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Pros and Cons of Technology in Health Care

US News & World Report - Health logo US News & World Report - Health 12/9/2019 Elaine Cox, M.D.
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Editor’s note: The opinions in this article are the author’s, as published by our content partner, and do not necessarily represent the views of MSN or Microsoft.

In today's world, we're driven by instant access to whatever we want. After all, you can do everything via an app: set up rides, pay bills, order food for delivery and shop for anything that can often be delivered overnight. Convenience has become the most important commodity. In addition, access to information quickly has become the norm. Newsfeeds and social media keep us up on everything important and trivial, often not distinguishing between the two. Cellular technology means we literally hold the world in our hands.

This information and convenience revolution has had a significant positive impact on society. We can ease the tensions of our day, from booking a flight to ordering dinner, which means we save time and energy for other work and leisure activities. And we can connect with people across the world for business or friendship. Connections abound!

However, when it comes to technology and health care, it does pose certain questions – opportunities and challenges, often both contained in the same scenario.

Let's start with access to care. Telemedicine can allow care and access to specialists across long distances. Often, people can be virtually seen by a provider – and get both a diagnosis and prescribed treatment – without leaving their home. One has to wonder how long before we'll be "streaming" all but the most complex health care interactions.

In addition, there are many patient portals. These allow for all kinds of interactions regarding our health needs without ever involving the team. Scheduling appointments, refilling prescriptions and even viewing lab results are readily accomplished via technology. It gives people access to their records and fulfills their needs without leaving their couch.

In the world today, those options may seem to be absolutely on point. We would expect all those metrics we measure to improve – access, flow and satisfaction. A whole new era of medical care could be on the horizon. But of course, as we're taught in 6th grade science class, for every action there is an equal and opposite reaction. And what those might be in a new techno-health care era need to be explored.

First of all, we should think about the entire health care experience on a continuum and not just siloed in one acute episode. Take the usual interaction with a doctor. The visit begins with office staff, which can be very insightful into how someone is doing. Take, for example, the elderly patient who's having trouble remembering things. This may impact medication compliance and other aspects of general health hygiene. Or the young mother who may be struggling with post-partum depression. The front lines at the door often note these subtle clues that something is going on. It's unlikely a portal or streaming service will have such intuition.

Next, the actual medical encounter. The bond between a patient and his or her provider has been sacrosanct for eons. The whole reason for the design of the medical home is to have a history that can be used for context on the health care journey. Sharing the intimate details of one's life in any relationship requires trust, which takes time to build. This is definitely true in health care, where some of life's best and worst moments involve one's doctor. The human touch should not be underestimated and is unlikely to occur via a smartphone or streaming box.

Lastly, test results can be – at best – difficult to interpret, and at worst, lead to devastating news. In the past, doctors would review these results and call and offer more than just a number or formal reading. They would interpret the results into something meaningful, and hopefully the delivery was with compassion. When someone who doesn't have a medical degree opens a portal and sees a flagged, abnormal result with no interpretation, there's room for all kinds of stories to form in their minds – plus great anxiety that may not even be necessary, as not every flagged result is clinically significant depending on the patient complaint. However, the workload of the physician can often result in delays hearing back on much anticipated results. Sometimes that means late-day phone calls, after office hours and when no one has much energy to talk.

So how does medicine adapt to the new technology age? How do we find a space where patients can be satisfied with their access and the transparency of the system? How can we create a space where doctors can be expedient with their time management but still retain the therapeutic relationship and provide much needed context for their patients? How can we stay true to our mission as a health care system to guide our patients through whatever journey they're experiencing, if we rarely engage outside a computer program?

Very talented companies are working on this dilemma. There are even sources for medical equipment that can be used by a patient at home to transmit vital signs and heart sounds through telemedicine. Some physicians and other providers are now routinely offering telemedicine visits to maintain continuity with their patients. It seems likely that some artificial intelligence company will come up with a way to give context to test results. It will all be accurate and expedient. It will also be episodic by definition.

But what it will not achieve is the warmth of human interaction and touch. Patients often need someone to listen to – and care about – their journey story. Physicians need validation that their reason for going to medical school, which was most assuredly that they wanted to help people, is still true. These attributes will never be realized through a sterile, human-less technology. It should be a tool, but using it as a total solution will most definitely have consequences that were unanticipated. Let's not allow our humanity to be one of them – whether we're giving or receiving.

Related Video: Convenience of Telemedicine Comes With Some Privacy Risks (Provided by CBS Dallas)



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