Practicing Medicine in the Digital Age

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Rare is the person whose job has been unaffected by technology. While medical advances have moved forward for far longer than the digital revolution has been around, the technological tools that affect how people live their daily lives are constantly finding new uses within the practice of medicine. Although medical training is slower to evolve, it’s safe to say that doctor jobs are significantly different than they were 10 or 20 years ago.

While it makes sense for doctor jobs to adopt the technologies that make so many everyday transactions easier, there must be an extra layer of caution. For one thing, the security and confidentiality of patient information must be respected at all times. For another, a tech tool that makes sense in other professional contexts may not be right in the context of a medical practice.

What all this ultimately means is that the 20^th century model of medical practice is in some ways woefully out of date in the 21^st century. Practicing medicine in the digital age requires continual monitoring of the technology landscape and finding ways it can be used to make medical practice better. This is true whether the technology is specifically designed for medical practice (like EHRs) or not.

In a Digital World, Physicians Are No Longer the Gatekeepers of Information

Perhaps the main revolution that the digital age has wrought is removing many of the gatekeepers that stood between ordinary people and information. Many doctors fret over the fact of patients using the internet to research their symptoms and diseases, but that’s reality and there’s no going back. Doctors who successfully marry their practices to digital-age technologies are the ones who accept that everyone has access to information, but not everyone has the hard-won clinical judgment necessary to use information appropriately.

Additionally, rather than consuming information through medical journals, today’s physician consumes information largely over the internet. Paper charts are giving way to EMRs and EHRs. Moreover, today’s doctor jobs require that physicians be comfortable with a physician-patient partnership and that they be patient-centric rather than physician-centric. Many physicians rely on mobile devices to make their work more efficient, just as many people in other professions do, and the paper inbox (and the email inbox in some instances) is outdated due to web-based tools for curating information and accepting input.

There’s More Information Than Can Be Assimilated

Not just in medicine, but everywhere, information is being generated at a pace that simply cannot be assimilated by even the most interested and committed person. Information increases at a rapid rate, is more immediate than ever, is largely unfiltered and is sometimes even unformatted.

What this means is that while information accumulates at a faster pace than ever, knowledge can never keep up with that pace. Moreover, patient knowledge is not limited by doctor knowledge. It is not uncommon for a physician to have results of a clinical study brought to his or her attention by a patient rather than a colleague.

For the most part, information will find physicians, but it will find them in different ways than it did in the past. In today’s world (medical and otherwise) publication is often the beginning of peer review rather than being the culmination of peer review. That’s because of the insights that develop post-publication. The conversation continues long after publication rather than the publication punctuating the research process.

What Doctors Want from Technology: Improved Efficiency

For the most part, doctors want the same things from technology as everyone else does. Just like the engineer, the business owner, and the caterer want technology to improve their efficiency, so do doctors. A recent study by the American Medical Association and Dartmouth-Hitchcock Medical Center reported that physicians spend two hours of administrative and EHR work for every hour they spend face-to-face with patients. If technology can improve efficiency so that the ratio of patient time to administrative time improves, it would be welcomed by physicians.

Care coordination, team-based healthcare and accountable care models can all be improved with the right technology. The problem is that there is a lot of trial and error involved in figuring out which technologies offer real solutions and which add as much complexity as they take away. That is why physician usability is such a huge factor in EHR technology. The investment of time and money in such systems needs to not only pay off in terms of compliance with regulations but also in terms of making the operation of medical practices more streamlined and efficient.

What Doctors Want from Technology: Better Outcomes

In addition to more streamlined, efficient medical practice operation, doctors want technology to make things better for patients. There’s no question that medical technology has advanced the practice of medicine in tremendously important ways, but again, it takes time beyond research and publication to determine which technologies make a real difference and are worth the investment of time and other resources.

More specifically, a 2016 Digital Health Study by the AMA found that digital tools appeal to physicians most when they increase patient safety, improve their diagnostic capabilities, make the physician-patient relationship better and help reduce the stresses that can lead to physician burnout.

