"Still, there’s often confusion about who is caring for the patient ... " Playing off of Jimmy the Greek's comment,…
I spent a couple of hours tonight on the phone with a colleague who is burned out and thinking about leaving medicine. She was asking my advice, not only as someone who has worked in a variety of different care-delivery paradigms, but also as someone who might be able to help mitigate some of the hassles she’s currently encountering.
She’s part of a large Direct Primary Care practice, which manages patients more like customers as opposed to patients. Unfortunately for the physician, that comes with the expectation of 24×7 access. Apparently the organization is using something from Salesforce as a substitute for a patient portal, and when messages come in, they are in a silo, requiring the physician to also log into the EHR, load the patient, then double-document in both places. Adding to her frustration is a recent change to the Salesforce side where she can only manage messages from a laptop, which makes it hard to be 24×7 accessible if you ever want to step away from your desk or have a life.
We had a good chat about alternatives to in-person care including telehealth, which I think she’s considering. We discussed some of the pitfalls of the different telehealth companies and the challenges of being an independent contractor versus being employed, as well as the dramatically different processes that the national telehealth providers use to onboard new physicians. As someone who has historically been efficient with the EHR, I think she’ll struggle with their homegrown EHR-lite solutions, but she needs a change if she’s going to maintain her humanity.
We talked a lot about the concept of moral injury and how hard it is to deliver good care when you’re constantly operating under crisis standards of care, you don’t have adequate staff, and you’re being pushed to see more patients per hour than your comfort level allows. I’m glad she reached out and is contemplating a change. Too often, physicians wait until they’re past the point of no return or until a significant negative event forces their hands. Hopefully, telehealth will give her some breathing room while she steps away from in-person care and allows herself to recharge.
Despite my disappointment at being denied a media credential for the Consumer Electronics Show, different examples of cool technology are falling into my lap through other outlets. The first thing I ran across today was the clear-sided toaster, which not only allows you to monitor the progress of your toast, but has one-touch defrost, reheat, and bagel functions as well as seven browning levels. I haven’t shopped for any kitchen electronics in forever, but if my $9 college toaster ever gives up the ghost, one with clear sides might just be on the short list.
Withings reached out regarding its new BodyScan device, which is undergoing clinical and regulatory validation. Described as “the first at-home connected health station,” it promises to deliver weight, segmental body composition, and six-lead electrocardiogram data as well as a calculation of vascular age and an assessment of nerve activity. I’ve been happy with my Withings blood pressure cuff and have a couple of friends with Withings scales. The BodyScan certainly looks interesting, and at a $300 price point, will be attractive to people who have become accustomed to spending $800-$1600 on a smartphone.
I also ran across this smart watch sensor that helps with opioid relapse. The team at University of Massachusetts Amherst, along with colleagues at Syracuse University and SUNY Upstate Medical University, received a $1.1 million grant from the National Science Foundation’s Smart and Connected Health program to continue work on the project. The sensor feeds data to a machine learning platform to help identify if physical signs such as respiratory rate, electrocardiogram findings, etc. are at levels that indicate opioid cravings. Once a craving is identified, the device alerts the wearer to consider mindfulness techniques to try to address the situation. Ultimately, they hope to customize those interventions based on individual patient characteristics. Researchers believe they can identify with 80% accuracy when a user has taken an opioid. They hope it may evolve to help ensure proper use of prescribed opioids to prevent opioid use disorder. This is an area where we need as much assistance from technology as we can get, so I’m excited to see how it progresses.
Kohler knows I’m a sucker for the dream of a high-tech, aromatherapy-rich bath, and sent me information about its new PerfectFill technology that uses voice commands to control the temperature, filling, and draining of a bath. No more sticking your finger under the faucet while you fiddle with the knobs or worrying about scalding a little one. A former urgent care colleague who left the urgent care trenches to go to school to become a plumber let me know that the bath I swooned over last year requires special installation considerations and that he used it as an example for a class project. I know who I’m calling when I win the lottery.
I also did a bit of technology mourning this week, as I learned that all former BlackBerry phone services stopped working this week due to lack of support. BlackBerry was a tech darling in the days prior to the iPhone and at one point seemed like the number one business accessory. The last BlackBerry OS was released in 2013, but people have been limping the devices along as phones or messaging devices. I have to admit I still have a BlackBerry Torch, with its keyboard hidden beneath a sliding touch screen. It’s possibly one of my favorite phones, and fun to show off when I participate in STEM-based education programs where we talk about the history of personal electronics and communication. Most of the youth I work with can’t imagine life without a smartphone, let alone life without the internet, so it’s fun to talk with them about the pre-internet days when we used dial-up connections to bounce messages around the country.
What’s your favorite piece of extinct technology, be it healthcare or something else? Leave a comment or email me.
Email Dr. Jayne.