The Next Generation of Clinician-Patient Interaction Tools

What is clinical groupware? It is the next-generation of EMR/EHR technology, but that understates the dimension.

Moderated by David Kibbe, MD, AAFP

David Kibbe thanked Aneesh Chopra and said it was nice for a government official to be excited and genuine about health 2.0 tools and innovation strategies. What is clinical groupware? It is the next-generation of EMR/EHR technology, but that understates the dimension. Involving patients and doctors as partners in this technology; sharing care plans, providing alerts, keeping everyone on the same team. Most care needs to involve teams! On the technical side/business side, shift in paradigm. Although the EMR/EHR companies are not going to be replaced; they need to be engaged with the users and patients; it involved platforms, people, and applications that embrace the technology and the Internet to make Health 2.0 better. Lower-cost, lightweight systems allow patients/doctors to communicate in a much more effective manner.

Paul Abramson, MD, Myca, demonstrated the HelloHealth platform with a patient in New York, who is using the platform’s IM tools to have a conversation with Dr. Abramson.

Martin Pellinat, CEO, Vision Tree Software (VTOC), demoed his program with a fictional patient. Made appointment thru secure messaging system. Dashboard had a nice UI. System has been around for seven years. Committed to collaboration and innovation.

Roy Schoenberg, CEO, American Well, described his online care framework, which has video tools and a live chat window (“Insight”). Better care than live? Ugh.

Steve Adams, RMD Networks. “Collaborate or die” is his slogan. ReachMyDoctor is a nice system to claim “meaningful use.” Key is a coordinated care plan. Integrated lab reports, personal health record, and provider-side tools that combined the collaborative care space (coordination of care). Healthcare is a team sport. Undercoordination drives overutilization. The ability to connect the care team so they can truly communicate is the highlight of the system. Patient is at the center of this.

Arien Malec, Relay Health. Took the application from a physician perspective. It’s an interconnected chart that connects info from the patient and health information exchanges (other MD’s, hospitals, etc). Can create an eScript, and send to pharmacy directly. Also has integrated lab results. All of the information is connected to hospital ordering system, back to the PHR. Clinical experience is made more powerful by interconnectivity.

All applications have a patient side for making joint decisions and making better decisions. Generally speaking, at the point of care. Interfaces are easy.

Q: What are the incentives for the doctor and for the patient? How does the information ultimately get aggregated?

A: The incentives are just now emerging. Pay-for-performance, etc. Meaningful use is going to be real. As more dollars are offered up and doctors work more collaboratively, the more they will be reimbursed. Patient incentives are around convenience. Doctors incentive are about money.

Q: A lot of different tools out there to empower patients with other patients/doctors. How do you motivate patients to use this platform from the social media side to use these platforms?

A: The engine handles the back-end of the medical practice and provides an open API that allow patient/doctors to collaborate. Some have found they love to access their doctors; those physician transaction leverage patient behavior. Under meaningful use, there is a level of patient engagement that can allow companies to provide patient education and patient interaction among other patient populations.

Q: Where are the additional opportunities for patient education? What kinds of next steps are being programmed?

A: Completely agree with you. There should be applications/opportunities to include this type of programming into these systems to get these patients engaged with their care. The frontier is acknowledged; extending the opportunity to extend themselves to learn more.

Q: Legal exposures?

A: This is the beginning of regulations in health IT. Words of wisdom include dealing with privacy issues right up front with patients and empowering the patient to include who has the information and when. Must be an integral part of the interpersonal relationship!

Q: Have any of you looped the payers/health plans into these programs?

A: Reversing the paradigm of bringing the healthcare to the patient will save money, and these companies are their clients. The underlying technology can be used for any institutional setting or payer.

Q: Operational side of telemedicine: what states are more aggressive?

A: Difference between different states. Northwest states, more rural are more open to it. But it has been flexible in the last 12 months so that these systems can be put into place.

Q: Some patients are apprehensive; what is the best way to change the dynamic of patients being less inclined to use this?

A: Trend is showing in the base of competition between doctors; those who are innovative in these areas will be ahead of the game; has to be about convenience and good information and good data.

Q: Demographics within patient users: Older users, Medicaid?

A: As of yet, Medicare does not reimburse for telemedicine visits. That may change, and there is movement. Patient demo is fairly young, and as the technology matures and devices will be created for the users not familiar with technology.