May 5, 2014

In the past decade, significant advancements have been made in medical research and technology that have improved the overall healthcare experience for patients and made it easier for doctors to provide better, more efficient care.

Electronic medical records (EMRs) have replaced paper files in medical practices and hospitals, patients are increasingly accessing their health records online and Google Glass is currently being tested to see how it can help physicians with patient consults.

The question now is: What’s next on the horizon for doctors and patients? We interviewed several medical experts to get their thoughts on the biggest changes likely to occur in primary care over the next decade. Here are their four most noteworthy predictions for doctors’ offices in 2024.

Doctors Will Rely on Wearable Tech for Real-Time Insights

Wearable technology is already popular among some consumer groups, particularly fitness enthusiasts. These high-tech fitness trackers measure everything from a person’s heart rate to activity level and even sleep patterns. As this technology becomes more efficient and less obtrusive to everyday activity, experts say it will likely become a big part of the medical community, providing doctors with patients’ real-time health information.

“Current wearables such as the Cuff and the Athos fitness tracker, among many others in this space, already allow patients to monitor their own health by measuring heart rate, respiratory rate and calories,” says Dr. Sandeep Rao, MBA. “The next step is for the patient to be able to plug this data into their medical records, which would allow us to mine data for both individual patients and groups of patients.”

One example Rao gives is treating a large group of high blood pressure patients with a certain anti-hypertensive drug. Wearable technology would allow the doctor to track the effect of the medication on each patient’s heart rate and blood pressure.

“The physician[s] could then aggregate this data centrally, analyze it and determine the efficacy of the medication on different demographics [women, young patients, Asians etc.], and finally target each population with the best medication,” says Rao.

Dr. Natasha Burgert, a pediatrician who frequently blogs about the patient-doctor connection, believes that wearable technology will also elevate the patient-doctor experience to new levels, providing doctors with a much more in-depth understanding of what activities and behaviors a patient engages in and how they affect their health.

She explains that patients aren’t always honest about their lifestyle choices, either because they know the healthier choice is the right answer, or they feel it’s not a doctor’s business to comment on a personal choice.

Regardless of the reason, Burgert says this leaves doctors advising patients with unreasonable or impractical approaches that are essentially unusable. “Wearable technology will give us a better understanding of how our recommendations may or may not be applicable for that patient’s lifestyle,” she explains.

For example, imagine a patient who doesn’t tell their doctor they’re working a second job to make ends meet, which leads to late night snacking and sleep problems—when the patient is trying to lose weight. “If information was shared through wearable data, the doctor could get a more accurate sense of natural awake/sleep rhythms and offer possible suggestions of what to eat late at night, rather than a blanket statement of, ‘don’t eat late at night,’” Burgert explains.

She also points out that wearable devices could be critical in reaching patients who don’t take good care of themselves. “The patients who really need to be tapped into are those with chronic illnesses who don’t think they’re sick, such as people with uncontrolled diabetes,” she explains. “This is a really hard population to reach.”

Wearable technology could alert the doctor whenever the patient was having issues or complications, as opposed to the patient ignoring the warning signs and waiting until their condition was severe to visit the doctor. This would help the patient recover faster and lower treatment costs, since less drastic measures would be necessary.

Waiting Rooms Will Be Phased Out

Talk to any patient, and they’ll agree that less time spent in the waiting room is a good thing. In fact, a recent Software Advice survey of 5,000 patients in the U.S. found that 97 percent of respondents felt frustrated by wait times.

Although the waiting room experience has already become more streamlined with advances such as online check-ins, experts say this process will continue to become more efficient in the future, or even disappear altogether.

Geeta Nayyar, chief medical information officer (CMIO) at PatientPoint, believes the waiting room will continue to exist, but that the time patients spend will be used more efficiently. “The visit will start right when you walk in the door,” she says. “For example, the provider might see that you have diabetes that requires a certain type of screening. If you complete the screening in the waiting room and test positive, that information can be sent directly to the doctor to make the visit more efficient.”

Burgert believes waiting room times will be significantly reduced. “We can do a lot more pre-visit education, and much of the form completion and scheduling can happen outside the office,” she says. “We could have the basic patient demographic data pre-loaded, so there won’t be any delays.”

Patients filling out pre-visit forms online coupled with data transmitted from wearable technology could give doctors most, if not all the advanced information they need.

Less time spent collecting background information means the visit can be devoted solely to the patient’s current ailment or issue, greatly speeding up the duration of appointments and reducing—or even eliminating—the need for wait times and waiting rooms.

In addition, Burgert says it’s possible that patients could have a smartphone application allowing them to scan or alert the doctor’s office to their presence when they’re in the parking lot or have entered the building. This could eliminate the need for wait times and waiting rooms altogether. “We could anticipate your arrival, meet you at the door and take you right back to your room,” says Burgert.

