Digital transformation trends for health care, chiropractic in age of COVID

Forecasting digital transformation trends for health care, impacted by COVID-19, through next year

The chiropractic profession, and health care in general, has been historically slow to adopt new technologies. However, we are all about to experience significant changes in the role technology plays in our practices. From how we communicate with patients to how we formulate a diagnosis and collaborate — tech will play an even greater role in digital transformation trends for health care in the next several years than ever before.

Digital transformation trends: telehealth

Driven by the COVID-19 pandemic, the rise of telehealth has been the most practically transformative source of change in health care in a decade. Limitations on travel and requirements for social distancing, combined with the temporary relaxation of HIPAA requirements and the ease of use of synchronous video platforms, has resulted in a rapid adoption of telehealth. This trend is not likely to decrease once the pandemic resolves.

Telehealth provides solutions to several significant challenges confronted by our health care system. Telehealth provides ready access to chiropractors, physicians and specialists during a time when physician shortages have increased the wait time many patients must endure when seeking care. It also is helping to reduce the rising cost of delivering health care by decreasing costly visits to the emergency room.

According to Kaiser Health News, the cost of unwarranted ER visits was $32 billion in 2019. Kaiser also reported that “A trip to the emergency room is on average 12 times higher [in cost] than being treated at a physician’s office for common ailments.”1

The Internet of Medical Things (IoMT)

The advent of wearable devices and mobile apps combined with telehealth has resulted in a new Internet of Medical Things (IoMT). The real-time monitoring of many common health status measurements including ECG and EKG, skin temperature, blood pressure and glucose level is becoming increasingly adopted in health care. Wearable devices enable physicians and chiropractors treating specialties such as weight loss the ability to improve outcomes, reduce hospital readmission rates, increase patient satisfaction, and prevent chronic illness for many patients.

According to the Accenture 2019 Digital Health Consumer Survey, “More than half of consumers (53%) in 2019 are more likely to use a provider offering remote or telemonitoring devices, compared to 39% in 2016.”2 These expectations are influencing who patients choose as a provider. Younger health care consumers are more likely to choose your practice if you have digital communication capabilities, including reminders for appointments via email or text.

Notwithstanding their benefits, significant challenges exist with IoMT devices. Device manufacturers use proprietary platforms, which makes interoperability and the sharing of data across platforms difficult or impossible. Potential security concerns must also be addressed. Accenture reports that “one in four U.S. consumers (26%) have had their personal medical information stolen from technology systems.”3

Digital transformation trends: cloud computing EHR

The use of cloud-based electronic health records (EHR) systems in chiropractic practices has been increasing at an exponential rate. In its simplest form, the term “cloud” is a metaphor for the internet. In the past, all your practice’s software and data had to be on a computer or server that could only be accessed at a specific location. More and more practices are migrating their record-keeping from server-based to cloud-based platforms. Hosted cloud-based EHR solutions offer providers the appealing benefits of lower cost, ease of scalability and greater portability of data.

Conversely, the reduction in data control that accompanies cloud-based EHR can be problematic in terms of HIPAA compliance. In a cloud environment, the means for ensuring and monitoring the security of electronic data including text messages, emails, video and audio must all be in place to meet compliance needs. Additional considerations arise with the use of cloud-based systems. Providers may experience a latency or lag time accessing while information across the web and bandwidth may be limited by a practice’s Internet connection.

Despite the concerns about security, the main driver behind the rapid rise of cloud-based EHR technology is that health care practices are no longer simple service providers. Today your practice is a true technology organization that depends upon your IT for clinical, administrative and financial functions. Add to this patients’ expectations of technological proficiency by their health care providers and these digital transformation trends become a crucial component of your practice.

Will blockchain be the savior of secure, shareable PHI?

Blockchain is a decentralized, shared digital ledger that main-tains an unalterable record of transactions between users. One of the greatest benefits of blockchain technology is that it stores data in a significantly more secure way than other platforms. This makes it especially attractive as a method of storing and sharing Protected Health Information (PHI).

Since blockchain is a decentralized network, it can alleviate the lack of interoperability between health care electronic record platforms and the inefficiency of data sharing between providers it creates. Medical records can become inaccurate as they are passed between providers. This can lead to duplicate or unnecessary treatment. Enabling interoperability allows providers to share information including treatment history, appointments, data from wearable devices and other demographics. This results in higher-quality health care.

Blockchain significantly improves data security because it has no centralized point of failure. Cyber-attacks on health care practices are becoming a regular occurrence. Blockchain can help secure PHI and stop these attacks. More secure data also means substantial savings to the entire health care industry.

According to a report from Deloitte, “On average, one data breach a day occurred to a health organization and [cost] an average of $3.62 million to the afflicted organization.”4 Blockchain technology can eliminate this risk.

Recent artificial intelligence (AI) device and application approvals

One of the health care technology trends with the greatest potential remains the development of artificial intelligence (AI). AI applications can process information and provide decision-making data, similar to the way the human mind works. AI can improve the speed and accuracy of the process of making a diagnosis.

The FDA recently approved the first AI diagnostic device that examines photos of the retina to identify eye disease. The device, called IDx-DR, examines uploaded images for indications of diabetic retinopathy. According to the FDA, “IDx-DR was able to correctly identify the presence of more than mild diabetic retinopathy 87.4% of the time and was able to correctly identify those patients who did not have more than mild diabetic retinopathy 89.5% of the time.”5

Another application of AI, Buoy Health, is being used by Harvard Medical School to help diagnose and treat patients more efficiently. Buoy’s chatbot listens to a patient’s health concerns and symptoms and then guides the patient to the correct care based on its diagnosis. Whether it is being used to improve diagnosis, drive surgery-assisting robots, or find new links between genetic codes, AI is reinventing health care with its ability to predict, understand, learn and act.

The digital transformation of health care

The synergies that will result from the confluence of these trends in technology will result in the digital transformation of health care. Wearable devices and the IoMT paired with tele-health and cloud computing will result in enormous data sets for AI software to analyze.

The interoperability and safe, secure storage of PHI made possible by blockchain will foster an interdependent ecosystem that breaks the practice of health care out of its silos and fosters collaboration among providers.

Mark Sanna, DC, is a member of the Chiropractic Summit and a board member of the Foundation for Chiropractic Progress. He is the president and CEO of Breakthrough Coaching and can be reached at mybreakthrough.com or 800-723-8423

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