Electronic Health Reporter

By Dr. Deborah Vinton, medical director, emergency department, UVA Health and Inlightened Expert. 

The way we talk, think about, plan, and innovate for healthcare delivery has fundamentally changed as a result of COVID-19. For those of us in healthcare, top priorities today are different than they were just a few months ago. Like in so many areas of life, coronavirus is rewriting the status quo.

As a physician on the frontlines, it has become painfully apparent that, as an industry, we have failed to design and develop tools and systems – for us – with us in mind. When it comes to innovating for those delivering the care, empathy is often times out of the process. From PPE (personal protective equipment) to telemedicine and everything in between, the lack of input and understanding may be furthering burnout, negatively impacting patient care, and fueling inefficiencies.

Empathy in innovation: We’ve made progress for patients   

In healthcare, we’ve done a better (although not remotely perfect) job of integrating empathy into the design and innovation process for the patient to optimize patient experience. From lobbies to hospital rooms, we’ve seen patient-centric design aimed at delivering more comfortable, less stressful, and seamless experiences.

Patients today enter buildings that are light and airy, no longer have the traditional “sterile” feeling, boast extensive entertainment options, and prioritize patient needs, like access to Wi-Fi and charging stations. Protocols are designed by considering various risks, and prioritizing policies and workflows that will most positively impact the patient. All of these efforts demonstrate a much-needed understanding of – and commitment to – the patient and their experience.

Physicians are left behind and burned out 

Like other industries, the evolution of healthcare has been aided by fast-paced innovation and technology. While conversations pre-COVID might have been around electronic health records (EHRs), real-time communication tools, and even innovating the scrubs we wear, COVID-19 has shed light on new priorities and the dramatic gaps that exist in the process for designing provider-centric tools.

According to McKinsey: From 2014 to 2018, there have been more than 580 healthcare technology deals in the United States, each more than $10 million, for a total of more than $83 billion in value. They have been disproportionately focused on three main categories: patient engagement, data and analytics, and new care models.

Consider the quick adoption of telehealth. While the ability to deliver care virtually to the patient was – and still is – unquestionably critical as the country sheltered in place, it has led to a lot of frustration and overwhelm for physicians who are trained to deliver patient care in-person. In medical school, we learn how to read what’s behind the presentation of symptoms and how to ask questions and listen to what’s behind the answer.

But we haven’t yet integrated into the curriculum how to implement technology to feel consistent with the way we’ve been trained to deliver care. We are being asked to understand – and flawlessly use – solutions that can be glitchy, disjointed, and impersonal, while simultaneously delivering care to patients that might be nervous, frustrated, ill, scared, or all of the above.

Another example is PPE. While we were talking about new technologies that could help us deliver care and communicate more effectively pre-COVID, we overlooked equipment innovation that was necessary to keep physicians safe and comfortable when worn for hours on end. Today’s PPE is hard to remove and change out quickly, causes physical discomfort, and acts as a barrier between patient and provider.

To drive real change in healthcare, empathy in innovation is critical  

We’ve seen incredible speed and agility since the beginning of this pandemic. Vaccine trials. Manufacturing-turned-PPE-making facilities. Telehealth adoption. We are living in promising times, with a shared global commitment to healthcare innovation and progress.

But one of the biggest measures of success will be whether innovation not only supports or enables improved delivery of care, but if it does so in a way that enhances physician and patient relationships while boosting safety and efficiency of care delivery. Both physician and patient preferences need to be at the center; not only enabling, but seamlessly supporting, the delivery of care – and much less time on “desktop medicine.”

While not the panacea, here are three ways we can begin to ensure empathy is at the center of healthcare innovation.

Appoint innovation leaders. 

Around the country, more and more innovation teams and hubs are popping up at various institutions. These teams are tasked with looking at end users – patients, doctors, nurses, etc. – and designing solutions to address their unique needs.

While the existence of these teams is innovative and the right step towards progress, it’s important that each has a leader (or a few leaders) who is not only empowered to actually drive change, but are also charged with ensuring empathy is at the core of every design. Having a team to collect information and gain perspective and understanding, then translate that to the team is critical to ensuring the end user is taken into consideration throughout every step of the process.

Beyond the design, these leaders need to understand, translate, and champion the adoption and operationalization of new tools and technologies. Such innovation teams play a vital role in discovering, incubating, and accelerating the use of patient and physician centered-technology in healthcare and other industries.

“Rather than pigeonholing promising inventions into existing business units and the most obvious applications, a robust innovation function fosters an expansive view of what a technology might become and then shepherds it down the most promising pathways,” says Gina O’Connor, professor of innovation management at Babson College.

Update medical school curriculum. 

Medical schools dedicate a tremendous amount of effort to training students to empathetically interact with patients. But, interviewing and examining a patient via telehealth, requires a new skill set that is not currently integrated into most medical schools’ curriculum. Historically, updating curriculum takes time and iterations to ensure it’s consistent in programs across the country.

But we don’t have that kind of time. Medical schools must quickly adapt to meet the current patient and provider needs as technology rapidly advances to ensure graduating physicians are prepared for a new, tech-centric way of delivering care. Medical schools must rapidly incorporate telehealth competencies to ensure new physicians can effectively utilize telemedicine to improve the quality of health care delivery.

Recognizing the importance of adapting to the evolving healthcare landscape, Harvard Medical School is working to create an elective that will incorporate telemedicine for clinical students, as well as for students who have already finished their Principal Clinical Experience (PCE).

Prioritize innovation and design.   

In addition to simply educating, we need to develop a new generation of physician innovators and designers. Relationships with patients are evolving; we see it happening in front of us as a result of a global pandemic. In addition, our relationship with technology – as physicians and patients – is changing, creating new challenges and opportunities for improving the delivery of care.

According to the Journal of Medical Education and Curricular Development, the structured design thinking process promotes an increased awareness and empathy of the patient’s perspective to inform a multi-professional team of healthcare workers about how to transform the patient’s experience.

We need to make space for and expose physicians to design thinking early and often so that, in addition to delivering care to their patients, they are able to see problems and solutions in a new light – and from a built-in position of empathy.

As we look to the future based on what we’ve learned from COVID-19, there are tremendous opportunities to integrate empathy into the healthcare innovation process: Designing medical record and charting systems that will decrease cognitive load; artificial intelligence-based tools that seamlessly connect patients with the right resources; and a focus on wellness tools and resources, whose benefits will stretch far beyond the clinicians using them directly.

While the pandemic has brought unprecedented hardship across the U.S. and the world, it has shed light on the areas that require focus in order to drive real impact for the future of healthcare. If empathy is one thing we take away, our healthcare system will drive the kinds of outcomes we can all feel good about.