How can advancements in health IT help combat physician/provider burnout?

Steve Gerst: New natural language processing and office-based virtual assistant technologies with artificial intelligence (AI) are now coming to market. This will allow physicians to focus directly on the patient while generating electronic medical record (EMR) notes for editing and acceptance by the physician, suggesting treatments and therapies, ordering tests, and querying the system for related conditions, as well as new research and alternative therapies. This will enhance patient-physician interaction while improving quality of care and documentation.   

Bill Rogers: Today’s nurses, physicians and other providers routinely perform mundane tasks (administrative responsibilities, follow-up phone calls, etc.), which limits their time with patients. Voice- and chatbot-powered virtual assistants, including those that leverage AI, can provide a streamlined experience by automating many of these tasks, resulting in optimized patient-provider interactions and, often, improved engagement among patients and consumers.

Annette L. Valenta: By advancing interoperability (lower repetitive data entry), improving human-computer interaction design (better usability/user experience), reducing unintended consequences of computerized physician order entry and clinical decision support (alert fatigue, medication administration and order entry errors), tackling disruptive workflow (improve work life balance), and adapting to the new computer-physician-patient triad and team-based care (recognize shifts in autonomy).

What is one recent innovation that can improve patient engagement?

BR: “Voice is a powerful interface for providing practical, evidence-based information that supports health and wellness goals,” says Sandhya Pruthi, MD, Mayo Clinic internal medicine physician. In a recent California-based home health pilot, patients used Amazon Echo devices to schedule appointments and receive medication reminders. In another study, diabetes patients were likely to eat better and exercise when using a voice assistant to set goals, complete health assessments and report concerns to providers. Chatbots are also powerful, including today’s newest voice-powered versions.

From your current vantage point, what does health care look like five years down the road?

SG: In five years, most health systems, health insurers and accountable care organizations/independent practice associations will be managing risk-based contracts by leveraging technology from the hospital to the home through a combination of remote patient monitoring, telemedicine with virtual visits, chronic care management, patient engagement platforms, AI through FDA cleared 510K wireless devices, and wearables using interactive tablets and mobile cellular devices.  

Personalized medicine based on genomic and epigenomic testing will be commonplace, and point-of-care testing will speed laboratory diagnosis to help determine specific antibiotic resistance within hours rather than days for better, faster, higher quality treatments and improved access. Nutraceuticals will grow as an industry segment including a variety of genomic-based microbiome products to improve health and longevity.  

Bacterially engineered biosimilar drugs will compete with “small molecule” drugs as more cost- effective alternatives, while precision-engineered pharmaceuticals will be more specific to an individual’s genetic constitution for better, faster, more accurate treatment protocols and improved productivity.  

BR: Today, in industries like hospitality, organizations are cost-effectively using messaging and communications platforms to ensure world-class experiences for their customers. Going forward, every organization will be differentiated by using branded virtual assistants that augment the consumer experience. This is especially powerful in health care where voice-assisted and chatbot-enabled conversations can deliver meaningful interactions.

AV: Continuing clinician shortages, evolving reimbursement strategies affecting patient care delivery, continuing reduction in solo or small group practices, increased use of mobile technology, increasing interprofessional collaboration and team-based care, increased use of design thinking for new care-delivery models, and increased use of business intelligence and other capabilities like AI.

What advice would you give a health care professional looking to implement new technology?

SG: Health care professionals should learn to take advantage of new technologies as they become available. This includes AI, genomics, proteomics, telemedicine, remote patient monitoring, clinical decision support, virtual assistants, natural language processing and any technology that will make their lives and practices more efficient to provide greater patient and provider access and quality at a lower cost.  Leveraging technology into the home will be the key to Chronic Care Management — which accounts for 86 percent of medicare spending — pediatric care and electronic triage. 

BR: Futurists see a bright outlook for AI-driven conversational interfaces. Today’s most digitally-savvy health care organizations are engaging people conversationally for next-gen digital marketing, member services, population health and beyond. With previous waves of digital disruption, we’ve learned a lot about the danger of point-solutions. Enterprise-grade virtual assistants provide a meaningful consumer experience to meet people wherever they are across the health care ecosystem.

AV: Health care technology is implemented within complex adaptive sociotechnical systems, influenced by external forces and encompasses the organizational structure, people, hardware/software, and the tasks themselves.  Well-recognized project management tools and best practices, by themselves, may deliver ‘on time’ and ‘on budget,’ but are not always adopted successfully as implementation may disrupt the ‘system.’

What advice would you give someone considering a career in health care informatics?

SG: With the vast amount of data that will become available, health care informatic professionals should focus on developing technologies with machine learning capabilities that can rapidly sort through relational databases and efficiently focus providers on the proper therapies, courses of treatment, alternative therapies, diagnoses and probabilistic decision making to guide them through the myriad alternatives available for each patient.  

Digital health and connected care through interoperable EMR systems will be the future, with a major focus on remote patient monitoring, decision support, telemedicine/telehealth, telebehavioral health, personalized medicine, genomics and chronic care management. 

AV: Hospital and vendor settings are high-growth sectors. Employers seek qualified candidates. The number of qualified candidates with a master’s degree in health informatics or a related field is far greater today, so anticipate the need for a master’s degree. Pursuing a career in academia?  A doctoral degree is required.