One of the most recognized annual awards programs in the world today—the MedTech Breakthrough—has recently announced the results of its 2018 awardees. Evaluated by an independent expert panel, the nominees were carefully examined, and winners were selected based on various considerations. Awards were given according to the following categories: medtech leadership, clinical and health administration, patient engagement, electronic health records, genomics, internet-of-things (IoT) healthcare, medical data, mobile communication and telehealth, healthcare cybersecurity and medical devices.
This award program is a testament to the continuous innovations in the field of medicine brought about by the incorporation of various technological advancements in other fields of science.
The Progress of Medicine
The progress of medical science at present is obviously at its zenith as compared to its level of progress in the past. Medicine, for example has existed for several millennia, and most of it was largely non-scientific, for in earlier times medicine was closely associated with religious and superstitious beliefs.
In our contemporary time, however, every aspect of medicine seems to be innovating at an unprecedented pace, and other technological advancements in fields like physics, genetics, computer programming and engineering, and chemistry seem to be all contributing to the progress of medical science and medical institutions.
By simply looking at the above mentioned awards distributed by MedTech Breakthrough, for example, you would immediately see the inclusions of the internet-of-things, genomics, medical data, mobile communications and electronic records, all of which seem to have a somewhat detached relationship to medical science. Yet, it is obvious that the progress of medical science can no longer be isolated from other technological advancements.
Medical Science and Alternative Medicines
Medical science has slowly detached itself from alternative medicines by strictly subscribing to the scientific method in the diagnostic and treatment of diseases. If a medical practice, therefore, is based only on alternative medicines without the backings of scientific studies, it is presumed to be based on unwarranted assumptions without scientific merit. Scientific medicine, however, does not peremptorily debunk the efficiencies of alternative medicines, for that would be unwise. What it is debunking is the method by which alternative medicines assume the efficacious of their alternative methods of treatments.
A good point of reference would be the practice of chiropractic. Chiropractors for example, start with the premise that diseases are simply indicative of the effects of subluxations. They focus then on the detection and eventual correction of vertebral subluxation to heal maladies. Although there are mixer chiropractors who combine diagnostic and treatment approaches from different osteopathic viewpoints, most of them still solely attribute diseases to subluxation. Yet, subluxation and its relationship to a disease is really hard to prove scientifically.
That was the subject line of the message from Lantern, a behavioral health startup whose app and coaching services I had used for a while. Lantern’s letter stated it is shuttering its business on August 1, helpfully offering to continue the coaching services for a limited period and pointing to other resources for those who relied on its services for six years since it started. News reports say Lantern is laying off 25 employees after failing to find a buyer for the company.
Firstly, I want to say this to the folks at Lantern: I’m sad we have to say goodbye. Although I had ceased to use the app a while back, I had developed a relationship with my personal behavioral coach who checked in with me regularly to see how I was doing with my meditation practice, often prodding me with a gentle nudge when I missed reporting on my sessions. I had the benefit of several conversations with my coach who was helpful, understanding and skilled at her work. Despite my short relationship with Lantern, I felt a positive impact on my well-being through regular meditation and mindfulness.
I came to know about Lantern back in December 2016 when I shared a stage as a speaker at an industry event with one of their executives. Back then, behavioral health was getting recognized as a $280 billion problem, which I wrote about after the Senate Health Committee announced the Mental Health Reform Act. Behavioral health is a complicated and expensive issue in U.S healthcare, which consulting firm McKinsey estimated affected 20 percent of the U.S population and was significantly underfunded in terms of treatment infrastructure.
In late 2016, there were more than 200 behavioral health startups, all of whom were responding to a brewing mental health crisis, and a favorable legislative and funding environment. Lantern was one of the highly visible ones, raising $17 million in series A money from marquee names, such as UPMC, Stanford University and Mayfield Ventures. The opioid epidemic and the exacerbation of related mental health issues was about to explode into public consciousness. Health insurance companies, faced with increasing costs for mental health and substance abuse, had started taking an interest in these startups. High profile partnerships were announced, such as the one between Highmark BCBS and Quartet. For a while, behavioral health seemed like a sure shot.
