When put under pressure in the last year, technology showed just how much it can support people across the healthcare industry — and, most importantly, patients. Here, Paul King, president and CEO of Stanford Children's Hospital in Palo Alto, Calif., shares his thoughts on how to embrace technology to close care gaps, improve the patient experience and help reduce variability.
Question: Technology has the potential to close gaps in care, access and health equity. Yet it also disrupts business models. How do you suggest organizations best embrace technology to close those gaps?
Paul King: The best and most impactful technology platforms are designed alongside those that are currently in that specific industry. For healthcare, that doesn't mean that we all become coders, but problem solving and workflow evolution needs to be front and center — or, in other words, building technology to solve a problem versus finding a problem to solve with technology.
In healthcare, technology gaps are more complicated than in many other industries. To be successful, you have to bring more people to the design table — and this includes the information services team, frontline physicians and clinical informaticists. If you have the voices of those who will be interacting with the technology on a day-to-day basis, you can create stronger, more streamlined end-to-end solutions.
This past year, telehealth workflow models took on new levels of complexity. As hospitals rapidly implemented telehealth for the safety of patient populations, there was a gap in centralized virtual support such as troubleshooting and tech support.
There are two key questions to answer that will improve telehealth access and experience: What does the optimal support model look like for both the patient and their physicians? And how can we continue to address language, digital literacy and technology barriers for our most vulnerable patients? If organizations are able to button up telehealth services and support, they will be able to create streamlined and functional workflows and reach broader populations.
Additionally, beyond the traditional concept of telehealth, organizations will have to strengthen approaches on capturing, uploading and analyzing data from a wider variety of sources. For example, at Stanford Children's Health, we are integrating diabetic patients' data from Apple HealthKit and our at-home monitoring tools directly into their EHRs, giving providers a means to continuously monitor patients' glucose levels. We have also developed our own analytics tool to process the data from these monitoring systems and put summaries directly into the provider notes so they have the information they need at the point of care.
Q: How do you see technology, in addition to telehealth, helping to improve the patient experience?
PK: The pandemic has accelerated the way doctors interact with and utilize telehealth, and has resulted in a positive change in practice and workflow.
There are so many stories of both patients and providers who have discovered a previously unknown value in telehealth, and in many cases, telehealth may be the more optimal method of delivering care. For example, at Stanford Children's Health, we had cases where our developmental and behavioral pediatricians found it more beneficial to see children in their home environment. Our care providers have been able to learn even more about their development as the patient engages comfortably in their own setting, compared to the clinical setting.
Furthermore, telehealth is particularly important for children and families in order to best support their health while minimizing the disruption to their schooling, extracurricular activities and work schedules. Unless a patient's condition warrants intensive hospital care or specific in-person procedures or exams, virtual visits allow physicians to see patients who require ongoing care for follow-up appointments, decreasing emergency room crowding and saving travel time for patients and families.
This also extends to patients who might be particularly vulnerable from exposure to certain environmental or outside stimuli, such as our patient population who may be immunocompromised or have suppressed immune response due to treatments and medications. Telehealth protects these patients and their families, limiting them to travel only when necessary.
Q: The U.S. suffers from healthcare variability across the country. How is your system addressing this variability and reducing it? What role does technology play in that?
PK: The role of technology and telehealth in helping to bring care to rural or previously-underserved communities cannot be understated as it helps to maintain the continuum of care by meeting patients where they are.
Specifically to California and its patient population, we are working hard to continue to make these services accessible to all. We are seeing overlapping community interest from schools and hospitals when it comes to technology, which could present great opportunity in the coming years. We are also working to enhance telehealth-integrated interpreter services, closed captioning and multilingual patient help desk and education materials to help address language barriers.
Adolescents are another vulnerable population that require specific considerations in healthcare. The recent 21st Century Cures Act seeks to empower patients with their health data, and we are working to support these goals in an age-appropriate manner for our pediatric and teen populations. At Stanford Children's, we are leading efforts to engage teens and their families, empower them with their health data to optimize transitions of care as they become adults, and enable confidential adolescent telehealth services as appropriate.
Another way we are currently closing these gaps is through partnerships. We partner with healthcare systems to provide pediatric services across the state and nation — including hospitals and healthcare systems that want or need pediatric services to provide better care locally for families. It allows us to keep the healthcare services and care locally where it makes sense — for care to be closer and more accessible to the communities served. To give you a sense of scale, we have over 65 different clinics/locations where we provide services to these communities. That has been a big step in the right direction and telehealth only makes this easier and more accessible, whether patient to provider or from clinic to clinic.