For many, the phrase “digital health tools” might conjure images of mobile apps, simulations and futuristic gadgets. But in order to be patient-centered, a digital health tool doesn’t necessarily have to be high-tech.
Depending on the patient population, a digital tool could be as simple as an automated phone call.
“The danger is the focus on technology,” said Lawrence An, MD, director for the Center for Health Communications Research at the University of Michigan, during a recent education session. “You build the coolest thing you can build, but in this world, it’s not a case of ‘if you build it, [patients] will go.’ You must emphasize the patient’s experience and the use of technology, rather than the technology itself.”
For example, statistics show about 90 percent of people use the Internet, but that number drops if someone is a caregiver, has had a recent medical crisis or has a chronic disease. Meanwhile, a digital divide exists—only about one-half of older adults aged 65 or older access the Internet, according to the Pew Research Center.
“You must be creative in determining channels to engage these populations,” Dr. An said. Tailoring health messages to specific populations is crucial to ensuring messages reach their intended targets, he said. For example, in a population that rarely uses smartphones, a health care app won’t be very useful.
Dr. An shared three examples of digital tools that effectively reached the intended patient population:
- Reaching prostate cancer survivors. In this project, Dr. An’s team needed to develop a system that could assess survivors of prostate cancer and give them self-management strategies. Initially the idea was to develop an online resource, but patients and spouses said they would rather have printed information. The team developed an automated phone program to call patients, assess their symptoms and determine priority health areas and strategies. With this information, the team used technology to create tailored, personalized newsletters that were printed and mailed to participants.
- Incorporating caregivers into care plan. In this program, patients with complex, chronic conditions receive automated phone calls during which they report on their health status. The system automatically informs not only the patient’s physician of any worrisome systems but also sends a text or email to a designated family member, friend or caregiver. The program has increased medication adherence in patients with congestive heart failure.
- Encouraging young people to quit smoking. After building a website with smoking cessation information, Dr. An’s team discovered the intended audience didn’t want to visit the website. After some retooling, the team redesigned the site as an online college life magazine, with articles about a variety of issues important to young people. Messages about smoking cessation were woven into the articles, and an online peer coaching component allowed participants to receive personalized videos from peers to encourage and offer support.
In a recent AMA Viewpoints blog post, AMA President Robert M. Wah, MD, shared a view of health IT that is similar to Dr. An’s.
“I often caution my fellow physicians that it’s easy to get overexcited about technology,” Dr. Wah wrote. “However, innovations are not just about the tech—they are about how we use the tech to take better care of our patients and be better physicians.”
The AMA is taking steps to ensure the healthiest use of digital tools in a several different areas. With its Accelerating Change in Medical Education initiative, the AMA is working with innovative medical schools and talking with tech entrepreneurs about the best ways to incorporate technology into future physicians’ training.
The AMA’s Professional Satisfaction and Practice Sustainability initiative, meanwhile, has investigated the things that make it difficult to provide high-quality care. Part of this involves revamping electronic health records systems to be more usable for physicians and patients.
With the AMA’s Improving Health Outcomes initiative, pilot sites in practices across the country are investigating how to better engage patients in improving outcomes for diabetes and hypertension, the two most devastating chronic diseases in the country. This initiative is exploring innovative ways to incorporate patient-physician feedback loops.
Read more about health IT at AMA Wire®.
