Month: February 2020

Technology gives people instant data at the touch of a screen, button, or keyboard. Millennials, as the Boomers take care to mention as much as possible, make great use of these technological advances, using them as crutches to aid in many areas of life, including with medicine. The medical field has experienced a multitude of changes as a result of this technological boom, and medical care as it was known a decade ago has significantly changed and morphed into something completely unrecognizable. First, millennials visit the doctors’ offices and clinics more than previous generations, but they are more inclined to visit retail health clinics like CVS or Walgreens for example over visiting their own primary care physician (PCP). The shift from PCPs to retail care is quite beneficial, due to the reduced cost and increased ease of the visits, but many problems are also associated with this millennial practice.First off, visits to a CVS or a Walgreens walk in clinic is extremely easy. These retail clinics remove the need to call the PCP and wait a few days or weeks for appointments—one can simply show up, get seen, and leave. In general, there has been a lifestyle change and people these days tend to be busier, always working or bouncing from one activity to the next, so retail clinics appear as an obvious time and effort saver. However, this approach does fragment health records because when patients visit different retail clinics alongside of their visits with their PCP, miscommunication is highly likely, as each healthcare provider requires different levels of information that the patient needs to provide and also use different forms and online data bases to store this information. This could also undermine the patient-physician relationship and could possibly complicate the oversight in treatment plans due to conflicting views and multiple sources of input. An article about the threats of retail clinics explains that, “physicians often take a negative view of retail clinics because of the lack of communication between retail clinics and primary care practices, citing a lack of cooperation or ‘unwillingness or inability on the part of convenience clinics to share medical information about patients with primary care providers’”(Warren, 2017). This can also create a sticky situation for the patient because they could feel awkward mentioning that they received care at a retail clinic due to the aversion from their PCP and could exclude something necessary to their treatment.

Additionally, an important aspect of retail clinics is the cost effectiveness of this approach. A 2013 study out of Harvard University found that retail clinic utilization is tied to lower total costs of care. The study compared insurance claims for patients who received care at retail clinics versus those who did not and found that those who used retail clinics experience lower costs of care by $262 (Sussman, 2013). In today’s society, people are very motivated to search for good deals, and saving money on cheaper medical expenses is very appealing. Although these cost factors are important to consider, but it is also important to note the lack of personal connection with the health care professionals in retail clinics. When visiting these clinics, patients usually do not have a choice in what doctor they will be seen by. In PCPs on the other hand, it is not unusual for a patient to have seen the same doctor for many years, creating a safe environment for beneficial conversations about medical problems that the patient may be sensitive to. A trusting and comfortable environment is ideal when concerning medical care, so it is important to weigh all the options before choosing between a fast and inexpensive retail clinic, or a personal and thorough PCP.Without the boom in technology, retail clinics would not be in existence in today’s society. Overall, they have transformed the medical field in terms of how patients are treated. There are many conflicting opinions in terms of the benefits and drawbacks of this system in comparison to PCPs, and it is important for consumers and patients to thoroughly understand the different sides to make their own decision on healthcare method that fits their own lifestyle and supports their views.

 

References

Heath, Sara. “What Are the Pros and Cons of Retail, Urgent Care Clinics?” Patient Engagement HIT, 25 June 2019, patientengagementhit.com/news/what-are-the-pros-and-cons-of-retail-urgent-care-clinics.

Rege, Alyssa. “These Are the 8 Most Disruptive Issues in Healthcare: Presidential Healthcare Policy and the Rise of Health IT like Artificial Intelligence and Precision Medicine Will All Have a Significant Effect on How Healthcare Is Delivered in the U.S.” Becker’s Hospital Review, 18 June 2018, www.beckershospitalreview.com/hospital-management-administration/these-are-the-8-most-disruptive-issues-in-healthcare.html.

Sussman, Andrew L. et al. “Retail clinic utilization associated with lower total cost of care.” The American journal of managed care 19 4 (2013): e148-57 .

Warren, Amanda. “Five Reasons Why Retail Clinics Are a ‘Game-Changing’ Threat to Traditional Healthcare Providers That Could Strain Clinical Laboratories and Pathologists.” Dark Daily, 2 Oct. 2017, www.darkdaily.com/five-reasons-why-retail-clinics-are-a-game-changing-threat-to-traditional-healthcare-providers-that-could-strain-clinical-laboratories-and-pathologists-1002/.

