The chiropractic profession, and healthcare in general has been historically slow to adopt new technologies. However, we are all about to experience significant changes in the role technology plays in our practices. From how we communicate with patients to how we formulate a diagnosis and collaborate—tech will play a greater role healthcare in the next several years than ever before.
Telehealth
The rise of telehealth, driven by the COVID-19 pandemic, has been the most practically transformative source of change in healthcare in a decade. Limitations on travel and requirements for social distancing, combined with the temporary relaxation of HIPAA requirements and the ease of use of synchronous video platforms has resulted in a rapid adoption of telehealth. This trend is not likely to decrease once the pandemic resolves.
Telehealth provides solutions to several significant challenges confronted by our healthcare system. Telehealth provides ready access to physicians and specialists during a time when physician shortages have increased the wait time many patients must endure when seeking care. It also is helping to reduce the rising cost of delivering healthcare by decreasing costly visits to the emergency room. According to Kaiser Health News, the cost of unwarranted ER visits was $32 billion in 2019. Kaiser also reported that, “A trip to the emergency room is on average 12 times higher than being treated at a physician’s office for common ailments.”1
The Internet of Medical Things (IoMT)
The advent of wearable devices and mobile apps combined with telehealth has resulted in a new Internet of Medical Things (IoMT). The real-time monitoring of many common health status measurements including ECG and EKG, skin temperature, blood pressure and glucose level is becoming increasingly adopted in healthcare. Wearable devices enable physicians to improve outcomes, reduce hospital readmission rates, increase patient satisfaction, and prevent chronic illness for many patients.
According to the Accenture 2019 Digital Health Consumer Survey, “More than half of consumers (53 percent) in 2019 are more likely to use a provider offering remote or telemonitoring devices, compared to 39 percent in 2016.”2 These expectations are influencing who patients choose as a provider. Younger healthcare consumers are more likely to choose your practice if you have digital communication capabilities including reminders for appointments via email or text.
Notwithstanding their benefits, significant challenges exist with IoMT devices. Device manufacturers use proprietary platforms, which makes interoperability and the sharing of data across platforms difficult or impossible. Potential security concerns must also be addressed. Accenture reports that, “one in four U.S. consumers (26 percent) have had their personal medical information stolen from technology systems.”3
Cloud Computing
The use of cloud-based Electronic Health Records (EHR) systems in chiropractic practices has been increasing at an exponential rate. In its simplest form, the term “cloud” is a metaphor for the Internet. In the past, all your practice’s software and data had to be on a computer or server that could only be accessed at a specific location. More and more practices are migrating their record keeping from server-based to cloud-based platforms. Hosted, cloud-based EHR solutions offer providers the appealing benefits of lower cost, ease of scalability, and greater portability of data.
Conversely, the reduction in data control that accompanies cloud-based EHR can be problematic in terms of HIPAA compliance. In a cloud environment, the means for ensuring and monitoring the security of electronic data including text messages, emails, video and audio must all be in place to meet compliance needs. Additional considerations arise with the use of cloud-based systems. Providers may experience a latency or lag time accessing while information across the web and bandwidth may be limited by practice’s Internet connection.
Despite the concerns about security, the main driver behind the rapid rise of cloud-based EHR technology is that healthcare practices are no longer simple service providers. Today your practice is a true technology organization that depends upon your IT for clinical, administrative, and financial functions. Add to this patients’ expectations of technological proficiency by their healthcare providers and tech becomes a crucial component of your practice.
Blockchain
Blockchain is a decentralized, shared digital ledger that maintains an unalterable record of transactions between users. One of the greatest benefits of blockchain technology is that it stores data in a significantly more secure way than other platforms. This makes is especially attractive as a method of storing and sharing Protected Health Information (PHI).
Since blockchain is a decentralized network, it can alleviate the lack of interoperability between healthcare electronic record platforms and the inefficiency of data sharing between providers it creates. Medical records can become inaccurate as they are passed between providers. This can lead to duplicate or unnecessary treatment. Enabling interoperability allows providers to share information including treatment history, appointments, data from wearable devices and other demographics. This results in higher quality healthcare.
Blockchain significantly improves data security because it has no centralized point of failure. Cyber-attacks on healthcare practices are becoming a regular occurrence. Blockchain can help secure PHI and stop these attacks. More secure data also means substantial savings to the entire healthcare industry. According to a report from Deloitte, “On average, one data breach a day occurred to a health organization and costed an average of $3.62 million to the afflicted organization.”4 Blockchain technology can eliminate this risk.
Artificial Intelligence (AI)
One of the healthcare technology trends with the greatest potential is the development of Artificial Intelligence (AI) machines. AI applications can process information and provide decision-making data in way similar to the way the human mind works. AI can improve the speed and accuracy of the process of making a diagnosis.
The FDA recently approved the first AI diagnostic device that examines photos of the retina to identify eye disease. The device, called IDx-DR, examines uploaded images for indications of diabetic retinopathy. According the the FDA, “IDx-DR was able to correctly identify the presence of more than mild diabetic retinopathy 87.4 percent of the time and was able to correctly identify those patients who did not have more than mild diabetic retinopathy 89.5 percent of the time.”5
Another application of AI, Buoy Health, is being used by Harvard Medical School to help diagnose and treat patients more efficiently. Buoy’s chatbot listens to a patient’s health concerns and symptoms and then guides the patient to the correct care based on its diagnosis. Whether it is being used to improve diagnosis, drive surgery-assisting robots, or find new links between genetic codes, AI is reinventing healthcare with its ability to predict, understand, learn and act.
The Digital Transformation of Healthcare
The synergies that will result from the confluence of these trends in technology will result in the digital transformation of healthcare. Wearable devices and IoMT paired with telehealth and cloud computing will result in enormous data sets for AI software to analyze. The interoperability, and safe, secure storage of PHI made possible by blockchain will foster an interdependent ecosystem that breaks the practice of healthcare out of its silos and fosters collaboration among providers.
References
https://khn.org/morning-breakout/the-cost-of-unwarranted-er-visits-32-billion-a-year/
https://www.accenture.com/us-en/insights/health/todays-consumers-reveal-future-healthcare
Dr. Mark Sanna is a member of the Chiropractic Summit and a board member of the Foundation for Chiropractic Progress. He is the president and CEO of Breakthrough Coaching (www.mybreakthrough.com 1-800-723-8423).
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