So what went wrong?
I’m sure the folks at Lantern and their VCs are pondering the question hard. However, back when I wrote about it, the signs of trouble were already visible. The Lantern executive I met at the time indicated that the lack of a reimbursement model for behavioral health was a huge challenge for growth. In healthcare, as we know, following the money is a prerequisite for success. The Department of Health and Human Services (HHS) had thrown $44.5 million at the problem, a drop in the ocean relative to the size of the problem.
Even for those who had access to funding, finding and recruiting trained clinicians with experience in behavioral health was a massive challenge.
Many startups, looking to stay outside the purview of regulation, tried to sidestep the FDA and go straight to employers and consumers (an expensive mistake that many failed digital health startups have learned the hard way).
Eventually, these problems had to come to a head. Lantern’s sad demise, brought about by a lack of ability to scale, and a lack of interest from the same insurance companies who were bullish on the sector two years ago, tells us that a business model with no revenue model has limited chances of success.
Is behavioral health dead then? Perhaps not. Many new telehealth companies, such as Teladoc, now offer behavioral health services. The CMS’s new rule to boost telehealth payments could be a shot in the arm that revives the fortunes of struggling behavioral health startups.
According to the Office of Coordination of National Health Information, 50 percent of healthcare dollars are wasted on inefficient processes. Transformative innovation must not only change the current way things are done, it must be disruptive by having a meaningful impact on time, quality, cost and operational effectiveness – it must dramatically simplify and accelerate the process it enables.
There are very exciting ways in which digital technology is creating transformation across the entire healthcare system in areas such as connected health, artificial intelligence (AI), blockchain, mobile data gathering, analytics, digital therapeutics and remote patient monitoring. All of these technological developments will improve healthcare efficiency, but more importantly they will drive the delivery of individualized care and dramatically improve patient outcomes as follows:
Access to Care
Connected health, or telehealth, is enabling the delivery of care to rural areas, where access is often nonexistent or very limited. It is also being used to address growing medical staff and physician shortages by providing access to timely care through collaborative tools such as eConsults. Telehealth delivers faster, less expensive and more convenient healthcare and in doing so significantly improves patient outcomes.
Conventional patient engagement systems display information at the hospital bedside, which is only one of many relevant ways to connect with patients. Companies are now integrating artificial intelligence or ‘virtual’ health coaches into interactive educational platforms, resulting in higher utilization and engagement, and delivering more robust, actionable content.
Remote Patient Monitoring (RPM)
A vast array of innovative wearables and sensors such as the biosensor bra patch, implantable glucose sensor, electronic tattoos and the cardiac mapping vest are revolutionizing remote monitoring capabilities. These remote monitoring systems have the potential to help achieve triple aim goals by leveraging the latest advancements to collect and analyze patient data beyond the bedside. Patients and providers can use smart phones, tablets and apps to remotely assess, diagnose and monitor their patients. Electronic monitoring can be an effective solution to identifying issues as they happen while also enabling more effective tracking of patients post-discharge, improving compliance and adherence, and reducing the number of re-admissions.
By James Smith, blogger and researcher of latest technological trends in the fields of health and lifestyle. He has his work published on various authoritative blogs and is currently working on a telemedicine project at Mend Family. For all the updates follow him on Twitter @JamesSmith1609.
E-Heath, telehealth, telemedicine are different approaches towards accessible healthcare in remote areas or over a long distance. Technology has come a long way, opening new gateways for communication and transmission of information. To a certain extent, it has helped healthcare become more accessible, especially in remote areas.
Because of a lack of infrastructure, facilities, equipment and other factors, it is not always possible to offer quality healthcare in specific remote regions. Opening a healthcare facility requires time and resources, which would be challenging to amass in the remote areas due to lack of infrastructural development, lack of talent, lack of investors and so forth. However, due to efforts to make healthcare accessible to all, which is also a major Sustainable Development Program (SDG) objective, technology is used.