Examples of Technologies Influencing Medicine in the Digital Age

Electronic Health Records (EHRs) have been around in some form since the 1960s, believe it or not. It took a long time for physician practices to become computer-based. Although the Institute of Medicine in 1991 set a goal for all physician practices to use computers by the year 2000, by the year 2001 only 18 percent of physician practices had EHRs. Medicare and Medicaid have begun imposing penalties on practices that accept Medicare and Medicaid that don’t use EHRs, and those penalties are designed to increase with each year that passes. Uptake has definitely accelerated, but there are still plenty of savvy, tech-friendly physicians who don’t like using the EHR their facility provides.

Other important technologies that are expected to increase in importance during the digital age include telemedicine, mobile health apps, remote monitoring of patients, and the use of wearable devices (like the Apple Watch) in medical applications. In the case of telemedicine, it isn’t technology holding back adoption, but the patchwork of state laws concerning the provision of telemedicine services as well as the necessity that doctors practicing telemedicine be licensed in any state from which a patient makes contact. Fortunately, legislation is being pursued on both state and federal levels to address these issues, and that could make telemedicine a significant part of medical practice within the next decade.

Technologies Doctors Are Most Excited About

It isn’t the specific technologies about which doctors are excited. Rather, they happily anticipate the improvements to their practice that these technologies can bring. For example, telemedicine has the potential to reduce overhead costs while allowing doctors to see more patients in a day. Remote monitoring of patients with chronic illnesses is expected to help reduce hospitalizations and readmissions after hospital discharge – something that is increasingly emphasized by Medicare and Medicaid.

Physicians are also happy about the prospect of technology improving doctor-patient engagement, by, for example, having patients use mobile apps that help them manage chronic diseases like diabetes or high blood pressure.

Doctors are excited about the fact that technology has simply made so much more data and information available to them. It’s a bit intimidating knowing that the medical research information they may need won’t be restricted to bound paper copies of medical journals. On the other hand, the free flow of information makes it possible for doctors to learn about best practices and directions of research much more quickly than they once did.

What Influences Technology Uptake Among Doctors

Age is actually not a huge factor in the enthusiasm with which physicians adopt a technology. Older physicians are about as likely as younger ones to adopt technology assuming it meets their clinical needs, according to the 2016 AMA Digital Health Study referenced above. Primary care physicians and physicians in larger practices are the likeliest to adopt new technologies, regardless of physician age.

Technological adoption among physicians typically requires strong assurance of data privacy. Better still is technology that can link to an existing EHR and/or billing technology. How physicians make decisions on what technology to adopt varies. Generally, it is practice leaders who make the final decisions regarding which technology to buy. Before doing so, they tend to look toward IT experts for reassurance about data security.

The World of Medical Recruiting Has Changed Too

Technology isn’t just affecting how the typical physician practice is run, but how it is staffed as well. The use of technology, including mobile technology, in recruiting has exploded in popularity in recent years. It isn’t just physician practices taking advantage of the time and cost savings of smart recruiting technology, but leaders in every profession.

The days when a physician set up practice or joined an existing practice and stayed there for decades are largely over. Physicians themselves are shaping their careers to meet their needs to better balance work and life, and new employment models have emerged. For example, while locum tenens doctor jobs used to be mostly relegated to retired physicians, today such positions offer their own unique career platform, with some doctors choosing the locum tenens life rather than signing on with a practice or hospital.

Benefits abound for both employers and employees. Technology allows employers and employees to find each other more easily, and parts of the recruiting process can take place remotely. Checking credentials is faster, and physicians looking for doctor jobs can more easily research the employers that make them offers. In short, technology has improved everything about the recruiting process.

Just as it has for everything else, technology has affected the practice of medicine. Lifesaving technologies continue to be invented at an accelerated pace, and technology plays an enormous role in the operational efficiency of medical practices. Physicians of all ages and at every stage of their career are enthusiastic about adopting technology as long as it offers efficiency gains, protects sensitive data, and works toward better care outcomes.

How might the medical practice of ten years in the future differ from today? It will probably make greater use of telemedicine, remote monitoring, and patient involvement with their own care via mobile apps. However, nothing so far has been able to replace the critical human judgment factor when it comes to diagnosing and caring for patients, and that will always be true.