Tele-medicine for Distance- Proxi-medicine for on Campus?
By Joseph Gary Seay, Principal Advisor, Brightworks Advisory
Tele is Greek for long distance. Proxi is the term for close or near. The idea of tool enabled, long distance patient examination, diagnosis and treatment planning (tele-medicine) has been around for decades. Much has been invested, first to enable condition or medical service specific software. Then came tool-enabled, vertical services (tele-radiology, tele-psych, tele-dermatology, tele-stroke and others). Some services and tool offerings have become really mature (tele-radiology), others continue to strive for traction.
Other technologies have evolved independently from tele-medicine tools and services. General purpose Electronic Medical Record systems capture comprehensive clinical data and treatment orders for patients and provide workflow support for care delivery. After over a decade of slow introduction, they are now deployed widely, driven by the “meaningful use” initiatives. Clinical staff communication tools have proliferated. Voice, text, email, video chats all got secure, managed, routable and workflow-enabled to provide effective, convenient consultation, collaboration and coordination of care from clinicians on the move.
Clinical practice concepts have evolved to offer alternatives to one lonely doctor making treatment decisions for patients. Multi-specialty group practices have improved patient outcomes and built reputations for quality (other industries would call it a “brand”) around highly collaborative, team-based patient care. These practices have relied heavily on culture, group norms and standards, along with defined processes, to consistently realize benefits of clinical collaboration. Tool support from vendors has been largely absent.
Imagine leveraging recent investments in EMRs and clinical communication tools, integrating them to deliver effective, tool-enabled, and metric based support for medical staff adoption of team based patient care. Add Artificial Intelligence learning capabilities to monitor patient information, physician diagnosis and treatment direction then suggest or invite colleague consultation from peers or other specialties to help assure sound clinical practice and judgment in every case. Deliver quality, convenience, speed, appropriateness of engagement and efficiency to collaborative clinical practice by adding tool support and enablement.
"Teamwork improves patient outcomes, reduces malpractice risk, accelerates pace of care, and supports professional development"
Leverage this higher form of tele-medicine to engage and integrate medical staff members in care delivery who are off campus or who may be “satellite” practitioners, active medical staff at partner hospitals. Engage the best available team to support excellent patient care in real time, conveniently and effectively with relevant patient data presented contextually with messaging services.
Proxi-medicine tools should enable teamwork. Teamwork improves patient outcomes, reduces malpractice risk, accelerates pace of care, supports professional development, reduces physician stress, demonstrates quality commitment, accelerates “best practice” adoption. Challenging cases get recognized early, right physicians are invited in to help solve the puzzle.
This is not really a new idea, even if I am inventing a label for it. Practices that have established cultures of team based care have cobbled together tool support for their practice, realizing efficiencies, supporting/enforcing compliance and analyzing outcomes.
Hospital and practice leadership seeking to build clinical quality reputations, grow market share and demonstrate value to payers should consider adoption of team based care. Integrating clinical communications tools with EMRs to make team based care easier can accelerate medical staff adoption. Providers may finally realize some material value from electronic medical record investment. It is time for tele-medicine to start at home.