Healthcare service delivery has improved over the last few decades by adapting to new technologies. Terminologies such as e-health, telemedicine, and telehealth are all formulations of healthcare delivery, combined with communications technology. The initiatives taken towards developing the health service delivery is phenomenal. However, it is essential to establish an understanding of the differences in e-health, telehealth, and telemedicine. Most people would confuse them to be the same; however, they are quite different.
In simpler terms, telemedicine refers to the use of electronic communications channel/mediums, as well as information technology to deliver clinical services to remote patients. While telemedicine is a part of telehealth, it is more concentrated towards the use of technology for clinical service delivery. The service delivery is the same as medical practice. However, the critical difference is that it is used towards reaching out to patients in remote destinations via electronic platforms. This usually works when a patient and medical practitioner interact using video/voice conferencing to offer professional advice on medication and clinical services.
Telehealth is a broader spectrum of delivering quality health care via online mediums. The primary aim of telehealth is to provide healthcare services in remote areas with lack of healthcare services. Telehealth operates on the same principals of traditional healthcare practice with the use of technology. Because of the practitioners’ inability to be physically present in the area, they rely on telecommunications, internet and other communication platforms to interact with the patient and offer professional guidance.
According to the Health Resources and Services Administration (HRSA), United States, telehealth is used to promote and support long-distance clinical health care. The use of telehealth helps with delivering professionalized clinical healthcare remotely. Furthermore, it also helps with developing and improving health-related education, health administration, and improving general public health.
Telemedicine can be delivered using various technologies, including the internet, still imaging, video conferencing, streaming media, wireless communications, etc. This means that it can be used in more than one way. For example, a patient can acquire professional consulting and diagnosis remotely.
Similarly, it can be used for educational purposes, for delivering quality healthcare education on recent discoveries, prognosis, diagnosis, and other evaluations. Telehealth is the primary method of providing quality clinical health care in underdeveloped regions. It is widely present in the African region and helps in offering quality clinical care to long-distance patients. In most cases, the practitioner would conduct examination using imaging devices, live video conferences, and by obtaining patient’s medical history. Moreover, doctors use telehealth to seek second-opinion or expert advice on complex medical cases.
In urgent care situations, being able to provide timely and quality healthcare is essential to the impact and satisfaction of the ED staff and related EMS team members. Using telehealth, current ED workflows can be enhanced to increase access and make collaboration between onsite providers and offsite colleagues and specialists easier and more timely. Virtual care platforms can rapidly improve the delivery of care, effectively addressing urgent patient needs while reconciling the gap in having available specialists on-hand / in-person for immediate consults. Virtual consults are a viable and valuable solution to helping improve outcomes in emergent care situations.
Providing Critical Care On-Demand in the ED
Seconds and minutes count in the ED. With a virtual care platform, a hospital’s ED staff can quickly access remote specialists and facilitate a virtual consult between offsite specialists and patients. Instead of losing crucial minutes, hours, or even critical days in the ED to call a specialist or wait for an in-person consult, ED staff can quickly reach the first available, designated specialist who can deliver a timely virtual consult and provide guidance as to diagnosis, admission, and/or transfer. With virtual care technology, specialists can provide the needed consult from anywhere and on any device. Key decisions as to whether the patient needs to be admitted, transferred or discharged can be made in minutes (vs. hours or days). The costs involved with keeping a patient in the ED are also contained, and the hours or days which a patient spends in the ED are reduced. As hospitals struggle to have multiple specialists on-hand at any time, virtual consult platforms can empower hospitals to leverage specialists within their networks to support their patient care objectives around-the-clock.
Reducing Waiting Time and Minimizing Leakage in the ED
Virtual care platforms are also being used to reduce waiting times in the ED and deliver routine care to patients with non-emergent conditions. In a recent study published in Telemedicine and e-Health, rural hospitals using telehealth reduced the time between patients entering the ED to receiving physician care, according to University of Iowa researchers.
