• Pump Your Own Care

    August 7th, 2017 : By steve

    A Very Short Vision of Future Health Care

    What in the world? Pump your own care?

    Well, in 1970, very few thought that pumping your own gasoline would be commonplace. Today, it is almost impossible to find a full-service gas station, and pumping your own gas is considered a routine event. Technology essentially transformed full-service gas stations into a predominantly self-serve business, and we now think it ordinary.

    Similarly, patients increasingly expect to be in charge of their own health care, served by a team of health-care professionals. Today, some believe patients will serve themselves and, in a sense, pump their own care, transforming patients into the ultimate center of their care. The change agent? Once again, technology.

    Technology is transforming health care, just as it changed the gas station business. By 2030, patients will think it routine to initiate a large proportion of their own care, to seldom visit a brick-and-mortar medical facility, and to use digital medical devices in their own home to transmit their self-initiated clinical data. All of this is made possible by the combination of digital medical devices; technology such as artificial intelligence (AI) and the electronic health record (EHR); and robotics—the three legs of the stool that will transform medical care.

    Let’s take a peek under the covers of the future as it relates to patient care. Here are some examples of what we could be doing at home in 2030 to take care of our own health.

    • We will use digital medical devices to transmit our physical and lab test data as we decide it is needed. We will take our own temperature and blood pressure and generate our own test results. We’ll record notes in our medical record that will become part of our progress notes. We will literally be able to perform all the services that generate metric or text data in the doctor’s office.
    • Artificial-intelligence (AI) applications will interpret symptoms and clinical data and generate evidence–based findings, patient instructions, and prescriptions when appropriate, all with the approval of a remotely attending health-care resource.
    • This data will be stored in our electronic health record (EHR), the repository of our health information that will be available to patient, caregiver, and all those we authorize to access our information.
    • There will be limited physical visits to a practitioner’s office and reduced or eliminated waiting in what are appropriately referred to as patient waiting rooms, as least the way we know them today.

    By the way, I’m writing this blog in a patient waiting room! In the future, the only time we’ll be in a waiting room as a patient will be if a procedure must be performed on us physically and not remotely. When just a face-to-face meeting must take place, FaceTime or similar technology is available. Such an appointment is especially critical to individuals living in far-flung places, such as the wide-open western U.S. states, where the nearest medical facility can be 30 miles or more away, or in congested cities, where public transportation takes longer than the miles traveled.

    Another technology is also being born and commercialized: robotics. Robots will be the next generation of medical assistants, designed to help patients, and most importantly, in their homes. Robots will become a “pump your own care” phenomenon, the third leg of the stool. They will become the companions and protectors of patients. These cheerful companions—and they will be always cheerful—are the embodiment of AI, programmed to provide medical care and advice. They will become the digital medical eyes and ears for families, nurses, physicians, and, most importantly, patients. They will populate a patient’s EHR with data for medical staff and other authorized individuals. The U.S. Census shows that one in five people will be over 65 by 2030; by 2050, this ratio will balloon to four in ten. To meet this future demand, robots can fill in the gap of caregivers and bolster the number of practicing medical assistants. They will be round-the-clock data gatherers for improved real-time medical care.

    Today, as these technologies become increasingly commercialized, they’re enabling the transformation of health care. Though we may be aware of the changes taking place in patient care, we may not be as aware of the paradigm shift taking place in our thinking because of it, the unseen leg of the stool. Like the proverbial frog in the pot of water over a slow flame, we may not notice that it is taking place to the extent that it is. We know change is occurring. We enjoy some of it but feel uncomfortable with other parts of it. Over time, we grow conditioned to the change and begin to love how we can help ourselves by using it, start to enjoy feeling more in control of our own health care, and are sometimes exhilarated when a plan comes together. Multiple studies suggest that patient engagement in their own health care is therapeutically beneficial. Overall, we become not only accustomed to the change; we become part of the change. We are the ever-present, unseen leg of the stool.

    The transformation taking place in health care is based on the premise that “the practice of medicine is the practice of information.” As we become more of the message and more active in our own care, all the legs of the stool will be sturdy, and the stool will be ready for steady use.

    Beth Evans