Dr. Eunice Yu has been a primary care physician for the last decade, with a front-row seat to digital transformation in healthcare. During this time she has seen her fellow physicians, business leaders, and of course her patients navigate the growing landscape of digital tools. This has only accelerated over the last 12 months as COVID-19 forced the majority of her practice from in-person to virtual visits.
Dr. Yu is the first in our series of conversations with doctors who help us understand the realities of taking their practice from "bed-side to web-side" over the last 12 months. In her current role, she is the primary care physician lead for design and innovation projects at Henry Ford Hospitals in Michigan, USA and helps the health system bring innovation into practice.
Digital health is changing faster than ever
The use of technologies for virtual care has doubled since 2016, according to an American Medical Association survey of 1,3000 physicians in 2019. The survey also found rising shares of physicians are using digital health tools to enable:
- Consumer access to clinical data—58%.
- Point of care or workflow enhancements—47%.
- Clinical decision support—37%.
- Patient engagement—33%.
- Remote monitoring and management for improved care—22%.
- Remote monitoring for efficiency—16%
It’s important to note that this data was also collected pre-COVID. As the pandemic erupted, US consumer use of telemedicine increased by up to 158% in some regions, opening the door for the adoption of other digital health tools. Markets also responded, and by the end of 2020, investment in digital health totalled $9.4 billion, exceeding the largest annual sum of $8.1 billion in 2018.
Putting strategy into practice
In our increasingly busy lives, consumers are harnessing digital apps in many parts of their lives, and healthcare is no exception. Imagine cumbersome health records and patient histories streamlined into a secure digital health wallet. By helping patients track and monitor their health metrics, these apps can take the guesswork out of relaying vital information to physicians.
These tools are especially useful when managing chronic diseases like diabetes where monitoring and collecting data about sugar levels, diet, exercise, and nutrition can be overwhelming for both patients and physicians. In our first clip, Dr. Yu shares her patient's experience with the diabetes management app, Livongo.
As Dr. Yu shares, the Livongo app helps patients track their sugar levels and provides wrap-around supports like diabetes educators that help translate a doctor’s recommended strategy into tactics that consider culture, lifestyle, and other environmental factors that are harder to unpack in a time-limited doctor’s visit.
Furthermore, the app is fully paid for by their insurance provider. This not only makes sense for the patient experience, but it also makes good business sense as preventative care is much less costly than hospitalizations or amputations that result from unmanaged diabetes.
Scaling up digital sustainably
Apps like Livango make lots of financial sense and help drive good patient outcomes - no question, but the systems to help scale them sustainably are lagging behind. For instance, doctors now have to manage patient portals of information, asynchronously communicating with patients throughout the day on top of their clinical work. Researching and integrating new technologies also involves training and set-up time that currently isn’t accounted for. This unseen labour is a barrier to effective adoption and also speaks to an outdated business model. It’s clear this area is ripe for disruption.
In our next clip, Dr. Yu helps us understand the fine balance between the excitement of digital technologies and the overwhelm of adopting yet more elements into a busy clinical day.
It is no surprise that primary care physicians have been described as the health system’s swiss army knife: an all-in-one solution for everything health and wellness while also helping patients navigate digital tools (while adjusting to the changes themselves). This approach is not sustainable, and the roles and responsibilities we give physicians need to be unpacked as we enter a future where managing digital transformation is its own full-time job.
Will the growing pains be worth it?
While digital health adoption is a tough pill to swallow today, we know it means better outcomes for patients and innovators are increasingly understanding that it can also mean better outcomes for burned-out physicians.
The previously mentioned AMA study also tracked physicians’ motivations for adopting digital tools from 2016 to 2019. During this time the top need filled by digital tools shifted from “Allows me to provide care remotely” in 2016, to “Helps reduce stress/burn-out” in 2019. An increasing number (40%) of primary care physicians saw the advantage of these tools, whereas only 33% of specialists said so.
Despite the hurdles of adoption, many primary care physicians are in support of digital transformation, especially when they can support a shift to value-based care.
Value-based care is a healthcare delivery model where hospitals and physicians are paid based on patient health outcomes. Under these agreements, providers are rewarded for helping patients improve their health and manage, or even prevent chronic disease. This differs from a fee-for-service or capitated approach, in which providers are paid based on the amount of healthcare services they deliver.
We love Dr. Yu’s vision for the future of healthcare, where she beautifully illustrates how outcomes-based mindsets paired with digital tools can return dignity to healthcare.
As Dr. Yu shares this shift to digitally-enabled value-based models allows doctors to invest in patient relationships, instead of being overwhelmed by an endless stream of new apps. This shift of mindset sets the stage for investing in long-term solutions that will slowly transform healthcare vs. short-term bandaid solutions.
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