We live in a time of imagination and possibility – or at least, that’s how it seems from the waiting room. Innovations in medical tech have given doctors and patients alike opportunities that they never could have dreamed of a decade or two ago, much less experienced firsthand. But now, those imaginings are tactile; an anxious young doctor can use virtual reality to practice imparting bad news to a patient’s family member, or develop their medical empathy by experiencing the physical struggles of an aging patient through VR. On the other side of medical aisle, patients have access to treatments that might as well have been pulled from a sci-fi flick: custom-fitted exoskeletons to help a paralyzed patient walk are as readily within reach as surgical robots are common to hospital operating rooms. When it comes to medicine, we have one foot planted in the future, readying us to spring forward – but the other is caught in a mire of outdated systems.
Pagers, faxes, and computers that haven’t seen a new operating system since 2001; it’s painfully clear to anyone who’s spent ten minutes in a doctor’s office that in-office communication tech simply hasn’t kept pace with the leaps and bounds of treatment innovation. On the surface, this may seem like just another annoying obstacle for doctors and administrative staff to handle on a daily basis, but recent research has found that the implications of the problem extend far beyond the occasional slowed computer and jammed fax. In 2013, a joint study by Ponemon and Impravata concluded that the outdated communication tools doctors currently use both hamstring productivity and cut into the time doctors can dedicate to patients. Over 570 healthcare professionals from a diverse pool of organization participated in the study. These respondents cited pagers (52%), limited WiFi (39%), sub-par email (38%), and the inability to text (36%) as significant drains on their workday time, and further noted that the communicating slowdown consistently leads to longer patient discharge times. All told, this inefficiency and wasted time costs hospitals across the country a collective total of over $5 billion dollars annually. The numbers speak more clearly than any anecdotal evidence: inefficiency poses a significant drain on much-needed medical resources.
With this in mind, we might ask – why not simply change it? Why don’t we update the systems, toss out the pagers, and bring in smart devices to win the day?
If only the fix were that simple.
For healthcare institutions, patient information security wins out over communication efficiency on the priority list every time – as it should! Every change to a working (albeit inefficient) system must be scrutinized for its potential risk to patient information. The impact of past efforts to bring medical communication systems onto the same future-facing platform as a treatment tech have been somewhat…underwhelming.
Take the fax machine. Described by one particularly irate Vox health writer as the “cockroach” of medical communications, the fax machine has remained plugged into the medical offices and hospitals for years longer than anyone might reasonably expect. As the same writer puts it in an article on the subject: “It frustrates doctors, nurses, researchers, and entire hospitals, but a solution is evasive.” Fax is notorious for being unreliable, slow, and painfully low-tech, yet some studies suggest that it may account for as much as 75% of all office communications. In 2008, the Obama administration tried to push the fax out of common use by encouraging record digitization for easy transmission. The program half-worked. From 2008 to 2015, the number of hospitals using electronic records shot from 9% to a comparably lofty 83%. But when it came to transmitting records, fax still won out over the seemingly more convenient digital means.
This seems odd, until you consider one point: digital health systems don’t want to make connecting with a competing system easy. Giving up proprietary data to allow for collaboration might be common sense for a healthcare institution, but the sacrifice just doesn’t make business sense for the system provider – so why would they volunteer? The urgent care you visit to set your broken leg probably won’t have the same digital management system as the primary care provider you visit for your follow-up, so the hospital will need to find another way to securely provide your information.
Ergo, the fax machine wins out again.
Right now, those of us in healthcare stand with one foot poised in the future and the other planted in the past; hopeful, but unable to move forward. Our efficiency disconnect is problematic, costly, and – perhaps most vexing – unnecessary. We have the technology to solve these communication slowdowns, but without rolling out the changes as a large-scale project, we won’t be able to institute the updates in a way that speaks to both connectivity barriers and security needs. We’re caught between a rock and a hard place, and updating in dribs and drabs won’t pull us out of our bind. We need a long-term plan in place. If we can integrate VR and robotics into common care, then surely replacing the pager isn’t beyond our reach.