Virtual care had decreased door-to-provider time by six minutes. The researchers also concluded that the length of stay in the ED of the initial hospital was shorter for patients who were eventually transferred but had initially participated in a virtual care consultation. At New York-Presbyterian/Weill Cornell Medicine, the Express Care program allows patients with minor injuries or non-life-threatening symptoms to be seen virtually by an offsite provider via video. When asked by the Wall Street Journal, “What’s the number one complaint of patients in the emergency room?” Rahul Sharma, the emergency physician-in-chief at Weill Cornell, responded: “Wait time.”
The hospital reported that the Express Care telehealth program has cut the average wait time in the hospital’s ED by more than half; between 35 to 40 minutes. As hospitals struggle to prevent leakage and minimize the chance of patients leaving their ED waiting room for another healthcare setting, virtual consults can help the waiting patients access the diagnoses and care they need in a more timely and convenient manner.
Expanding Impact into the Community
ED staff can also use virtual care platforms to expand their impact within their respective communities. Rural hospitals face some of the biggest deficits in terms of having a range of specialists on staff. Providers in these hospitals can have access to a greater pool of specialists who can support urgent patient care via video when a particular specialist is not already on staff or readily available in-person. Giving ED staff the ability to facilitate virtual consults on-demand improves their impact within their own community – regardless of distance between the ED and the specialist. ED staff can also conduct HIPAA-compliant virtual meetings to drive better collaboration amongst the broader care team across the care continuum. Communication can be maintained with the appropriate care team members (including the patient’s PCP, a pharmacist, a coordinator at the next care facility, etc.) to ensure the patient’s overall health needs are regularly discussed and addressed in the ED and during the transition of care – without requiring care team members to drive to/from meetings at different locations and facilities.
Looking back at 2017, we see some of the same significant trends that have been gaining momentum, along with a few newcomers. Together, these top-five trends will impact hospital medicine in 2018 in both traditional and unexpected ways.
Growth Despite Reimbursement Parity Confusion
The telemedicine industry’s growth continues rapidly despite the widespread confusion over reimbursement for telemed services from state to state. Why? Because most hospital leaders understand they face far more significant costs from the lack of proper physician and specialist coverage than they ever would by a less-than-optimal reimbursement rate for telehealth. A teleneurologist consult in the ED might be reimbursed at a lower rate than an in-person visit with an onsite neurologist, but keeping the stroke patient in the hospital could mean a $10,000 DRG reimbursement that the hospital would lose if the patient had to be shipped to a tertiary referral center for treatment. Which is the smarter investment? And more importantly, which scenario better serves the patient?
Expansion into New Types of Inpatient Settings
As micro-hospitals and long-term acute care hospitals (LTACHs) grow, they are looking for single-source providers of solutions, with one point of contact, one operating system, and one set of tools and processes. Telemedicine fits their models very well, helping them avoid contracting with a wide array of specialists to meet their patients’ needs. Micro-hospitals are already established in 19 states, and LTACHs are growing since a federal moratorium prohibiting their expansion expired on Sept. 30, 2017. Being able to access a variety of specialists via telemedicine, depending on the needs of patients on any day, is something these facilities need in order to fulfill their commitment to the communities they serve.
Increasing Use of Telemedicine in Metropolitan Hospitals
Rural hospitals have long been a sweet spot for telemedicine. The physician shortage is certainly more acute in rural areas as community hospitals struggle to recruit physicians, keep beds filled and, in many cases, stay solvent. Recently, however, more metropolitan hospitals have seen the advantage of telemedicine in two key areas. When cross-coverage calls are handled by telemedicine teams, it takes considerable pressure off night hospitalists who may already be overwhelmed with admissions, and yet their phones are ringing constantly with requests to respond to patient issues on the floor.
By the same token, telemedicine offers “surge protection,” providing assistance with patient admissions during ED bottlenecks, and cost-effective relief from hospitalist overload.
