Future Health - 10/18/19

Delivering care in the new virtual world…

 Displacing Telemedicine With Telemessaging – As reported in the Associated Press (AP), there are a growing number of companies that offer “message-based treatment” for a variety of minor injuries or illnesses.  The companies argue that there service is even more convenient than telemedicine services which are increasingly provided by both newcomer as well as traditional health care organizations.  The potential reach for these companies and the relatively lower cost of service could reach “millions of Americans” according to the AP release.  Examples include 98Point6, and K Health – part of the new messaging approach to care delivery. It’s all part of the consumerization of health care and, a trend that is not going away.  Companies like CirrusMD can connect patients to a physician in a minute or less.  These trends will only grow.  While the physicians can argue about quality of care and outcomes, the proof will be in the results.  We should anticipate that it will not be as dire as the physicians say and that tying these products to real-time clinicians will likely be the most desirable approach down the road.  While there is clearly a place for “quick care”, it’s also clear to me that there needs be a tie back to the traditional face-to-face provided by your primary care physician.  Otherwise, we will simply be engaging in the disintermediation of care delivery with all of its attendant consequences.  Bringing the two sides together is the best option and should be the focus of care delivery organizations.  If you want to discuss it further, let me know – This email address is being protected from spambots. You need JavaScript enabled to view it.. 

On Transparency and Trust – I recently read an interesting article (“Plain language about health data is essential for transparency and trust” – October 9, 2019  6:35 PM EDT) published in one of my daily newsletters, The Conversation.  The article cuts to the very heart of a critical question we are facing in health care – transparency and trust.  While the focus was on the general considerations related to transparency and trust, health care is a prime example where we need to do a better job.  The full article is available in the International Journal of Population Data Science, where a plan is outlined for working with the public to simplify communications about health data.

Specifically, the article outlined the Five Safes framework and released by the Wellcome Trust, a U.K. based charitable health research foundation in its  One-Way Mirror Report. The focus of the report was on what the public believes are crucial considerations about how health data is used by companies.  While all of my health care colleagues should read the full article, the essence of the framework for sensibly managing health data is as follows:

  • Safe Projects: Is there scientific merit? Is there public value?
  • Safe People: Who is using the data? What training do they have?
  • Safe Data: How potentially identifiable are the data? Is there consent? Is there legal authority for use?
  • Safe Settings: Where will be the data be analyzed? How will they be managed?
  • Safe Outputs: Is there any potential disclosure, either of individuals, families or communities?

 These critical questions are where we in the health care industry need to focus our time and energy as it relates to personal health information (PHI).  Laying out the framework for our policies on these crucial Who? What? Where? When? How and Why? questions will move us forward in some very positive directions. Finally, the article also pointed us in the right direction by highlighting the work that has been done in Canada [Digital Charter]and the U.K. [General Data Protection Regulation]. Consider it…

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