes the needs of developing countries make technological adoption quicker and more focused than it would ever be in the US. For instance, a new ultrasound scanner has been invented that can do ultrasounds anywhere in the world, with a device the size of an electric shaver, connected to an iPhone.

As the New York times reports, “Two-thirds of the world’s population gets no imaging at all,” so the allure of an ultrasound wand that can provide even rudimentary imaging is compelling for medical providers and NGOs in developing countries. Many times, the stance is one of finding innovative ways to use technology, rather than having the immediate reaction be one of resistance. Further, experimentation seems to come at less of a perceived cost, as downsides of failures may not be as dramatic in terms of repercussions.

So within a short period of time, providers in Uganda used their new ultrasound wand to scan everyone from babies to nonagenarians. And their approach to using it in service of diagnoses was deeply creative.

 

My challenge as the founder of a medical technology company is to support US medical providers in approaching innovation in this same way — but of course in combination with all of the advantages that we have in our medical system. How is that possible?  I believe that when providers in the US make an effort to try new technologies as quickly and cheaply as possible, it lends us the type of speed and innovation sometimes only found in a country like Uganda when experimenting with an ultrasound wand. The smaller and faster our experiments are, the less investment we have in every single one succeeding. That's what I'm so passionate about iClickCare as a medical collaboration tool  it doesn't require expensive hardware, even one doctor can start using it on his/her own, and it's so intuitive to use that you can do your first consult within minutes. That means that it's inexpensive and fast for medical providers to experiment with its optimal usage in their unique medical setting  making innovation much faster and more expansive than it is with huge, expensive, and years-to-implement videoconferencing hardware. 

 

We can certainly learn something from the resilience and creativity of other countries  and innovation around medical technology may be one place to start. 

Try iClickCare for free, and do your first consult in minutes:

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Tags: telemedicine technology, healthcare collaboration software

Your Medical Team is Changing, Whether You Like It or Not

Posted by Lawrence Kerr on Tue, Jul 31, 2018 @ 07:00 AM

rawpixel-577480-unsplashOne of my favorite parts of medicine is the experience of working across the continuum of care, with providers from a variety of backgrounds. Certainly, colleagues like nurse practitioners and RNs are deeply valued but people like orderlies and administrators are also passionate parts of the healthcare system that form key parts of the team. 

In my practice, one of the most successful parts of the what we did was to demonstrate in word and action that every single person, who is part of the medical team, is deeply valued and has a unique contribution that only he/she can bring. This approach was brought into our lauded Cranio-facial Team, as well, through which providers from social workers to plastic surgeons to oral surgeons, each of whom collaborated on complex cases like cleft palate and cleft lip care. In short: much of the richness I find in medicine comes from the diversity in our medical teams. 

That said, it can feel unmooring or even alarming to notice the ways that our medical teams are changing, especially when it comes to a relative decrease in the importance of physicians and the boom in numbers of providers like nurse practitioners. 

A recent article in the New England Journal of Medicine, Growing Ranks of Advanced Practice Clinicians — Implications for the Physician Workforce, looks at the boom in advanced practice registered nurses (APRNs), relative to the almost imperceptible growth of physicians in the US.

To start, one simple fact stood out to me: “Throughout the history of modern medicine, physicians have made up the vast majority of professionals to diagnose, treat, and prescribe medication to patients.”  This, of course is changing. An increasing part of healthcare is done by advanced practice registered nurses (APRNs), including nurse practitioners and physician assistants. Even with the current numbers, 41% of physicians work with nurse practitioners.

While the number of physicians in the US is growing very slowly (projected at 0.5% per year 2016-2030), the number of APRNs is growing quickly. Training times for these providers are shorter and there are fewer institutional constraints. The article authors did a rigorous projection of expected physician growth alongside expected APRN growth, based on census data, growth rates, and other key data. The result is that comparing 2001 to 2030, the percentage of APRNs relative to the pool of providers and APRNs together will go from 13% to 35%.

As doctors, we can bemoan these changes. We are all too familiar with the depth and rigor of the training we’ve received and it’s hard to fathom how an APRN can provide care that is as good as training that is less sophisticated.

But the reality is that, as the study authors assert, "These dynamics will have lasting effects on the composition of the health care workforce and working relationships among health professionals.”  Our medical team is changing -- our choice is how we adapt our work so that our medical teams can be as effective and satisfying to us as possible. 

The authors state unequivocally that “The changing composition of the workforce will have implications for provider teams.”  They point out that primary care providers are tending to work in larger groups with varying backgrounds and types of training. But this doesn't always go smoothly. Alarmingly, a recent study of NPs and physicians working on primary care teams “found that physicians, other staff, and patients often confused the roles and skills of various providers and that these misunderstandings often led to practices undermining the productivity and efficiency of NPs.”

