As the concept of patient-centered care continues to evolve, a key to its success is the relationship between physician and patient. But factor in all the technologies springing up left and right, and finding the perfect balance between patient engagement and new IT initiatives can be tricky.
"Focusing specifically on the physician-patient relationship – it's behind the rest of the world," said Steve Wigginton, CEO of Medley Health, a medical practice marketing and communication services company. "But there are a lot of benefits to be had. More information is readily available to physicians as a result of IT, and therefore, it's easier for them to keep track of what's going on with their patients."
"IT has, in some ways, made it possible for patients to be more self-serviced around transactional types of interchanges with their doctor," Wigginton continued. This includes "scheduling appointments, reviewing bills, etc. Those are just some of the main ways we're seeing IT have an impact so far."
Wigginton breaks down five keys to understanding IT and the patient-physician relationship.
1. Patient-centered IT initiatives hold multiple benefits for the physician. Small physician practices in particular, Wigginton said, need to adopt the same features as their competitors. And, it's important to note their competitors are no longer just their fellow physician practices down the street. "As Walmart and Walgreens and CVS expand into transactional, low-cost primary care, there's a competitive pressure to be able to add these features," Wigginton said. And although a competitive edge is important, he said maintaining closer and more convenient relationships with patients has incredible value. "Your inability to communicate with them in modern terms is a big hindrance," he said. "My financial planner, my physician trainer – all the people in my life who are important to me, I can communicate with through email and other channels. It makes it easier to achieve the best health outcomes when a physician practice adopts this."
2. Challenges exist when it comes to reimbursement models. The disconnect between physician practices and IT initiatives almost always involves the business model, Wigginton said, and the value of the technology. "There are some challenges that aren't widely addressed but are brought to light by both physicians and patients with the advances in IT," he said. The biggest of which is the advancements in IT – emailing, texting and video conferencing – coming without payment. "There's no good reimbursement model, and most of those reimbursement models are rooted in the traditional office visit," Wigginton said. "So it puts pressure on the physician to do more for less – not the same, but less. It's a double whammy because there's a higher service load on the physician and higher expectations from the patients, given these tools. There are only a few instances where the business models align."
[See also: New report addresses HIE sustainability.]
3. Patient-centered IT practices continue to vary. While larger-volume practices are using email and patient portals to optimize patient input, lower-volume, more patient-centric practices are using email, text, video and mobile apps, said Wigginton. "They're doing it to create more of an impact across a broader spectrum of their patients' health; they're helping them manage it not only when they're sick, but also interactive wellness programs." The most important part of employing these technologies, he continued, is to find what works best for the patient. "If I'm a texter, I'll text, if email is my thing, I'll do that, and if I want to come to your office, I can," said Wigginton. "I want my physician to be highly knowledgeable about me and communicate with me and have a relationship with me."
Continued on the next page.