The culture war between those with clinical backgrounds and those without needs to simmer down. The bottom line is that American medicine is facing a long, hard road of transformation, and not every good idea is going to come from one place. The most potent sources of innovation, as in every industry, are going to be disruptive. Making the most of these disruptions does not involve exchanging labels of “bully” and “victim” amid the turmoil, or qualifying who has more at stake in managing the transformation.
The way the story has been told so far largely involves victimized clinicians, overworked and overburdened already, being handed new problems packaged as solutions by EHR advocates and misguided admins.
Alternatively, it has been clinicians too steeped in “the way things are” to make room for the big new ideas coming out of the tech sector, making the transition difficult for everyone.
Obviously, everyone has an interest in making healthcare better–and in giving clinicians all the tools, support, and latitude possible to enable them to simple carry on practicing medicine. The conflicted views of the whole process arise from the fact that the sort of big changes healthcare is undergoing are not merely evolutionary, they are revolutionary. They are disruptive.
This is precisely why the non-clinical world has such an important part to play. In recent years—decades—disruption has become a permanent feature in the business sector, all triggered by digital innovations. One of the important lessons visible from this ongoing revolution is the role of iteration; also, incidentally, the one healthcare is currently struggling to apply.
Mobile devices quickly revealed themselves as much more than a better tool equipping people to perform the same tasks they had been performing before. It was an entirely new platform, in need of new media; it was a new way of communicating, ripe for new messages. It was personal, and created new opportunities for lateral personalization–contingent on users opting-in to personalized messages.
“The mobile medium is different from other traditional media in two ways: it is more location-specific and more interactive. In the U.S., it is also permission-based,” said Fareena Sultan, a business professor at Northeastern University.
Sultan has been studying mobile marketing for nearly a decade, and her earlier findings on the subject, especially that opt-in, remain as vexing as ever for those brands and companies who can’t seem to rise to the challenge of this new medium.
“Only if you provide something of value will consumers let you enter their private space via mobile devices,” Sultan explained, back in 2008.
That “something of value” bit may raise the hackles of clinicians who felt underdeveloped, user-unfriendly EHRs dumped on them by government fiat under Meaningful Use regimes. But even if they have been forced to the stakeholder table, they are now part of the iteration process, wherein questions of value, service, and utility can be aired and addressed by both sides, users and developers.
Mobile marketing has been a disruptive force in part because it changed the marketing equation. As Sultan observed, simply having a message was no longer sufficient for brands to penetrate the mobile space; consumers changed their expectations, and then demands, and brands had to catch up to stay relevant. They had to compel consumers to opt-in to their messaging, and that meant changing their whole marketing strategy.
Physicians and care networks, need a similar approach to reach and engage patients. Like clinicians, patients have been underwhelmed by the supposed benefits of the digital transformation in healthcare.
Patient portals are pretty feeble in terms of offering value, interactivity, and any sense of user benefit. Static records of test results or physician notes becoming transparent without any interpretation are not engaging or illuminating. Just as the first wave of EHRs were missing clinical design input, patient portals are missing that clinical voice and personalized touch.
We need an opt-in.
Patients need something more than raw data from their portals: a compelling reason to access, and interact. It might seem counter-intuitive, but the fact is that despite personal health literally being a matter of life and death, comfort and discomfort, happiness and misery, it is still difficult to get patients actively engaged in their care. Medical messaging is still just messaging, and in an age of messaging overload, those messages need to be compelling and efficient to avoid being tuned-out. The opt-in is critical to avoiding the fate of other advertising messages.
And before patients can opt-in, they need their physicians, nurses, and other clinical gatekeepers to get on board with the new medium.
All the stakeholders are shouting to be heard over the din of technology, so it is hard to find a place where real listening occurs.
The herald call that healthcare needs to learn more lessons from the business world is on point. EHRs, like mobile platforms, are here to stay, but that doesn’t guarantee their quality. The iteration phase of the revolution needs an exchange of ideas and perspectives to succeed; it requires each side to be able to opt-in.