This is where I believe my colleagues who are innovating in the field of care coordination, medical collaboration, and hybrid store-and-forward telemedicine have some crucial insights to share. By using telemedicine-supported healthcare collaboration, we fundamentally change the orientation of medicine from a sole provider giving the best care she can to a team of providers offering the best care they can. If we are individual providers working on our own, APRNs are a threat to physicians, and vice versa. Further, their very existence muddles things, creating confusion in care plans and complicating care coordination. In many instances, this is how things are right now.

On the other hand, if we have a consistent system to use telemedicine-based healthcare collaboration to work as a team -- like iClickCare -- then APRNs and physicians can work together smoothly, each contributing his/her unique perspectives in a way that doesn't detract from the work of the other. 

And ultimately, that's a more satisfying, effective, easeful way to work, regardless of what the healthcare landscape looks like now, or in the future.

You can try iClickCare without cost or implementation challenges. Get it free here:

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Tags: nurse practitioners, care coordination, telemedicine technology, Physician Assistant, healthcare collaboration software

Big Investments in Telemedicine Have Risks and Rewards

Posted by Lawrence Kerr on Thu, Jul 05, 2018 @ 06:00 AM

rawpixel-570908-unsplashMany people, and most hospitals, identify money as the “missing piece” for the many projects they want to take on.

You would do that kitchen renovation, were it not for lack of funds. Your organization may add that new patient wing, but only if the fundraising goes as planned.

For decades, telemedicine — and digital health more broadly — existed in a very similar way. The field tended to feel resource-constrained and undervalued societally. There was so much we wanted to do, if only there were the money for it.

Recently, it has looked like that is changing — but is it for the benefit of medicine as a whole or not?

Looking at the business side of our arena, it seems as if investors are catching on to the potential. Rock Health has released a new report showing that “Investors sunk $3.4 billion into digital health companies during the first six months of 2018, nearly matching the record-setting $3.5 billion during the first half of 2017.”  Investors are investing more total, and more in each deal — the average deal size is currently $17.9 million.

Mostly, I think, this is a very positive development. Telemedicine has lagged behind so many areas of investment. And the truth is that investments in this kind of technology and workflow often have incredible benefits, financially, medically and socially.

Further, it looks as if this investment may be more considered than impulsive, with repeat investors leading the way. “Rock Health analysts noted that there have been more repeat digital health investors than new ones since 2016, a sign that the field is attracting experienced firms with long-term goals rather than 'tourists' attracted to the hype of the digital health industry.”

All of that said, I do think that intensive investment carries its risks. The cycle of invent, test, traction and sell can lead to a pace of growth that may not be sustainable. Is there a place for responsibility, measured growth, and stability? Excessive investment, poorly considered, at too fast a pace, usually only benefits a few -- and then only in a limited way. (We can all think of the example of the disillusioned startup founder with limitless wealth but deep dissatisfaction.)

Digital health may be a trendy field, but ultimately, it all boils down to a single patient, talking to a single person caring for him or her, and each of them working together to pursue the messy art of health. This isn't a process that can be rushed, forced, or even "optimized" in many cases.

Ultimately, I think that both the risks and the rewards of this kind of investment can be instructive to healthcare providers and hospital systems. Investors have sophisticated vetting mechanisms and the fact that money is pouring into this space, is important information that may indicate where hospital systems should invest too. That said, just as nationwide investment should allow for reflection, organic growth, and ethical considerations -- I believe that investment at the organization level should allow for these "slower" considerations too. As long as patient care improvement, and not resistance to change, leads the way

 

To learn more about one of the most important sectors of digital health, download our Quick Guide to Hybrid Store-and-Forward Telemedicine:

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Tags: hybrid store and forward medical collaboration, telemedicine technology

Why Intensive Programs Can Save Money Long Term

Posted by Lawrence Kerr on Thu, May 17, 2018 @ 06:02 AM

nick-hillier-328372-unsplashSometimes it is said that one needs to "slow down in order to speed up" -- meaning that the things that take time now can often save us time later. 

UnitedHealthcare's HouseCalls program, which recently surpassed 5 million visits, seems like just that kind of "slow down to speed up" situation. You wouldn't think that the program -- which brings healthcare to people's homes with house calls -- would be any kind of revenue generator or money saving initiative. But the results have been surprising.The program brings healthcare providers into peoples' homes, primarily for checkups and preventative care. For Paul Engwall, the visit by Hesper Nowatzki, a nurse practitioner, was life-saving. A simple urine dipstick done during Nowatzki's home visit, revealed kidney disease, which has since been treated. 

