Twistle Medical Director Rameet Singh, MD, MPH FACOG, recently participated in a panel discussion at a HIMSS Accelerate Health digital event. The discussion centered around disruptive innovation in healthcare and how to address it (read a recap here). In addition, the panel was beginning to touch on the topic of disintermediation of traditional healthcare when they ran out of time.

The Twistle Team circled back with Dr. Singh to explore a couple of pressing questions: How will retail-based convenient care impact the physician / patient relationship? Are these disruptions changing healthcare for the better?

Twistle Team (TT): With the pandemic, there have been many changes in the telehealth/digital health space. Are traditional health systems responding to consumer demand for convenience, access, and information?

Dr. Singh (RS): Health systems have traditionally been slow to adapt to changing consumer expectations. While they have deployed EMR-based patient portals to engage patients in their care, these tools do not align with consumer needs for an information-rich, functional, and connected experience. Patients are open to new, better experiences that align with the service and access they are used to in other facets of their lives. As a result, traditional healthcare must invest in technologies that are patient-centric to stay competitive.

TT: Do you think these new disruptive healthcare entrants are making our system better or harming it?

RS: On the one hand, disruptors offer radical convenience and access to care for people that might otherwise go without essential healthcare services — more screening and faster care have a positive impact on outcomes. But, on the other hand, it further contributes to a disconnected experience when patients later seek care for more complicated illnesses from traditional healthcare settings and expect data continuity and a seamless hand-off.

I am also concerned about the impact that will have and the overmedicalization of our average lives. One of the ways this manifests is around excessive prescription provision. According to some data I recently saw, 55% of Americans regularly take prescription medication. Additionally, the number of yearly prescriptions clinicians are writing has increased from 2.4 billion in 1997 to 4.5 billion in 2016. Many health conditions can be addressed without medications. Still, it takes time to educate patients about the health care situation and behavior, diet, or other changes a patient can make to address the specific health care concern.

In addition, one has to consider the financial impact of shifting the low acuity and potentially more profitable care from privately insured members away from health systems. Thus, while we constantly need to look for ways to reduce care costs, we still have to ensure those health systems can afford to keep the doors open.

TT: How can traditional healthcare providers and health systems improve care while responding to the disruptors?

RS: I think our healthcare system needs to capitalize on the telehealth wave, continuing to implement technology that empowers patients with convenience, access, and knowledge and makes them active participants in their medical plan of care. Let us move beyond the broken patient portal experience where Apps have to be downloaded, information is sparse, and the user interface is confusing. Engaging through patient portals is as low as 25%, based on some estimates. We need to consider other more convenient and user-friendly ways to connect with patients.

Once we can reach patients where they live their digital lives – their mobile phones – we can start to have a meaningful impact on the health and wellness of our nation. We can deliver preventive care reminders, screen for risk factors, provide education and coaching to shift lifestyle choices, and treat disease on a daily, rather than annual, basis. Technology will become an extension of the healthcare provider, keeping patients on track with their care plan.

I think the responsibility for chronic, complex disease care will still lie mostly with large health systems. Technology can have a dramatic impact on an organization’s ability to deliver daily, consistent care. Disruptors are not focused on long-term care – health systems should be.

I think the responsibility for chronic, complex disease care will still lie mostly with large health systems. Technology can have a dramatic impact on an organization’s ability to deliver daily, consistent care. Disruptors are not focused on long term care – health systems should be.

Rameet Singh, MD, MPH FACOG

Medical Director, Twistle

TT: What are the barriers to delivering comprehensive care, particularly with chronically ill patients?

RS: Health Systems have a large and expensive real estate footprint, so seeing healthcare moving out of the bricks-and-mortar setting certainly will feel like a significant disruption. This is an opportunity, though, for providers to stay connected with patients via technology. In addition, if large health systems can make healthcare delivery more effortless, more convenient, and ultimately bridge gaps in care, patients won’t seek other sources of care and can potentially be healthier.

I also think our industry has not historically been incentivized to manage chronic illness outside of the hospital or office setting, so we haven’t gotten very efficient in this endeavor. We’ve hired care coordinators, case managers, and home health nurses to perform manual tasks like phone calls and home visits, and then patients are left on their own to manage their illness in-between. But we know that patients need constant encouragement, reinforcement, and reminders about how to stay on track with their care. We must embrace technology to automate many of these tasks, ensuring consistency and reducing care variation.

TT: How do you think health systems should view technology for their organization?

RS: Convenient care is very transactional and could feel very disconnected for the patient. I think organizations must engage patients in new ways and invest in technologies to do so. Patient-centric technology can support patients along their health journey, keep them connected to their care team, and help them achieve their health goals. For busy healthcare providers, having great patient engagement technology will be essential to meet the needs of patients, automate administrative tasks, and focus efforts on patients who need extra support.

TT: Do you think there are parts of healthcare still in need of disruption?

RS: For all of the disruption, there is still a significant need for transformation in healthcare education, policy, transparency, accessibility, and cost to address and reduce healthcare inequities, especially for our communities of color. Until everyone has the care, tools, and resources they need to be healthy; our healthcare system is still falling short.

In her work with Twistle, Dr. Singh is helping us provide even better patient engagement experiences for each unique health journey. Learn more today