Not long ago "IT to business alignment" was the IT industry's darling phrase and one of the top agenda items on CIOs' to-do lists. It might be still there, but we don't often hear it much.
As the businesses from across industries grew fast over the last 10 years, IT's ability to manage expectations became the biggest challenge. Businesses started to place more and newer kinds of demands on their IT such as M&A, compliances, etc., and the gap grew wide between the demands placed by business on its IT and IT’s ability to deliver on those expectations.
Thus, the discussions started on how IT can deliver true business outcomes and meet the fast changing needs of the business, and then "IT to business alignment" jargon was born. To achieve it, frameworks such as ITIL – how IT should be serviced and control objectives for information and related technology – COBIT (how IT should be governed in an organization) – started to do the rounds and became de facto guidelines to achieve those business to IT alignment objectives.
I remember my HP days while advocating ITIL/ITSM across Asia-Pacific countries. Gradually, organizations started to adopt these processes and governance frameworks (coupled with cultural and mindset shift). As a result IT started to align with business proactively. With arrival of software-as-a-service and the cloud, this topic diminished slowly.
It seems like physician-to-patient alignment in digital health is at the same junction as IT to business alignment was a few years ago. Digital heath is exploding with new innovations everyday across all areas of patient care be it telehealth, mHealth, patient engagement, population health or remote monitoring, etc. For tech ntrepreneurs, it is like a new found land. Digital health is swiftly changing the way medicine is practiced, making it more integrated and engaging. It is transforming patients' behaviors and experiences. Patients like it because they feel empowered and listened-to. They are rushing for it as it provides them convenience, greater accessibility to physicians, personal health information, education etc. The interesting part is they are demanding the same from their physicians.
In a nationwide survey conducted by TechnologyAdvice on 406 adults early this year found very interesting statistics, and it's worth mentioning here. In that survey, more than 60.8 percent of patients said having services such as online appointment scheduling and bill pay is "important" or "somewhat important" when choosing a physician but only 19.7 percent and 17.7 percent of patients said that their physician offered online appointment scheduling or bill pay features, respectively. Just 27.8 percent of patients said their physician provided the ability to view online test results.
This signals a significant shift in patient expectations for their primary care providers. Another interesting fact from the same survey was the top digital health services patients would like their physicians to offer are online test results, online appointment scheduling and online bill pay, followed by secure messaging outside of the office hours, smartphone app for scheduling and finally educative health resources.
From the age group point of view there were different choices as well: 41.2 percent of the patients among age group 25 to 34 years said they would like their physician to offer online appointment scheduling. Smartphone apps for appointment scheduling was the most requested feature among 18 to 24 year olds and 48.4 percent said they wished their physician offered one.
I was particularly surprise by a recent Accenture report, which presents a very encouraging picture of seniors adopting digital health. Seniors are particularly eager to use digital health. They want to embrace online tools to manage their own care. The report showed 67 percent of seniors want healthcare access from their homes. More than 60 percent are amenable to wearing digital monitoring devices. In addition, 60 percent use online communities to confirm their doctors' recommendations.
So, what's wrong with physicians adopting digital health tech, and why there is a reluctance?
The silver lining I found from the Accenture report is 73% percent of physicians believe that digital health IT will improve the quality of care provided in the longer term – higher among physicians with 10 or less years in practice (81 percent) and those in larger practices (80 percent).
The reason is simple. Some physicians are tech savvy; they adopt digital health technologies, but not all. Still many see digital health as a distracter to their job. Some of them complain that new health applications and technologies provide little clinical value or do nothing to improve patient care and collecting and deliver irrelevant data are generally useless. Though, I don't think physicians are at fault.
Physicians are very busy doing their daily job of seeing patients. One of the challenge physicians have is where and how to start and better understand the value digital health solutions bring to their patients. The choices across digital health technologies are simply too many, and they are growing every day. Physicians are lost on what to choose. They don't have much time to review hundreds of apps and figure out which one is best for a specific area. And, this is partial reason for their lack of appetite when it comes to digital health.
Mobile technology is critical in patient-physician engagement, especially since 87 percent of physicians are currently using mobile devices in the workplace. But according to a Deloitte report only 43 percent of physicians use mobile health technology for clinical purposes. As per physician practice very few physician, roughly 10 percent, are using them to assist with direct patient care. Physicians have to know what is coming and they have to be part of the solution. Morristown Medical center in New Jersey recently established a digital health shop next to the lobby to expose digital health innovations (devices, app etc.) to physicians and patients. This is a great example, and I believe more hospitals should do it. It is not a question of which physician will adopt digital health but when.
The other aspect which has potential to change physicians' behavior towards adoption of digital health is the involvement and participation of more and more physicians in the development of digital health technologies. The recent reports about physicians leaving their medical studies / residencies to join health startups clearly shows that a certain segment of young doctors are taking active participation in health tech innovation. Physician-led digital health innovations and startups have the highest peer influence.
No doubt that there is a gap growing between the services patients want and what is being offered from their physicians and it is concerning. While meaningful use incentives and government regulations are the kind of things that are driving the alignment, but providers and small practice physicians should view this change as expected components of a modern practice. A simple patient portal can help a lot in this alignment need.
It takes mindset, efforts, money and a huge cultural shift for physicians to adopt digital health. A good motivational factor for physicians is that health outcomes are positive for using digital health. At a patient engagement summit in Orlando earlier this year, there was a great deal of discussions on how, why and where to start engaging patients in digital health. I think it is time now to start talking about how we can engage more and more physicians in this equation and bridge the gap.