As Fierce Healthcare reports, "The program was solidified six years ago with the purchase of XLHealth, a Medicare Advantage plan that focused on beneficiaries with chronic conditions that were also eligible for Medicaid. At the time, UnitedHealth predicted it would add about $2 billion in revenues." 

The program tends to cut hospitalizations and high-cost admissions. "Practitioners typically spend 45 to 60 minutes with each member, often addressing issues that a primary care physician can’t, such as access to food and transportation that may be inhibiting access to care." 

This program may not win any awards for most cutting-edge technology, but the care and savings are exemplary. To us, it's a great example of a simple program that questions what we think are the most cost-effective ways to provide care, in order to prioritize care that is truly helpful for our patients.

Of course, we happen to think the program would be even more powerful if nurse practitioners like Hesper Nowatzki had the capability of collaborating with other providers (like specialists). How much better if any little "red flag" didn't mean the patient immediately needing to jump in the car, but could rather be additionally helped by a remote team. But for now, programs like these are certainly steps forward -- they question the things that we think will save money and prioritize the things that will really improve care.

 

Hear stories of how telemedicine programs are cutting costs and improving care: 

ClickCare Quick Guide to Telemedicine

Tags: telemedicine technology, telehealth and hipaa

Evidence-Based Analysis of Healthcare Costs -- and The Role of Telemedicine

Posted by Lawrence Kerr on Wed, Mar 28, 2018 @ 06:00 AM

Q

The most common questions that we get about iClickCare are related to cost and ROI.  What is the return on investment of telemedicine? Can doing healthcare collaboration bring additional income into the organization? Will iClickCare help us cut costs? (To which we answer: the ROI is excellent; definitely; and for sure.)

It makes sense, given the cost pressures that providers, practices, and hospital systems face these days. So much of what we do boils down to cutting costs or increasing income for the institutions that we work for.

This focus on costs makes sense in a lot of ways. But it is also a shame, given the profound impacts of using telemedicine for healthcare collaboration that go far beyond cost savings. Ultimately, for us, iClickCare is about good medicine, not just good economics. We find that healthcare providers, who do telemedicine and do healthcare collaboration, experience less burnout, better outcomes, AND increased income and decreased costs. It simply goes back to providing the best care that we possibly can for our patients: a principle we all learned in medical school.

That said, we were intrigued by a recent study that gets deep into healthcare costs in the US — with some surprising conclusions. Fierce Healthcare elaborates on the study by Papanicolas et al., which was published in the Journal of the American Medical Association last week. It's an exploration that lends some good science to the conversation around costs.

There are fascinating findings, some of which debunk drivers of healthcare that we tend to take as “obvious” causes of high costs. Conventional wisdom says, "Sure, medicine in the US is more expensive than in other places, but outcomes are better, and the costs generally come from use of high-tech interventions and pro specialists." 

The reality is more complicated than that. In 2016, the US spent 17.8% of its GDP on healthcare. That's significantly higher than in the 10 other high income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) that the study looks at. Expenditures in those countries range from 9.6% (Australia) to 12.4% (Switzerland). And, sadly, life expectancy (perhaps a proxy for outcomes, or perhaps not) is lower in the US than it is in the rest of these high-income countries.

The first focus of the study was the source of these high costs. As the study authors report, “Administrative costs of care (activities relating to planning, regulating, and managing health systems and services) accounted for 8% in the US vs a range of 1% to 3% in the other countries.” It turns out that it is precisely these administrative costs, alongside pharmaceutical costs, that account for the total cost difference in the US relative to the other countries -- not costly specialists or expensive procedures. 

The study certainly raises important questions about value. And the conversation around evidence-based approaches to costs is hugely important. It's certainly detrimental to our field that we often don't tend to apply the same amount of rigor to analyses of costs and drivers as we do to the content of our medical practices. Ultimately, cost concerns drive the context in which healthcare providers work, so it's crucial that we understand these costs accurately.

But there are no easy answers. Why do we spend more on administrative costs of care? Is it because we're failing at care coordination and healthcare collaboration or is it for another reason? Why is our life expectancy lower? Is it because of poor outcomes relative to the other countries, or does our heterogenous country have different starting points than these other countries (as just one example of an additional explanatory factor.) 

While fascinating and helpful, the study certainly doesn't give us simple conclusions. It's an important conversation to be having, but it's also important not to jump to knee-jerk responses that don't really support us in moving forward.

