The Cost of Healthcare Digitalisation
You have been having some palpitations over the last week. Your family has some history of heart diseases, so you are naturally worried about your health. You booked a consultation with a cardiologist through the hospital’s online booking system. On the day of the appointment, an SMS reminder popped up, you followed the instructions to register online and was given a virtual ticket.
At the hospital, the self-service kiosk scans your ticket and allocates a waiting time for you. 15 minutes. Another SMS popped up, asking you to fill up a short questionnaire on the reason for your visit. “To increase the quality of consultation between physician and patient”, the questionnaire claims.
Your queue number beeps and you enter the room for your consultation. The cardiologist greets you and turns to the computer, reading your input in the questionnaire. He occasionally turns to you, asking more questions then return to the computer to type out his notes. He decides for some blood tests, a chest X-ray and an ECG. All of which he ordered through the computer. You leave the room and go to the various locations for your tests. Once finally done, another SMS arrives, asking you to return to the cardiologist’s room.
You enter the room again, this time the doctor’s concentration is fully on the computer, looking at the results of your blood tests, X-ray and ECG that has been uploaded to the centralised hospital system. After a couple of minutes, he gives you a clean bill of health and assures you that the symptoms are most likely due to lack of sleep. He rattles off some advice about getting enough sleep, eating well and doing regular exercise to keep healthy. Typing at the computer, he prints out a medical chit for 2 days, giving you some time to rest at home.
You leave the room, make the payment and leave the hospital. Almost a seamless, hassle-free experience of visiting a hospital. And a clean bill of health too! You should be elated and relieved. Instead, you still have that nagging feeling behind your head and then suddenly, you feel that familiar palpitation again.
One of the recent advances of modern medicine is not a new antibiotic or a revolutionary surgical technique but it is the digitalisation of healthcare. A term used to describe the digital transformation of healthcare delivery, it has drastically changed how we practice medicine. Information technology has progressed at an astonishing speed over the last decade and has pulled healthcare in its slipstream. Telemedicine, integrated health systems, blockchain technology, big data and artificial intelligence (AI) are all now a norm in today’s healthcare systems. Not to mention wearables that continuously tracks health data and personal health assistants on smartphones, the world is now dependent on technology for their healthcare services.
But the question is, at what cost?
The doctor-patient relationship
Taking the situation above, if we strip off the various layers of technology involved in the hospital visit, the experience would be substantially different. You probably would have to manually register at a counter manned by a clerk. The waiting time for the tests you went through will take longer to reach the doctor. In fact, the total waiting time would be much longer, as most of the processes are not immediate. Healthcare digitalisation arguably made your visit and the system more efficient.
But for every layer of the process handled by technology, it also demands an equal effort of interaction from the provider, in this case, the doctor. The health system in which he ordered the tests will require him to concentrate on the computer, navigating through the maze of drop-down menus to click the right tests. The ability to manipulate the X-ray image will require him to search for various buttons and toggles. The text boxes of the patient’s clinical notes will require him to scan the screen so he knows what and where to type. All of this effort, focus and time are now diverted from the single most important entity of this whole healthcare process: you.
Healthcare delivery is a complex and highly dynamic situation. It involves multiple processes and systems. It is no wonder that digitalisation was aimed to make the system more efficient and easier to navigate. But it tends to forget the core of the process, which is the relationship of the doctor and patient.
The art of medicine
Medicine is as much as a practice of science it is an art. The art of medicine is how doctors build rapport, establish trust and ultimately not just treat but also to heal the patient. All of these which no technology can replicate. It is this experience that patients look for when they seek a doctor, not only to be treated for the ailments but to be healed for their worries. But that is not to say we should shun technology. It is here to stay, no matter our preference. Not embracing it would only give a disadvantage to health providers to treat patients. What is needed, therefore, is a balance.
The human touch
Health providers now need to carefully balance the use of technology in their practice while preserving the fundamentals of a doctor-patient relationship. The technology is there to complement the healthcare delivery, not replace it. Nothing will replace having good eye contact with the patients, reassuring them that their blood tests, X-ray and ECG are normal. And that the palpitations you feel are indeed just from lack of sleep.
Let not the digitalisation of healthcare cost us our greatest healing power: the relationship with the patient.
We communicate but do not connect. We are efficient but not empathetic. And we practice medicine but not healing.