Up to 35 Percent of Visits Will Happen Virtually—Or Not at All

Traveling to the doctor’s office for a routine checkup can consume a decent chunk of your day. While these visits are important for ensuring your ongoing health, the future offers a more efficient and less time consuming solution: telemedicine (also called telehealth).

Patients are already starting to connect with doctors via video call, and some are currently able to order new prescriptions through patient portals, saving them a trip to the doctor’s office. Over the next decade, this trend is expected to rise.

“I see no alternative but to resort to this technology for common and non-emergent maladies,” says Dr. Barbara Bergin, a board-certified orthopedic surgeon. “As patients find it harder and harder to find doctors to see them, hindrances to virtual medicine—such as liability issues—will diminish out of necessity.”

Burgert agrees that telemedicine will increase over the next decade, as it allows doctors to easily interact with, and treat patients with, minor ailments. “If I looked at my schedule today, somewhere between 10 to 20 percent of the visits could be conducted through telemedicine,” she estimates.

Over the next decade, telemedicine will also become more advanced. “In the future, we’ll be able to collect new pieces of data to share in these visits,” Burgert says. “For example, patients may be able to use their smartphone to take their own EKGs [electrocardiograms] or, if they have diabetes, send their A1C and blood glucose numbers.”

Depending on the scenario, Burgers says, patients could send their health information directly to their physician for interpretation and guidance, bypassing the telemedicine video conference altogether.

Nayyar agrees that telemedicine will continue to grow in the next several years, mainly for primary or urgent care services, e.g. if a patient has a sudden, pressing question for their doctor during non-office hours. She estimates that as much as 25 to 35 percent of visits could be conducted in this manner in the next decade.

Nayyar also points out that this technology could potentially alleviate the shortage of providers. “We will always have a shortage of providers, and [telemedicine] offers an opportunity to close some of those gaps from a simple logistics perspective,” she says.

Patients Will Increasingly Control Their Medical Charts

According to a new survey from Wolters Kluwer Health, 80 percent of patients want greater control over their own healthcare, but only 19 percent have access to a personal health record. In the future, patients and doctors could satisfy this demand by charting their visits together, and Burgert says she already knows a few doctors who are actively working on this.

“These doctors are in unique medicine models—concierge/direct care—and can [chart visits with patients] because they’re not bound by the ICD-9 coding system,” she says. “This document partnering, however, doesn’t have to be a privilege only to those who work with direct care documents.”

Charting the visit together would allow patients to share more of their story. Patients often share a lot of detail during their visit with their doctor, much of which is lost during the note-taking process. It’s not that physicians don’t want to capture this information; it’s simply not practical to record paragraphs of information, so instead it’s boiled down to a sentence or two.

“Patients really want their story to be heard, but as they tell that story, it’s very difficult for us to translate that story into our electronic records,” Burgert explains.

But in the future, Burgert imagines that new technology could include a simple series of questions with drop-down menus and comment boxes that could be uploaded into the patient’s EMR.

This survey or intake form could be emailed to the patient a few days prior to their appointment and the results pre-loaded into the system. The doctor could then read it prior to the visit, ask relevant questions when with the patient and then add to the narrative as he/she saw fit.

“It would allow the time with the doctor to be more efficient, with less frank ‘data collection’ and more supportive questioning,” Burgert says. “This would optimize face time with the patient and optimize the use of a skilled practitioner’s time, allowing better assessment and plan discovery for both doctor and patient. It would also allow more time for the patient to engage in self-assessment by committing their story to paper, possibly even facilitating more honesty in the medical record.”

Preparing for 2024

It’s clear there are many exciting developments on the horizon that will change the way doctors and patients interact in primary care practices. While all changes require some type of adjustment, there are a few steps doctors can take now to get a head start.

➔ Get involved in professional associations. Nayyar explains that professional associations often have the latest and greatest information relevant to your particular specialty. She also recommends talking to colleagues to find out what worked and didn’t work for them so you can use this information to invest wisely in different types of technologies for your own practice.

➔ Listen to your patients. Healthcare is continuing to evolve into a consumer-driven space, explains Nayyar. If your patients express a desire to be more involved in their care, spend less time in the waiting room or have the ability to email or text you with questions related to their care, you should start thinking about how to integrate technologies into your practice that will enable this.

➔ Embrace new technology. As new technology becomes more widespread in healthcare, patients are likely to not only embrace it, but seek out physicians who are using it. Learning and adopting this technology early on will put you ahead of the curve. Burgert explains that much of this emerging technology is how doctors will maintain their relevancy and new patients in the future—and ultimately, avoid becoming “obsolete.”

The key for success, Burgert says, is for physicians to push through the learning curve and anxiety associated with many new technologies and be open to the changes that lie ahead. She explains: “Physicians who maintain their willingness to listen and learn, despite the common anxiety of not knowing everything in uncharted territory, will be better positioned in the future.”


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