As healthcare providers, most of what we can control is just in our patient-by-patient decisions, trying to improve care, bringing down the time that we spend playing phone tag or coordinating care, and improving outcomes. And ultimately, that may make the biggest difference of all.

 

Get an honest review of one of the most cost-effective telemedicine approaches available, here:

 

ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: telemedicine technology, healthcare collaboration software, cost effectiveness

Looking to the Future of Medicine: Machine Learning, Telemedicine, and iClickCare

Posted by Lawrence Kerr on Wed, Mar 07, 2018 @ 06:01 AM

markus-spiske-187777-unsplash.jpgWe’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: 

 

ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: telemedicine technology, store and forward medical collaboration

What Your Netflix Recommendations and Telehealth Have in Common

Posted by Lawrence Kerr on Wed, Sep 06, 2017 @ 06:01 AM

samuel-zeller-360588.jpgAs you probably know, machine learning refers to the process through which a system can use a programmed process to "learn" and become more accurate over time. It's different from the way most of us think of a robot or a computer program because in this case, the programming changes based on the results it gets and new inputs available.

Experts say that the extensive use of machine learning in healthcare is inevitable. But how might that affect healthcare and what will the consequences of it be?

Machine learning is not a new field -- in fact, it was described by Arthur Samuel in 1959 as, “the field of study that gives computers the ability to learn without being explicitly programmed.” But exponential improvements in computing, plus innovations in AI and technology in general, have meant that the field has started burgeoning over the last few years.

Machine learning is used in applications from cyber security to healthcare to, well, the movies that Netflix suggests you watch after a long week. In medicine, we're seeing applications in everything from cancer prediction and prognosis, to diagnosis in medical imaging, to treatment suggestions.

For instance, when you search for, say, peach pie recipe on Google, you'll see search results based on what Google thinks matches those words. That's a regular computer algorithm. Machine learning comes into play, however, in that Google also "watches" (actually a computer collecting data) which search results you click on, and how much time you spend on the pages you visit, to re-rank and re-sort the search results it gives the next person searching for peach pie recipe.

There is a lot that is scary and even threatening about this new world of technology. It's disturbing to think that the best doctors are sometimes worse diagnosticians than computers. And it's true that, as this JAMA paper identifies, "comparative studies on the effectiveness of machine learning–based decision support systems (ML-DSS) in medicine are lacking, especially regarding the effects on health outcomes."

The JAMA paper looks at several potential unintended consequences of the use of machine learning in medicine, for instance:

  • Reducing the skills of physicians
    For instance, a study of 30 internal medicine residents showed that the residents exhibited a decrease in diagnostic accuracy (from 57% to 48%) when electrocardiograms were annotated with inaccurate computer-aided diagnoses."
  • Overreliance on text.
    The JAMA paper reports that machine learning "could lead to reduced interest in and decreased ability to perform holistic evaluations of patients, with loss of valuable and irreducible aspects of the human experience such as psychological, relational, social, and organizational issues."

Ultimately, machine learning is like any other technology in medicine -- the scalpel, anesthesia, or telehealth. These tools are powerful, and come with almost inalterable impacts on how we practice medicine. They're also in our control, we're supposed to wield responsibly and manage the negative consequences. 

In the field of telemedicine, we at ClickCare are determined advocates for healthcare providers to be thoughtful about what technology they use for telehealth, and how they use it.

We advocate for healthcare providers to do 2 key things when it comes to technology in telehealth and telemedicine:

  • Be open to new technology even as you're discerning about what to use.
    Of course, technology comes with unintended consequences and challenges. But it can also enrich and enhance the practice of medicine. We advocate for providers to be proactive in selecting technology that really works for them -- neither a "bury your head in the sand" approach, nor a "take whatever comes along" approach. You know what's best for you and your patients.

  • Be open to redefining some aspects of your role as a medical provider.
    As technology shifts, we have the opportunity and responsibility of shifting our roles as providers, too. Machine learning may create the ability for providers to focus less on the mechanics of medicine and more on the human art of it. Telemedicine based medical collaboration allows providers to step out of their silos and treat patients as a true team. We believe that the most successful, happiest providers are those that are willing to find new ways of working as our tools change.

 

We believe the same principles apply to our adoption and use of machine learning in medicine. And we look forward to being on that journey with you. 

 

Want to get all the information before making a telehealth or telemedicine decision? Get our free summary of hybrid store-and-forward telemedicine so you can be informed:

ClickCare Quick Guide to Hybrid Store-and-Forward

 

Photo by Samuel Zeller on Unsplash

Tags: telehealth, telemedicine technology, ACO

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