Technology can be both a blessing and a curse and nowhere is this more painfully evident than in the U.S. health care system. If technology is to be used to improve the patient-doctor relationship, its systems should be designed by physicians who understand these needs, not by regulators and health care conglomerates for whom business objectives are paramount. When it’s all about billing and meeting documentation checkboxes and hospital requirements, clinicians are diverted from their core mission and patient care suffers.
A good use of technology would be the creation of a single compatible medical record system that enables all doctors to access each patient’s records of care. The banks did this with ATM systems 45 years ago and they trust this system with trillions of dollars. ATM systems all over the world adhere to a common protocol and security framework, while the banks’ security and consumer privacy are maintained with PINs, passwords, two-step verification and other measures.
This solution should be adapted for the health care system as well. Data could be stored centrally and accessible from anywhere across health systems and locations. When a patient sees a new health care provider, the physician can log in for immediate access to all previous health records, including a list of active and inactive problems, lab results, imaging, procedures, and outcomes. This is a far cry from our current system in which primary care providers and specialists waste endless hours trying to track down each other’s data while patients – the real owners of these records – wait to be treated.
Large health care systems have their own patient portals and patient-consumers log in, similar to the way they enter their online retail accounts. Instead of selling socks or books based on a customer’s previous purchasing history, limited artificial-intelligence algorithms can give anticipatory guidance based on each patient’s medical profile. Taking into account each person’s personal data such as blood pressure, lab values, medications, and family history for certain disease, the algorithm can generate certain health recommendations. Until now, different health systems’ portals have been proprietary so clinicians from different health systems often generate recommendations without access to a patient’s complete information. Incompatible medical data systems are far less likely to generate appropriate recommendations.
An AI system can operate a self-driving car, but it must access a multitude of different data. For example, speed is moderated based in part on location – whether the car is on a driveway or a freeway. If the system doesn’t have all the information centralized, it may miss the fact that a street is one way. If that vital information is locked away in a different, incompatible system, the car will go the wrong way and risk a collision.
An AI system for health care requires seamless connectivity between record systems and should be designed by physicians with broad experience who understand the needs of a wide range of patients. Information can be collected in a way that’s meaningful and reproducible from one patient to the other.
Using AI, a message about strep throat, for example, can be customized for a 17-year-old patient. This discussion would center on the need to continue taking the full course of antibiotics even after a patient’s throat feels better. Because the patient is a teenager, there is no need to include details about liquid antibiotics and how many teaspoons to take. Moreover, most people pay closer attention and show better compliance when messages are targeted to them and evidence knowledge of their specific personal situations.
Another positive goal for implementing more sophisticated technology into health care would be voice capture systems that would enable doctors to talk to patients and face them, instead of a screen, while they are simultaneously documenting the details of the encounter. Such a system would bypass and perhaps even eliminate the keyboard and mouse, instead recording the doctor’s and patient’s voices, restoring the discussion that is so essential to maintaining a relationship of trust between them.
The technology to improve and save lives is here — even without new advances in medical and surgical care itself — through improved functionality in information systems. Let’s put the needs of patients first and design systems that will compile all patient information, connect all providers, enable them to utilize the broader knowledge, and personalize management of each patient. We can inspire confidence in the medical profession and do what we do best: heal the people who seek our expertise and care.
Alan Kadish is president, Touro College and University System.
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