On February 6, a set of key priorities for the future of healthcare was released by AdvancedMD. I talked to Tim Costantino, vice president and head of product, about challenges and potential barriers to meeting these goals.
AdvancedMD is a cloud-based service merging an EHR with a health care management solution, and has recently announced upgrades to its EHR, practice management, and patient engagement functions. Believing in “self-service” and “trusting the patient,” AdvancedMD focuses on things that should improve both efficiency and the patient experience in their document. The practices they herald look valuable and necessary, so I decided to focus on what could get in the way when I talked to Costantino.
For reference, a summary of the AdvancedMD predictions follows.
- Medical offices will adopt a broader selection of patient-centric payment capabilities.
- Mental healthcare will become an integral component of the healthcare experience.
- There will be a resurgence of independent practices with more physicians choosing to take full ownership over their offerings and administrative processes.
- Medical practice owners will lean more heavily into workflow and process automation improvements that enable informed decision-making capabilities based on highly-accurate data – significantly boosting the practice’s financial performance.
- Remote patient monitoring solutions will gain popularity, vastly improving patient outcomes and care management.
- Medical offices will offer comprehensive self-service capabilities that give patients more control over their healthcare experience.
Can the Medical Profession Achieve a New Relationship to Patients?
AdvancedMD envisions a more equal collaboration between patients and clinical staff. This shift will probably please most patients, but it might be harder to sell to the doctors.
Systems such as AdvancedMD allows patients to do more things online, making clinical visits more like an online retail experience. The service can be both empowering and convenient, but it does expect a bit more responsibility for the patient; when scheduling visits, for instance. And the AdvancedMD principle of “trusting the patient” isn’t always embraced by doctors.
Even more disruptive is the uploading of vital signs and other data from fitness devices and scales, glucose monitors, etc. Doctors say, “When will I have to look at this data? What do I care how many steps the patient is taking?” Certainly, it’s no good stored in a spreadsheet somewhere, or even a field in an EHR.
But the data is invaluable when processed to look for trends or anomalies. Analytics are thus the crucial companion of devices. The analytics have to be tuned carefully so that an alert is accurate and actionable. Undoubtedly, though, handing patient-generated data requires both trust and a change to the clinicians’ workflow. Fee-for-value will encourage more reliance on data and analytics.
I asked Costantino how we can encourage doctors to rely on analytics. He said that they’re already trained to practice evidence-based medicine. So analytics must be based on firm research and be documented to show the ties to research. Always, the doctor makes the final decision about diagnosis and treatment.
Alleviating the Mental Health Crisis
Another plank in the AdvancedMD platform is to integrate mental and physical health. Thoughtful observers have known for a long time that the two are inseparable. But mental health professionals are stretched thin, and many are leaving the field as the demand for mental treatment grows. What can we do to address the gap?
Costantino said that when primary care and family practice clinics weave mental health professionals into the care, they can use the professionals more efficiently. A PCP might prescribe treatment for everyday cases of depression or anxiety, leaving the mental health professionals to treat more complex cases.
And each patient could be assigned to the appropriate profession—social worker, M.Ed, and so forth—so that the most expensive professionals are consulted only when they are needed. Costantino calls this “making sure everybody is at the top of their license.”
Telehealth also tends to be more efficient, and allows clinicians to reach people who have little in the way of mental health professionals nearby.
Because there’s fierce competition for some specialties, including mental health, clinics that can automate away tedious clerical work and make the experience more pleasant for its staff will have more luck recruiting them.
The changes proposed by AdvancedMD are neither unique or controversial. But it was great to see that the organization has been thinking through the implications of their vision and finding solutions to the touch challenges it presents.
