From 3M Health Information Systems
The good, the bad and the (sometimes) ugly of health care technology
The contribution of scientific knowledge to the improvement of health care is self-evident. Medicine, devices, surgical techniques and diagnostic tools have improved and saved countless lives over the past century. More recently, digital technology has improved communication, patient monitoring, medical information access and telehealth while creating time for providers to care for patients. How can technology be even more helpful to patients and when can it be too much of a good thing?
Technology can both facilitate and impede communication. The electronic health record (EHR) is a good example. Transitioning from paper-based to a digital patient record has allowed providers to access and share patient diagnoses, lab reports, medications and notes more efficiently and easily. Theoretically, this means providers can spend more time with their patients and deliver higher quality care. However, EHR use does not always translate to greater efficiency, as practitioners spend more time entering notes on a computer than being present with their patients.
Ambient intelligence used during an office visit addresses the problem of prioritizing the clinician’s interaction with the EHR over the patient. A patient’s conditions, treatment and outcomes can be effortlessly recorded and coded without taking time away from the important interaction between the patient and clinician.
Computer-assisted coding (CAC) also provides an opportunity for health systems to leverage natural language understanding (NLU) to improve the documentation of a patient’s conditions and treatments. While the primary benefit of CAC software is to create a more efficient method of documentation that leads to improved revenue, there are benefits to the patient that are often overlooked.
Improvements in clinical documentation that benefit the bottom line without benefiting the patient are incomplete. There is valuable information available in a patient encounter that is often underutilized. Medical claims data can be used to create a categorical patient classification that is essential to facilitate patient outreach and care management. Non-medical information such as social determinants of health (SDoH) can be captured with ICD-10 Z codes (Z55-Z65). This enables providers to treat the whole person by addressing the entire spectrum of a patient’s socio-clinical needs.
Technology must be used to appreciably improve the quality, cost, outcomes or experience of the patient. Technology that leads to higher prices does not always lead to improvements in quality or the patient experience. For example, the proliferation of MRI and CT scanner units in Japan led to price decreases, whereas in the United States it has resulted in unnecessary utilization, as well as higher prices. Also, the use of expensive da Vinci robots has not shown a difference in cancer outcomes between robotic and less expensive open surgery.
Technology in the right hands, used for the right purpose, is essential to improving communication, coordination and care that results in a positive patient experience. Technology that inhibits these or prioritizes profits over the needs of patients must be reevaluated.
Steve Delaronde is senior manager of product, population and payment solutions at 3M Health Information Systems.