The Doctor Can Virtually See You Now

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With digital medicine, patients in rural and remote locations now enjoy much higher levels of medical attention 

By Justin Williams

Americans love change.  Except when it applies to their own lives.  The nation’s medical community feels the same way.  

There are, of course, innovations in healthcare happening all the time.  But for the most part, those innovations take place within the discipline of mainstream medicine, administered in a hands-on fashion at hospitals, clinics and doctors’ offices, under provisions consistent with the arcane stipulations of health insurance policies, and in ways compatible with the extensive business ecosystem that supports providers of healthcare.  Changes which threaten to disrupt that comfortable pattern are deeply suspect.

But for an industry involving trillions of dollars a year, the attraction of new players into the lucrative healthcare market is easy to understand.  So it’s no surprise that some of the nation’s biggest and most technologically sophisticated companies are elbowing their way into different areas of medicine – particularly those that involve big data.  

Predictive analytics, imaging analytics, genomics, precision medicine, financial analytics and risk assessment tools are all in high demand right now.  By aggregating masses of health-related data, analyzing them with artificial intelligence, and then moving them around the globe as needed, these non-traditional players are shaking the foundations of modern medicine.  Beyond that, the greatly elevated role of digital assets in medicine comes at a time of already tremendous disruption created by Covid-19. 

One of the pandemic’s most likely legacies is expected to be a lasting redistribution of America’s workforce away from central offices and into private homes in cities, suburbs and exurbs.  At the same time, though, the decentralization of America’s workforce echoes yet another reality: despite the country’s long-standing pattern of urbanization, there remains a rural population in need of medical attention where getting to a full-service hospital or clinic may be many hours away.

The fact is, getting health professionals to set up shop in rural areas is hard to do.  It’s both personally and professionally challenging for them.  And it’s almost impossible to find enough work in rural areas to sustain their specialization and retain their skills.  Yet a rural diabetes patient will need the same forms of attention – dietetics, podiatry, exercise advice, prescriptions and pain relief, for example – as an urban patient.  But for rural patients, surrounding themselves with such specialists in a remote location is simply unrealistic.

Different strategies have been devised for providing healthcare to remote locations.  In one Scottish rural community, for example, residents decided they would turn to local volunteers led by a paid, knowledgeable health professional.  But community members weren’t able to decide on the sort of practitioner they needed to lead the effort.  What they really wanted were parts of the skill-sets of nurses, doctors and health promotion advisers.  The closest they could find were physician assistants, nurse practitioners and paramedics and those just wouldn’t do, they concluded.  As a result, implementing their innovative healthcare model proved to be impossible.  

Healthcare is complicated, and there is almost certainly no one-size-fits-all template that would work for every patient in every rural area.  But a workable solution is available.  The same digital technology now challenging medical traditions is also offering a promising approach to tracking patients’ vital signs, even from great distances.  The emergence of telemedicine combined with electronic monitoring devices wirelessly connected to a physician’s office by internet, cellular service, phone lines, satellites, or even RF signals, can provide visibility into a patient’s health almost as effectively as in an office visit.  In fact, it can be better in some ways because the connections can be set to transmit continuously or at least frequently enough that troubling developments don’t have the opportunity to sneak up and catch the physician by surprise.  

Cloud-based electronic platforms serve as companions to those devices, receiving, combining, and interpreting that data, as well as issuing alerts and giving recommendations based on that information, regardless of distance.  Among the current remote care capabilities are the capacity to issue prescriptions, provide patient education, help with scheduling, issue reminders, complete surveys, present educational videos, and participate in video visits with the virtual care team.

Each platform works a bit differently.  One company, for example, has configured a 30-day protocol to remotely evaluate and monitor patient populations regarding potential exposure to COVID-19 and its symptoms, as well as underlying conditions.  Another provides updates to doctors by tracking patients between visits for blood pressure, weigh, and blood glucose.  A third operates a capture platform that integrates the data from patient monitoring devices with patient support information while automatically updating their medical records.  

For residents of isolated communities where full-service hospitals could be hours away, digital medicine combined with remote patient monitoring, is capable of offering healthcare systems and individual providers a level of care never before available in rural areas.  Its artful combination of distance and data – separating the doctor from the patient by many miles while closely monitoring their conditions – is a clearly disruptive challenge to the hands-on tradition of medical attention.  But unlike some other changes, it’s one that physicians are feeling increasingly comfortable about. 

Justin Williams is the CEO of Noteworth, a first-of-its-kind Digital Healthcare platform for modernizing Digital Medicine delivery operations

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