Thomas Wang
MD resident in the MGH internal medicine program (primary
care track)
PGY-1
My
First Connected Health Conference: Inspirations and Revitalizing the Human
Element
As a technology enthusiast and a doctor in training, I was thrilled
to have had the privilege of attending the Connected Health Conference right
here in Boston. The conference in many ways easily met my expectations. I sat
through dozens of highly stimulating sessions on how we can better use
technology to improve patients’ lives and experiences engaging with the
healthcare system. I saw first-hand dozens of new, innovation solutions
currently being explored for a diverse range of patient populations.
One of the central themes that was brought up again and
again during the conference was the focus on the human element and the patient
experience. During Dr. Joseph Kvedar’s talk, one of the many keynote speakers
and vice president of Partners Connected Health, he brought up the image “The
Doctor”, an 1891 painting by Luke Fildes that demonstrates a Victorian doctor
observing at the bedside of a critically ill child at home. During that era,
society’s medical knowledge and technology paled in comparison to what we have
existing today. Unlike the broad arsenal of pharmacological agents, imaging
modalities, and electronic systems we have now, doctors at the time often had
little to offer – hospitals were places were people went to die, antibiotics
did not exist, and medical treatments often had no scientific evidence behind
their use and often did more harm than good. The human element, however, has
not changed much since then, and one can argue that in many ways the human
element has now taken a much less significant role.
Back then and stretching all the way back to ancient times,
doctors routinely made house visits and really knew the people in their
communities; interestingly, this was often the most therapeutic and impactful
part of their role, serving as a source of support and expertise, however
limited, as patients and their friends and family suffered through health
issues and moments of hardship. Nowadays, although we are still trained on the
art of medicine (i.e. how to engage in compassion and empathy with patients),
this has unfortunately become merely a small portion of our vast array of
clinical responsibilities: placing dozens of orders in the electronic medical
records per hour, typing up long notes that were designed more for billing than
for readability, and engaging with consultants and other essential medical
staff through hundreds of E-mails and in-basket messages a week. All of these
responsibilities are crucial in advancing patient care, except for one thing:
none of them involve directly engagement with the patient. 5-10 minutes, and if
lucky 15-20 minutes, is the norm rather than the exception in direct provider face-to-face
time with patients in the outpatient clinical setting. In the hospital, this
can become as low as a few minutes per patient per day. Both providers and
patients over the last few decades have become cogs in the wheel within the
vast medical industrial complex that hospitals and healthcare systems have
become. This is a fundamentally flawed system, and one of my larger passions
and career interests stems from how we can improve the patient experience while
navigating the healthcare system and to keep patients healthier in the
community and reduce preventable re-hospitalizations. This passion originated
from my own experiences engaging with patients and the healthcare system on my
medical school rotations, and the sadness and frustration in seeing patients
come in to the hospital again and again, each time sicker than the last. We do
a lot to patients in the hospital, but how much are we really doing for these
patients?
As such, I was pleasantly surprised by the focus on the
human element, a recurrent theme during this conference. I completely agree
that this is the right approach in this day and age when our responsibilities
in taking care of patients are becoming increasingly dehumanized. Technology is
merely a means to an end; it does not matter how advanced the technology is if
it does not improve the patient’s experience. Just because something is
expensive and cool does not mean it holds value.
During the few days of the conference, I loved hearing about
the different approaches and philosophies of healthcare leaders of large
institutions and disruptive companies and how they exploit technology to better
connect patients and providers. I went through a great workshop hosted by
Partners Healthcare Pivot Labs, in which we explored a case study on how we
would sell and implement an A.I. solution for hospitals to help predict and
potentially prevent re-admissions for patients with heart failure. We explored
three central themes: the business case, workflow integration, and the data
collection process itself. We asked many
important questions: would patients and providers trust this solution? Who is
it for? Would hospitals even be interested? Who are the stakeholders and what
are their incentives for engagement? How can we demonstrate value? I sat in an
intellectually stimulating debate on the fundamental question: is telemedicine
really even worth it? In other words, does it improve patient outcomes and is
it cost effective? One can argue either way, and the literature and evidence as
a whole is at best mixed.
I came away from this conference inspired and
full of ideas, and this is exactly what I had initially hoped to take away. I
see innovation and improvements in the healthcare system playing a large role
in my future career, and I am glad to see the thought leaders in this space
have the right intentions and are passionately engaged in confronting this
balance between exploiting technology to improve efficiency and value of
healthcare providers and not losing the human element, which ultimately is the
key component of the greater recipe in determining the effectiveness of our
interventions. For future trainees at this conference, I would encourage them
to attend sessions that span a diverse range of topics, find workshops/lectures
that interest them and challenge their assumptions and worldview, and talk with
as many folks as they can! I had multiple great conversations during this
conference and made many new connections. The whole itinerary was somewhat
overwhelming at first, but a lot of the talks are very similar in their overall
themes, so I would not feel discouraged if there was a session that you really
wanted to attend but could not due to time constraints. I would definitely
encourage future trainees to attend this conference if they can, and I am very
glad they hosted it in Boston this year!