Virtual Partners for Solo Specialists
Individual specialists in pulmonology, cardiology, nephrology, and other areas might be on call with a local hospital 24/7/365, with no backup for nights, weekends, holidays, or vacations. Telemedicine specialists share coverage with these physicians—individuals and small practices alike—to help ease the demands on them. For example, a community hospital has a local cardiologist on call 15 days a month, and a telecardiology team on call the other 15 days of the month. This is just one real-life example we’ve seen as hospitals find new ways to meet the challenges of another trend that just keeps growing: physician burnout, coupled with a greater value placed on work-life balance than in generations past.
One of the largest barriers of delivering mental healthcare is the critical shortage of mental health professionals across the country, despite the significant prevalence and impact of mental health conditions. The National Alliance on Mental Illness and the National Institute of Mental Health report that 1 in 5 Americans live with a mental health condition and more than half of American adults with mental illness did not receive treatment in 2016. The U.S. Health Resources and Services Administration estimates an additional 70,000 mental healthcare providers are needed by 2025 to meet the expected growth in demand. In Chicago alone, patients may wait upwards of 10 months for a psychiatrist appointment.
Timely and quality behavioral healthcare is essential for improving patient mental health outcomes and increasing provider satisfaction. Telehealth is emerging as a viable approach to traditional on-site care methods, as it can rapidly improve the delivery of care by effectively addressing patient needs while reconciling the workforce gap. Specifically, telehealth can allow for immediate consultation (especially crucial in time-sensitive situations), increased treatment capacity and collaboration across the continuum of care, and improved outcomes (especially by allowing patients to receive care in the comfort of their own home).
Increased Access to Care In a given year, approximately one in 25 adults in the U.S. experiences a serious mental illness that substantially interferes with, or limits, one or more major life activities according to the National Institute of Mental Health. The American Journal of Psychiatry reported that untreated mental illness is estimated to cost approximately $100 billion annually in lost productivity.
Patients can benefit from providers who use video-based technology to conduct “virtual consults” when providing an initial diagnosis, as well as making recommendations for admission, treatment, transfer, or discharge. Additionally, for ongoing treatment, video offers patients a way to participate in ongoing care and support via “virtual visits” with mental healthcare providers. Convenient access to care can help patients who may avoid seeking initial mental healthcare and/or ongoing treatment as some patients may unfortunately avoid visiting a nearby mental health clinic or provider for a needed diagnosis if they are wary of public recognition and social disapproval. Patients might also not adhere to scheduled follow-up appointments if visits to these “known” mental health clinics in one’s community are required. With telehealth, patients can remain comfortably at home and confidentially receive the care they need.
New applications of telehealth that enhance existing provider-to-provider communications are revealing a new way for healthcare organizations to ensure patient care remains in-network. As hospital M&A activity accelerates and organizations strive to glean the most value from their investments in technology and human resources, telehealth is recognized for its role in keeping communications and care in-network.
Telehealth is increasingly being leveraged to offer providers immediate in-network specialist expertise and to reduce ad hoc out-of-network referrals. These kinds of applications make the in-network choice convenient for providers and patients while driving increased patient engagement and more integrated care across the broader care team.
Providers are seeing that telehealth applications can be complementary – instead of disruptive – to their workflows and provide them with a new approach to practicing medicine via technology.
Immediate Communications with Colleagues
Video-based technology can help providers optimize their current workflows by facilitating faster and more flexible consults with on-demand access to in-network specialists. A provider’s network of experts can be built into the technology, which enables a provider to immediately reach the designated, first available specialist for answers. Instead of wasting valuable seconds and minutes looking for the names and contact information for specialists, providers can use telehealth to expedite provider-to-provider interactions which accomplish the critical objectives of doing what is both right and timely for the patient’s situation.
For example, a provider may be examining a patient and realize that the patient’s condition requires specialist expertise. With telehealth, the provider can immediately reach out to an in-network specialist. The specialist accepts the virtual consult request, from anywhere and on any device. During the virtual consult, the specialist can evaluate the patient and communicate the appropriate next steps. All stakeholders – the provider, the specialist, and the patient – benefit from the immediacy, efficiency, and effectiveness of a virtual consult conducted in real time.
