As the public is ordered to stay home to flatten the curve, healthcare systems are tasked to ‘raise the line’ by increasing staffing, adding beds, and moving to a telehealth model to keep patients out of hospitals. Clinicians who are not on the frontlines of the COVID-19 response are being asked to help assist the rest of medicine. During these virtual care visits, it’s critical for these clinicians to utilize clinician decision support software to aid in diagnosis and keep as many patients out of the acute care setting. These software systems can not only help triage cases of COVID-19 but also help quickly and accurately treat patients presenting with other conditions that still require care. Clinical decision support also supplements telehealth services to improve the patient experience, ease patient anxieties, and reduce some administrative burden for providers.
Response from Chris Caulfield, RN, NP-C, co-founder and chief nursing officer, IntelyCare
As a result of COVID-19, demand for healthcare professionals is at an all-time high, with nurses on the front lines providing care to patients in need. In this unprecedented time, nursing and other healthcare professionals need their provider organizations more than ever to support and protect them. One significant aspect of keeping nurses and their patients safe is COVID-19 education. The virus is rapidly evolving and nurses don’t always have time to find and walk through new COVID-19 protocols before each shift. Organizations can offer and promote online learning so that nurses can complete training on their devices and on their own time, and so facilities can ensure the entire workforce is well-equipped to treat and prevent the spread of COVID-19.
Another way to protect facilities, staff, and patients from unnecessary exposure to COVID-19 is the implementation of an online symptom screening that enables workers to remotely verify whether or not they are experiencing COVID-19 symptoms. Nurses that are experiencing COVID-19 symptoms can be removed from the shift without penalty, which can prevent the further spread of the virus to other nurses and the vulnerable populations they’re treating.
Response from Erin Jospe, MD, chief medical officer, Kyruus
With health systems needing to respond nimbly to the rapidly evolving landscape of caring for patients in the midst of a public health crisis, the key, as with any crisis, is to pursue a plan of action with thought and purpose. At a time when the majority of people seek healthcare information and services online, this principle and plan must extend to the role of digital access. The promise of digital technology is to leverage it creatively as a force multiplier, and to do so with an eye toward minimizing friction in care delivery and enabling the safest care possible. In the ambulatory setting, there are three distinct populations we need to think about servicing this way.
The first is the general population needing guidance on safely assessing their health while physically staying in their homes if at all possible. This is best achieved through the interplay of screening tools and virtual assistants with appropriate triaging for 1) those who can safely obtain self-care instruction 2) those who should have additional assessment through a combination of virtual appointments and direction for screening tests if warranted and 3) those who require immediate direction to the closest hospital or care facility. Screening engagement platforms, in conjunction with telemedicine, can decompress call centers, thereby freeing up staff, and help keep more patients safely at home.
In addition, more clinical staff can work remotely to provide virtual visits, maximizing the use of dwindling PPE resources for those who continue to serve on the front lines in direct patient contact. Digital technology can thus similarly benefit this second population, your health system staff and clinicians, by respecting their need for technology that works for and with them, promotes their physical safety, and conserves increasingly limited resources.
The third key population is patients with non-COVID medical needs, who require attention and outreach to help maintain their health. Digital platforms (e.g., telemedicine, automated outreach) can play an important role in keeping these patients well-informed, monitored, and safe, with clear access to information, both static and offered dynamically through real-time interactions when needed. Furthermore, those with chronic conditions that can become increasingly complex if left unchecked and where compliance issues may be exacerbated due to economic pressures, must be supported during this time even in the absence of acute symptoms – for their own well-being and to minimize the need to compete for scarce complex care resources.
While we all struggle to act quickly under these exceptional circumstances, using your digital investments to speak creatively to the needs of these populations is not only possible, it is necessary.
Healthcare technology continues to proliferate the sector, the developments almost too many to track. The sector abounds with innovation and push forward in the name of better – even the minutest – advancements of care and better care outcomes. The coming year will be no different. As we enter the final year of the 21st century’s second decade, we’ve witnessed a tremendous amount of evolution in just 19 years. What role will our healthcare technology play in the healthcare industry in the next year?
A lot. And not just for a few, but members of many, many areas, even those peripherally involved with the boundaries of care. We must understand where current innovation is, but also the challenges these migrations attempt to solve. Being aware of the trends ahead can give us all a better grasp of how care delivery is changing and we can better understand how new areas can resolve real industry problems.
To help us navigate the year ahead for healthcare and its technology, the following are some of the trends that it leaders, observers, insiders, consultants and investors think are important or need to be taken notice of in 2019.
In rural America, patients often find themselves more than 30 minutes away from hospitals or care facilities, making it extremely difficult to receive consistent quality care. In fact, there are only 39 physicians per 100,000 people in most rural areas, and specialists are often few and far between. With the average rural area income being more than $9,000 less than the average household income in the U.S., there simply aren’t enough doctors or financial means to see a specialist in a rural setting. This leaves patients waiting three to six months to see a doctor with the appropriate expertise and can lead them to receive care from non-physician providers, who may not have the same clinical training that a physician has. As a practicing family physician in Springfield, Missouri, I experience these challenges almost daily and as technology advances I have found new ways to help my patients to significantly decrease their need for a specialist visit.
Some of the most common health issues I face as a primary care physician that fall outside of my normal scope are dermatological, cardiological or gastrointestinal. In urban areas, patients can easily make appointments at respective specialists, but in a rural area like my own, diagnosis and treatment is often left to the primary care physician. While seeing patients for regular scheduled appointments, I typically encounter 20 dermatological cases a week including conditions like eczema, psoriasis, warts and actinic keratosis.
Although these are common skin conditions, when I encounter these types of conditions I take my years of experience and try to assess to make a diagnosis and develop a treatment plan, even if I am not 100 percent certain of the specific condition. Thanks to technology, more and more tools are being developed that can help diagnose the conditions – whether common or more intricate – that primary care physicians may not be expertly trained on. These tools, known as clinical decision support tools, enable us to make more accurate diagnoses at the point of care.
Technology as an aide, not a replacement
When I talk to my colleagues about utilizing technology in our everyday practice, I commonly get pushback because there is fear that technology may put us out of a job. The truth is that clinical decision support tools are becoming essential tools for rural health care providers as the volume of available data increases alongside our responsibility to deliver value-based care. These tools are simply aiding us, not replacing us.
A tool I’ve been using for the past year, VisualDx, allows me to access thousands of medical images that I can use to compare to a patient’s skin rather than referring them to a dermatologist with a long wait time. By looking through multiple examples of the same condition on different body parts and on varying skin tones, I can accurately identify a patient’s condition and recommend a suitable treatment plan. This visual element allows me to be confident in each diagnosis and share my findings with my patients directly in the room.
Earning patient trust with technology use
When a patient comes in with a specialized health issue, they are often hesitant to trust that the diagnoses I’ve made are accurate due to a lack of expertise in a certain area. I recently had a parent bring in their child requesting a referral for dermatologist due to some bumps on her arms. In this case, I already knew the diagnosis as the rash had a very characteristic appearance of molluscum contagiosum. However, the patient’s parent was concerned that I was not knowledgeable enough in this area and was insistent upon a referral. In this case, I was able to use the tool to show her the diagnosis, the time frame that it usually lasted and the recommended treatment. This extra level of reassurance allowed the patient to trust my diagnosis and recognize that a referral was unnecessary.