commentary MEDICINE’S DIGITAL REVOLUTION
BY AMIT N. KESWANI,MD With the con- tinued evolution of medicine and the application of business principles that transformed the automotive and elec- tronic industries in the 1980s, it was only a matter of time before that tech- nology began to infiltrate health care. The development of lean production systems, the application of six sigma principles, and supply chain manage- ment have put us in a digital revolu- tion in medicine and data analysis. We live in a data-driven culture
and are able to access data at a rapid pace, whether it be emails, texts, pho- tos, books, or video searches. A 2010 report from the Centers for Disease Control and Prevention (CDC) states more than 80 percent of Americans have looked up health-related ques- tions on the Internet, and more than 20 percent of adults have posted on a health care online forum. This digital revolution of medi-
cine — where medical knowledge is readily accessible from digital devices
— means patients now demand more autonomy of their health care. This is positive not only for the patient but also for the practitioner. I often see my older attending phy-
sicians grumbling when patients talk about researching a disease on the In- ternet and then ask questions. I, how- ever, am glad patients are embracing their problems and trying to improve their fundamental understanding of the disease process. More important- ly, I look at that as an opportunity to shape where their information comes from and to have conversations about what active roles they can take in im- proving their well-being. It is not uncommon to have pa-
tients in our clinics who track their measureable data, such as blood pres- sure, heart rate, weight, or daily steps. I encourage my patients to embrace the wireless accelerometers and pe- dometers available, as long as the de- vices inspire additional cardiovascular fitness. It makes sense to use these de- vices to help manage chronic diseases, which a 2009 CDC report estimates account for more than 75 percent of all health care expenditures. Unfortunately, there remain prac-
titioners averse to embracing these advancements, and shockingly, there still exist practitioners who do not use electronic health records (EHRs). Health care systems often switch EHR
systems in an attempt to add function- ality. But doing so compromises physi- cian satisfaction. EHRs will continue to change with the implementation of ICD-10 this fall, as medical billing be- comes even more complicated. As technology continues to de-
velop and adapt, parts of health care will continue to become more remote and decentralized. If we follow the te- nets of keeping it simple and focusing on patient care, navigating the digital revolution in medicine will only be to our advantage as practitioners. When we hear words like quality,
process improvement, and data man- agement, instead of shuddering in fear, we should learn more about this jar- gon, as it will continue to infiltrate the health care industry. Physician leaders can help use data and improve patient care by deciding which data are useful and which are not. We must all learn to embrace
change and not avoid it. Our success as physicians will only be retained if we help our patients adapt to and manage the immense, complex data accessible to them. An empowered, knowledgeable patient is our ally, as long as we can help that patient navi- gate data properly and safely. n
AMIT N. KESWANI,MD, is an intervention-
al cardiology fellow at The University of Texas Health Science Center at Houston. He will start a career in academic medicine this fall.
An empowered, knowledgeable patient is our ally.
August 2015 TEXAS MEDICINE 11
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