There’s growing interest among both consumers and clinicians for people to DIY health care. Consumers are even keener than their doctors about the self-care concept, PwC’s Health Research Institute has found.
Doctors who are already in value-based payment mode — participating in accountable care organizations, at-risk for reimbursement, doing population health — are earlier adopters of digital health tools that enable patients to care for themselves outside of the health care setting. These providers are also working more on care teams, where physicians can work at their ‘highest and best use,’ complemented by nurse practitioners, physician assistants, diabetes educators, and other ancillary clinical professionals who can extend the physician’s time and workflow.
PwC polled both providers and consumers to gauge their respective interests in digital health technologies and found a greater preference among consumers for five of the six technologies assessed. One exception was for patients doing urinalysis tests at home with a device on the phone, which was preferred by more doctors than patients (47 percent vs. 42 percent). Consumers prefer, in greater numbers:
- Using an at-home strep test at a (retail) store
- Checking vital signs at home with a device on their phone (with nearly as many doctors comfortable with this, 55 percent vs. 53 percent)
- Sending digital photos of a skin problem to the dermatologist
- Checking for an ear infection using a device on their phone
- Having an ECG at home using a device attached to a phone
The two most significant concerns for providers adopting mobile health technologies are privacy and financial issues – especially the doctor’s perspective that “I don’t get paid to use mobile health tech or delivery digitally,” the survey discovered. The expense of digital tech as a concern has dropped from 35 percent of physicians in 2010 to 24 percent in 2014. Concerns about workflow are also increasing, with only 18 percent of doctors concerned about workflow challenges in adopting digital health, up to 24 percent in 2014.
The most common mobile device activities among physicians are accessing EMRs (among 45 percent), prescribing meds (aka ePrescribing, for 41 percent), reviewing images (32 percent), and communicating with patients (31 percent).
Health Populi’s Hot Points: There were several surprises in the PwC survey data which demonstrate a moving needle for physician adoption of digital and mobile health tools. The 31 percent of physicians who reported communicating with patients on a mobile device in 2014 is noteworthy, as well as 14 percent of physicians who receive data from a mobile app a patient uses to track data.
Among the 40 percent of physicians who monitor patient data generated by a mobile health app or digital tool, 83 percent told PwC that doing this is, at least, somewhat helpful. However, the challenge to scaling this and optimally benefiting from patient-generated data (PGD) is overcoming the lack of connectivity between the PGD and the clinician’s electronic health record. If clinicians are to fully embrace and succeed with value-based payment and population health, incorporating PGD into the EHR to build a more complete picture of a patient’s life (outside of the doctor’s office, at home where she “lives, works, plays, and learns”) is crucial. For non-communicable diseases and chronic conditions, the health care outcome has more to do with daily living and self-care than in episodic visits to the health care system.
For patients, there’s another important finding from a recent PwC survey on wearables to weave into this story. That data point is that consumers would prefer that digital health technologies for DIY health be free or, better yet, have use of the device paid-for by a third party. So consumers, too, have their financial obstacles related to adopting digital health tech. Free may not be cheap enough.
This post originally appeared on Jane's Health Populi blog on November 19, 2014.