Dr. Steven Davidson, chief medical informatics officer at Maimonides Medical Center and practicing emergency room physician, is a self-proclaimed “physician-executive geek.” But he’s not interested in jumping on every new technology brought to market; rather, he supports technology that helps physicians build trust with their patients. Dr. Davidson told us about the ways in which he, his colleagues, and patients use mobile technology to build trust and create a better patient experience.
How do physicians and patients use mobile devices?
All physicians are mobile users. We are always up and moving around. We depend on our devices to communicate among ourselves and manage our personal and professional lives. A more useful mobile device facilitates interaction with patients with tools such as apps that deliver asynchronous communication like text messaging and email, that also file to the patient’s medical record and personal health record. When we use our mobile devices for patient care, we need apps that are HIPPA compliant and support communication between the physicians who are caring for the patient.
Using a mobile device also means we can spend more time with hospitalized patients at their bedside. Applications now allow for physicians to enter information into the EHR just as they would using a pen and paper. After talking to the patient, physicians can look over the information privately and then engage the patient and patient’s caregiver in a discussion about the options for the care plan along with resources such as images, animations, and videos that better help the patient understand the potential course of treatment and the benefits, possible alternatives, and risks. In fact, when we do speech and swallow testing for stroke patients, we walk the patient through the process using a video on a tablet. The patients and physicians see success because it’s a visual demonstration of a process that’s hard to articulate.
Patients use their mobile devices to support their care as well. Some physicians decry it, but many patients use their mobile phones to get a second opinion from Dr. Google. In addition to accessing information, tablets are a key communication tool for patients. They use smartphones and tablets with Skype to help a family member lend support remotely.
How does an organization change the culture to welcome mobile devices?
Clinicians are skeptical about change for many reasons, including wanting to protect their patients and their income. To get them to accept change, you must show the value of the new approach and compare it to the value of the technology that’s currently being used. They’ll change when you implement a solution to improve patient care, not just a new technology.
Physicians my age are often in the mode of digital migrant. It takes us a bit longer to get with the program, but we’ll get there.
Where do you see technology going in the next three years?
To accommodate any changes over the next three years, we must have bandwidth improvements so we can manage more images and video. Video will certainly play a bigger role in patient care. In fact, data is emerging that suggests that up to two-thirds of encounters with physicians for managing chronic conditions don’t require an examination. If that’s the case, then we’ll see more telemedicine and video conferencing with patients. It means that people who live remotely can still get great treatment and those who live closer are not inconvenienced with a trip to the doctor’s office.
How do you use technology to collaborate?
Collaboration begins with communication. Communication is where humans exchange information and it’s where we build confidence among interlocutors. Through good communication, patients build confidence and trust in their doctors. The advances in telecommunication and the cloud are supporting better communication between physicians for better patient treatment.
I’m the co-author of a study from the American Journal of Radiology that looked at the communications errors over the course of the last two decades. We found that communications failures between doctors and patients as a cause for action of malpractice suits grew from about 7 percent to nearly 8 percent. Technological improvements in telecommunications will only help reduce that number. Patients will gain more confidence in their doctors if physicians use these technologies in ways that facilitate genuine communication and approach the effort with a genuine impulse to partner in trust building and information sharing in support of the patient’s health.
What is the one technology you would like to invent?
I would love to have a trust-o-meter. With this device, the patient and I could look at each other and come to a mutual understanding and balance of trust and respect around the work we are doing together.
Until the trust-o-meter is invented, mobile technology is the ascendant technology. People of all socioeconomic groups are using smartphones and other devices as their preferred means of reaching the Internet, and this opens up great possibilities for participatory medicine. Mobile devices accessing the Internet and the cloud allow patients and physicians to meet and share information together and engage one another in a quest to support the patient’s health through their own activation and connection to knowledge and community. That’s a big deal.
Follow Dr. Davidson on Twitter (@sjdmd) for more insights on technology and patient care.