The broader healthcare organization (whether a medical practice, a hospital, or a health system) will benefit from an increase in in-network referrals. By leveraging the organization’s network to drive better patient outcomes faster, providers can deliver lasting value for the healthcare organization and enhance its overall reputation.
Increased Patient Engagement
Technology can also help providers optimize their current follow-up processes and easily check in with patients after a hospital stay or outpatient procedure. Providers can use telehealth to offer patients appropriate follow-up care at their own home via video. This allows providers (or providers’ in-network resources) to reach out to patients based on those patients’ preferred contact methods (e.g., email or text) and languages (e.g., Spanish, German, etc.) to remind them of their upcoming video visits. The result is increased patient engagement in their ongoing treatment plan. Travel time, related transportation expenses and appointment no-shows are minimized due to this efficient method of follow-up care.
For example, a provider can facilitate a virtual visit with a patient to ensure understanding and adherence. During a virtual visit, the provider (or related in-network care team members) can evaluate the patient’s progress, answer questions in real time, provide patient education, and re-emphasize the treatment plan – all while the patient stays comfortably at home and the provider remains conveniently in the office. All stakeholders – the provider, the care management team members, and the patient – benefit from timely conversations which can drive better adherence and overall outcomes.
Many healthcare organizations refer to the at-home, at-risk patients as the “sickest of the sick.” Unfortunately, these patients may receive inadequate care and attention after being discharged and often rely on emergency medical services and/or the ED to answer questions and provide care in non-emergency situations. The model for treating these patients and attempting to keep them at-home (and not back in the hospital) has not changed substantially in decades. In an attempt to minimize re-admissions, hospitals may schedule case managers and/or nurses to physically visit these patients at-home in an effort to help the patients stay on track with their adherence.
However, this continuum of care model is not sustainable. The budget and resourcing implications are significant when most of the staff’s time is spent behind the wheel vs. in front of the patient. Significant opportunities exist for telehealth solutions to bring the care closer to the patient — at a more convenient and cost-effective manner for all involved.
Why Reducing Readmissions Matters From the patients’ perspective, returning to the ED and potentially being re-admitted is disruptive and stressful for patients and family. Patients may be put at an additional risk for hospital-acquired infections and complication. Returning to the hospital can also lower the rate of patient satisfaction and weaken overall outcomes.
From the perspectives of health systems and health plans, readmissions are costly. Since the introduction of HRRP (Hospital Readmission Reduction Program), hospitals that exceeded the national average of readmissions for specific conditions (within the 30-day window) have been penalized by a reduction of payments across all of their Medicare admissions. More than half of hospitals in the HRRP program were penalized the past five years, resulting in $528 million in withheld Medicare payments. Re-admissions can also negatively impact measures in Hospital Compare data, levels of provider satisfaction and the health system’s overall reputation in the community it serves. Re-admissions cost more than $26 billion annually but $17 billion is considered avoidable.
What Happens Today Keeping at-risk patients at-home is critical to reducing re-admissions and the associated consequences. Typical discharge programs with in-person appointment schedules often fail the at-home, at-risk patient, the providers, and the healthcare system by insufficiently engaging the patient at the point of discharge and upon returning home. The rates of patients being readmitted are significant:
Nearly 20 percent Medicare patients are readmitted within 30 days.
34 percent of Medicare patients are readmitted within 90 days and 56 percent within 1 year.
64 percent received no post-hospital care between discharge and readmission.
What happens in-hospital and at-home which leads to this situation? In-hospital experiences can adversely affect health and contribute to substantial impairments during the early recovery period, an inability to fend off disease, and simple mental error. As a result, patients may leave the hospital deprived of sleep, experiencing pain and discomfort, without sufficient nourishment, and with medications which may alter cognition and physical function.