Society today is changing in the way common practices are viewed. Especially in the medical field, common procedural techniques and even the way medicine as a whole is viewed is becoming more and more technologically advanced. As a society, the United States is one of the most technological dependent and innovative countries in the world. According to the Global Innovation Index, commonly referred to as GII, in 2019, the United States was 3^rd in the GII top ten countries, only behind Switzerland and Sweden (Lanvin, 2019). This means that the United States has both an economy large enough to sustain innovative activities, like creating new technologies and researching new methods, and it has an economy with diverse products and services for export that are more innovative. In many cases, this technological boom in the United States solves many problems and makes life easier, like the many “smart products” available. But, controversies regarding technological advances in the medical field are in debate over many ethical reasons. This series of civic issue blogs will be focused on dissecting some of the controversial changes in the medical field relating to innovation. The main issue addressed in this blog post is the dispute over digital therapeutics, or DTx for short.

DTx, is an emerging health discipline that uses technology to amplify or even replace active drugs in disease treatment. This practice has the ability to revolutionize how common medical procedures are monitored and create a more accessible and easy recovery plan for patients. DTx could also make medical care and pharmaceutical purchases less expensive, while also providing a more personal approach, catering specifically to the patients’ needs. However, like many other technological advances, there are drawbacks to each benefit provided by DTx.

The main purpose of DTx is to deliver direct therapeutic interventions like ways to prevent, manage, or even treat medical disorders or diseases. This would mean that there would be less doctors’ visits, and more assessment through a network. Even simple data, like the health data stored on any iPhone could be considered DTx, when used in relation to treatment options. For example, in treating more chronic illnesses, physicians can use the number of steps taken per day to assess the individual’s activity levels. When treating patients with mental illnesses like depression, data like outgoing texts, number of calls, and sleep patterns can reveal to a physician or therapist how much the individual is engaging with activities in their daily life and if they are receiving adequate social support. These “treatment” options could be a touch away on an app or on your smartwatch, but since there are so many wellness apps available, it is difficult to discern which applications are actually useful for the treatment option a patient is pursuing. Furthermore, although a simple app for treatment sounds appealing, private medical details would need to be entered into the system that many people would prefer not to be released. And since DTx is all technology based, it could be relatively easy for a hacker to gather private data using DTx.

Other than the accessibility and ease of DTx, it can decrease the cost of medical care. By allowing patients to skip out on several doctors’ appointments, private therapists, and even medical consultants, DTx could save people lots of money in the long run. But, this technology does cost a lot of money to research, and since it is still in its up-and-coming phase, there are lots of unknowns. According to an article on Healthcare IT News, “$12.5 billion into digital health ventures in 2017 and 2018… Compared with 2013, this level of investment represents an increase in funding of 230 percent, while the average funding deal size grew 67 percent over the same period” (Siwiki, 2020). This immense growth of investment is costing companies billions of dollars, so in the end, DTx is not significantly reducing all cost factors, just the ones associated with the patient.

Less expensive healthcare options appeal to most citizens, but one of the greatest incentives for using DTx is the personal approach to care. The artificial intelligence incorporated into many of these apps allow the program to learn from actions, creating a treatment program specific for you. This is helpful because those who feel that physicians may be biased towards one treatment or another will be at ease with this method. But, this also reduces the amount of patients that physicians see, if DTx were to increase in popularity. This would cause a decrease in jobs for some of the most highly trained and educated professions out there. Artificial intelligence is in-and-of-itself a controversial issue regarding replacement of human workers with machines.

In an age of rapid innovation and technological dependence, it does make sense that the medical field is shifting towards a more tech-savvy approach to treatment, diagnosis, and disease management using digital therapeutics, or DTx. As comes with any technological advancement in its early stages, there are many arguments both for and against this shift, but it is important for people as consumers to be concerned with how their medical procedures are being dealt with and to be educated on the possibilities that could become of them.

References:

Chen, Cherry. “Innovation in Digital Therapeutics.” Plug and Play, www.plugandplaytechcenter.com/resources/innovation-digital-therapeutics/.

Lanvin, Bruno. “The World’s Most Innovative Countries, 2019.” INSEAD Knowledge, 24 July 2019, knowledge.insead.edu/entrepreneurship/the-worlds-most-innovative-countries-2019-12016.

Siwiki, Bill. “Here Are 6 Major Issues Facing Healthcare in 2019, According to PwC.” Healthcare IT News, 17 Jan. 2020, www.healthcareitnews.com/news/here-are-6-major-issues-facing-healthcare-2019-according-pwc.

“What Are Digital Therapeutics?” Digital Therapeutics Alliance, 9 May 2019, dtxalliance.org/dtx-solutions/.