MH: The IT space is ripe for being used to interact with the consumer. There’s a lot more than the portal going on. Are your patients or prospective patients using IT to help them have healthier lives or interface with the system?
For us it’s been a 20-year journey. In 1999, we first made available the entire electronic health record, labs and meds, and problems, to every patient via a web browser. Then, about five or six years ago, we added every note written about you by every person so that truly nothing would be done without your involvement as a shared team member.
That was actually kind of tricky. This actually happened. I wrote the following note: “The asthma patient came to the emergency department with SOB.” That means shortness of breath. The patient thought I was referring to her husband. So it’s a journey, right?
Then we’ve moved from web to mobile, and 80% of the accesses of Beth Israel Deaconess data by consumers today are done through mobile applications. The web is dying and maybe even mobile will die in a couple of years and be replaced by Alexa and ambient listening in the home. The apps we’ve launched are such things as BIDMC@Home, and the internet of things, where a device in your home reports its data to us, subjective and objective data, surveys, how you doing, what’s your mood.
What a portal does is not actionable. You reschedule appointments, you get referrals, and you engage in almost social media-like interactions with your care team using mobile applications. That’s the next couple of years for us. But we are doing the Alexa experiment as follows: If an ambient listening device in your home, with your consent, hears something like, “I need to see my doctor,” it then responds, using the Amazon Alexa API, “Next Tuesday at 3 there’s an available appointment. Is that OK?” Booked! That’s the kind of trajectory we’re on.
The web is dying and maybe even mobile will die in a couple of years and be replaced by Alexa and ambient listening in the home.
Dr. John Halamka
Probst: We’re just tooling right now for consumerism. We’ve done everything from portals to mobile, and we’re playing with Alexa and looking at specific apps and piloting a lot of things. There are so many levels you have to work at.
There’s the technical level where we’ve got to figure out how they can interact with our legacy products because patients want to know about their medical records. They want to be able to order prescriptions. They want to be able to schedule things and a lot of that ends up landing inside of our legacy applications.
We’re working hard on a middle layer that’s going to allow us to surface data in these more consumer-based applications. But applying technology to our current operational structure, even the way our buildings are built, is automating chaos. So you’ve got to have this very process-based, operations-based change.
And then what’s kind of unique is a mentality of marketing. How do we apply social media? How do we use these different pieces of technology and information to engage our patients better? It doesn’t have to be through an app. It could be through a phone call. It could be through advertising that’s appropriate. We’re just in the tooling stage. We’re building the journeys— that’s the terminology today, patient journeys. We’re looking at building those journeys and applying the technology to support them.
Chambers: We are so far behind every other industry that we can steal unabashedly. We’re just now starting to understand that we need to interface with the patients the way they want to be interfaced with, as opposed to what we’ve traditionally done for the past hundred years, which is, “You will be here at this time and if you’re late you don’t get in and, oh, by the way, the doctor is already 30 minutes late.”
We’ve all got a lot we can do to improve. Treat patients as if they have a choice, because they do. For a long, long, long time, we haven’t treated them that way.
Treat patients as if they have a choice, because they do. For a long, long, long time, we haven’t treated them that way.