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  • Writer's pictureALEJANDRO

When patients have less patience

Ten years after my first remote patient monitoring initiative, we are living longer, dying less from accidents, and surviving more heart attacks. Many diseases have become chronic and manageable, when not outright preventable. The healthcare world has accelerated its transformation with COVID’s digital shock, in a world where patients have less patience.

Healthcare leaders are figuring out a digital strategy, with the digital experience of care becoming strategic. The FHIR standard -our aspirational interoperability Esperanto-, has been steadily adopted, and regulations promote an outward mobilization of data while maintaining patient privacy across the care continuum. And, just as importantly, new reimbursement codes have been instituted to sustain a new age of access expansion through the virtualization of care.

We are undergoing a change in which answers are still outnumbered by questions. As human beings and economic agents, how can we find an equitable and just experience of care? Where lies the difference between a patient and a healthcare consumer? How can we equalize the doctor-patient knowledge asymmetry permeating the system, with all the inefficiencies it creates? How can we move to identifying, predicting, and acting on opportunities for low-cost early care interventions?

Our contribution to change rests on a simple, yet powerful idea: the digitalization of the patient journey. A digital patient journey is a set of clinical instructions and activities, within a specific cultural context, that follows a care orchestration logic and is delivered to patients and their care ecosystem, fundamentally via mobile devices. Via this relationship model, clinicians can assign digital patient journeys as a single, consumer-driven logic. These operationalized pathways provide new visibility, measurements, and insights. They address diverse clinical goals, activities, cultural specificities, and the needs of communities, all coordinated over time, at scale. At the same time, its workflows support the billing of virtual care reimbursement codes.

In the age of artificial intelligence, data poverty, and digital determinants of health, access and outcome disparities are growing between communities, not shrinking. Digital technologies have the power to help close this gap, but improperly applied, they can also make it deeper, wider, and more persistent.

Community healthcare providers must invest in the creation of their own digital capabilities and assets to update their business models, digital capabilities, and virtual care offerings. Episodic care and patient-generated datasets, and community-specific AI/ML models will help personalize care and infer early opportunities for low-cost interventions.

Nevertheless, we must check for AI models training extrapolations, black boxes with no clear accounting for transparency, fairness, or the inevitable biases. Building trust with patients is probably the hardest quality to achieve and maintain in the patient-doctor relationship, more so, when digitally mediated.

The completion of a full digital transformation in healthcare is nearer than it seems. The digital organizational interface will connect the “last mile of care” between healthcare providers and insurers with their customers. This will enable new experiences of care, and the birth of new digitally-enabled care delivery models while augmenting existing ones.

A new healthcare system truly consumer-centric, nimble, and profitable, is now possible.

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