Sixty-three years ago, my grandfather suffered a heart attack. His physician arrived at the house upon receiving a call from the family, quickly made the diagnosis, ensured his stability, and recommended that he relax and enjoy life outside the hustle and bustle of the city for a while.
"Not to worry," relatives recall the physician saying, "I am only a phone call away." The entire visit lasted no more than a handful of minutes and after a few phone calls to check-in over the coming months, he was feeling well enough to return to work.
The doctor charged three dollars and fifty cents.
Clearly our healthcare costs and treatments have changed vastly in the half-century since, but so has our medical culture. House-calls and afterhours communication have given way to physician answering services of questionable utility while barriers to physician consultation have made patients feel disconnected, compelling them to seek care in the emergency department. While some have pointed to the diminishing time spent with patients as the main source of erosion to the physician-patient relationship, family doctors as far back as 1950 saw an average of twenty-six patients per day which averages to about 15 minutes per patient--not too fundamentally different than doctors today.
The main difference, rather, is not face time in the examining room, but the connection (perceived and actual) that exists during the 99% percent of the time the patient and physician spend apart. In recent decades, that connection has too often been lost. My grandfather's doctor truly was a phone call away, a tremendously reassuring fact for himself and my family that no doubt aided in recovery. Unfortunately, despite the similar minutes per visit statistics, today's physician struggles to offer the same promises.
In healthcare, texting and emailing patients isn't allowed because of this liability or that rule, but many of us do so anyway because we know it often leads to better care. Not everyone is so bold and due to advancements within the field of mobile health, not everyone has to be. Nor do physicians have to revert back to working 18 hours per day, 7 days per week to rebuild that sacred connection.
Steve Jobs greatest gift to mankind may be that he brings the practice of medicine (and not its technology) back to the Norman Rockwell era.
My journey in medicine has taken me through institutions where anesthetized surgery was first performed and the life sustaining agent used to save countless premature infants, surfactant, was discovered. However, these and many other world renowned institutions are still pouring billions (yes, billions) of dollars into technology for patients and physicians whose original software code dates back to the 1970's. Not only does this system not allow for seamless communication between physicians, patients, and the entire healthcare team, it doesn't even work on a smartphone.
Yet, mobile health is different. Unlike electronic medical records, insurance exchanges or provider order entry systems, mHealth is fundamentally self-directed. No electronic health record titan or insurance conglomerate can force physician adoption. Rather, like house-calls, physician utilization of mHealth stems from the passion to provide the best possible care in a way that patients desire. The apps and mobile technologies which were once the defining features of success at Kaiser Permanente (at one time considered the Walmart of healthcare) and boutique healthcare groups like OneMedical (who received a $40 million investment from Google) are now widely available to any physician who wants to use them.
As such, the mHealth movement has democratized mobile-based secure healthcare communication allowing every electing doctor to work in teams, message, share photos, and exchange files on HIPAA-secure mobile platforms. So today, the local family doctor doesn't have to raise $40 million of venture capital. He or she can leverage a smartphone to practice medicine like my grandfather's physician, and still elect for a weekend with the family at the lake. They can diagnose, treat, educate, and empathize all through the power of a 4-inch screen and a wireless connection, and so while medicine may never return to $3.50 check-ups, it can once again be about the connection that exists between a patient and a doctor. Only this time, it may be 4G.
This post is part of a series produced by The Huffington Post, the mHealth Alliance and HIMSS Media in conjunction with the mHealth Summit, which will take place in the Washington, DC, area on December 8-11, 2013. The Summit brings together leaders across sectors to advance the use of wireless technology to improve health outcomes, both in the United States and globally. For more information about the mHealth Summit, click here.
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