When a patient is discharged, the patient may continue to face physical, emotional and even financial issues, depending on one’s condition, health history and home environment. A patient may be discharged without adequate instructions and information for self-care and follow-up. The patient may be provided with comprehensive verbal instructions but quickly forget the detailed instruction. Written instructions may be provided to the patient but the patient may fail to keep the information handy and/or share the information with family/friends serving as caregivers. Internalizing the discharge program and being able to practice self-care may also be negatively impacted by a patient’s level of English proficiency, health literacy, socio-economic status, gender and cultural background.
Sherlock Holmes famously captured the popular imagination with his uncanny ability to make wild, but accurate, leaps of logic to solve mysteries. By observing Dr. Watson’s suit jacket sleeve, upon their first encounter, he was able to deduce that Watson was in fact a surgeon, in the British Army, and had recently returned from Afghanistan, where he had sustained an injury.
When he slowed down to explain his reasoning, it was easy to follow; what made his deductions impressive was how quickly he would skip from observation to conclusion. I’m no Sherlock Holmes, but it seems to me that chatbots are poised to take over much of modern healthcare.
As more data is moved to portals through EHRs and digital documentation, there is increased patient interest in and demand for other digital and remote encounters and health resources. This, along with improving technology and competitive solutions, is helping increase adoption of telehealth. So, patient portals lead to increased telehealth adoption.
Finally, although part of the premise and value of telehealth is enabling face-to-face encounters between caregivers and patients without respect to geography, hospital waiting rooms, or other physical barriers, it changes certain expectations. Like all mobile and web-based services, telehealth feeds a consumer mindset that expects everything on-demand, all but instantaneously, and highly customized at that.
While portable patient records facilitated by EHRs and interoperability can help this, customization and on-demand healthcare doesn’t just put pressure on records and data. Patients want fast and personalized answers. As customer service centers, tech support, banks and virtually every other consumer-facing industry has learned, a lot of the on-demand load can be pushed onto increasingly sophisticated chatbots.
So, telehealth leads to growing expectations for on-demand clinical encounters and chat, which is provided by chatbots.
The Case for Chatbots
Retail has previewed much for healthcare: See how customer service upgrades have turned everyone into “The Most Important Person Here” wherever they go, in person or online. Consumers demand personalization, expedition, authenticity and they want it all exactly when and where they want it. And now, see how AI is not yet taking over the world, but is making FAQs and other routine customer service interactions painless for those answering, and interactive enough for those asking.
Retail is even making inroads to healthcare, as consumer-facing devices promise to measure and track all manner of health metrics. Statistics-loving sports fans witness the increasing digitization and quantification of athletes, games, injuries and training, and they want a similar level of insight and precision for their own care. Mobile technology is redefining and disrupting even the oldest and most stable of markets and industries, bit by literal bit.
So how long until the dry, repetitive questions doctors routinely must answer in check-ups and physicals are ethically and effectively offloaded onto chatbots programmed to triage and educate patients without wasting valuable human resources? How long until using telehealth to keep nonemergency patients out of the emergency room merges with using chat and AI — the basic recipe for chatbots — to keep healthy but curious or concerned patients from wasting time and money going through full encounters simply to get their general questions answered?
It doesn’t take a lot of sophistication to realize the benefits of AI at scale. Google has all but taken over the modern world by connecting searchers with answers to their questions; Wikipedia has all but bankrupted the encyclopedia industry with free, accessible, general knowledge. In a world where health literacy is so lacking in the majority of the population, some interactive resources could go a long way to chipping away at ER overuse and healthcare overconsumption, just by giving people an alternative to seeing the doctor.
Automation of Care, Automation of Crime
As quickly as potential benefits can scale, very real risks and both moral and financial hazards scale even quicker.
The growing popularity and implementation of chatbots has given hackers and cybercriminals a new way to scam, defraud, and generally abuse unwitting consumers. Sometimes that means hackers take over a company’s chat system with their own bot and solicit data. Sometimes fraudsters attract visitors with a spoof website, then use a bot to similarly extract volunteered data at scale from misled visitors. However it is done, it scales almost as well as a more conventional data breach, and can be harder to detect or track.