With the rapid growth of health information technology, it is difficult not to get swept up in the possibilities that technology has to offer. Technology, while helping improve healthcare delivery in many ways, also hinders its more human aspects.
Nick van Terheyden, MD, CMIO of Nuance, says that the healthcare industry needs to bring the focus back to the interaction between the patient and the physician. Here, he discusses the ways in which technology hinders the patient-physician relationship, as well as how technology can help improve it.
Question: What excites you most about health IT right now?
Dr. Nick van Terheyden: That's a really tough question for me because there are so many aspects of health IT that are fascinating right now, especially in terms of tools for providers that help rather than hinder them. I was at the pediatrician's office with my daughter and the interaction was centered around tablets. This was relatively new, and I, as a clinician and a dad, was very excited.
We left the office and I asked my daughter what she thought of the new technology, she said "It was cool, but I wish the doctor had spent as much time with me as the technology," and that summed up the problem for me. We have forgotten the patient and the clinician. The technology shouldn't be the focus of the interaction, the patient should be.
We should use speech recognition tools to allow the clinician to focus on the patient not the technology. Speech recognition and intelligent voice interactions will offer patients a new way of engaging in the care process, drawing them in as team members and making care more accessible. With the technology we have now, physicians end up becoming data entry clerks — picking from lists and selecting codes. Human beings deal in narrative and stories, patients want to tell their story and clinicians need the richness of the narrative to help guide medical decision making.
Q: What are some of the ways in which technology forms a barrier between physician and patient?
NvT: It is a physical barrier to the interaction. The minute the screen pops up, the focus is on the screen. Clinicians spend more time dealing with technology than the patient. The question I always ask is "did you see you see your physician or did you see the PC?" We have made healthcare focused on IT. Because of that, we may get more data, but how we collect that data has become a real barrier and often times takes the "care" out of "healthcare." The key to our future and to the successful use of health IT will be turning the focus back on patient and the physician.
Q: What are some ways in which this can be avoided?
NvT: So I would go back to the basics. What is it that patients are looking for? A Cleveland Clinic study found that patients cared most about human factors — passion and listening. Health IT needs to fade into the background. It needs to become part of the fabric of the office rather than the focal point, and then the interaction will change. Speech and language understanding are critical ways of changing that interaction, because they enable engagement and interaction while also capturing critical data in real-time.
Q: Do you think patient access to their EMRs is a good idea?
NvT: It's absolutely a good idea. At the end of the day, who has the biggest vested interest in quality of care? Including patients in the EMR process is essential. For too long have we considered that to be the right of the physician or hospital. Some physicians say that patients won't understand the content and details contained in the EMR, and my response is that the patient should understand it and physicians, as the experts, should help them understand it. Additional engagement with the patient is important in helping them make informed and appropriate decisions or choices in their healthcare. There are many different decisions to make, and patients need to understand all the information for themselves and for their loved ones.
Q: What advice do you have for CMIOs in the industry right now?
NvT: I think my overriding message is that this is such an exciting time and there are so many opportunities. I think we are about to see a revolution in healthcare. One thing CMIOs complain about is that they are always the bearer of bad news because in many instances the technology has taken away from the physician-patient interaction, and it has been the job of the CMIOs to champion health IT and help their colleagues use the technology effectively.
The good news is that they will become the knight in shining armor, helping introduce technology that is going to help versus hinder physicians and revolutionize their interaction with patients.
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