Strategies for deploying connected healthcare tech equitably

Addressing patient and provider challenges during technology integration

Connected healthcare technologies aim to strengthen the provider-patient relationship by creating a greater number of touch points and enhancing data exchange between the two. While these technologies provide numerous patient care benefits, they also require adjustments to clinician workflow.

According to Frank Osborn, M.D., chief medical officer of the Tufts Medicine Integrated Network at Tufts Medicine, culture is more important than strategy when redesigning clinician workflows to include new connected healthcare technologies. Establishing a physician-led culture can help organizations better understand the actual pain points in clinician workflows -- as opposed to what management thinks are the pain points -- and implement technology that effectively addresses them.

Integrating Advanced Connected Care Technologies into the Care Continuum

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"Listening to the physicians and understanding what they want to change, you're going to get there faster by doing that," he said during a panel discussion at the conference.

Tufts Medicine has implemented a technology integration process, where new technologies are deployed in short phases so that the teams overseeing the deployment can address problems as they arise. It also gives health systems time to gain critical provider buy-in.

"We've had a lot of things that we've done that we've just done forever because that's how it's been, and no one wants to change that, but people want to somehow magically get to a different place," Osborn said.

In certain industries where the risks are low, trust is easier to build, but where the risks are high [like] in our area of work, trust is very difficult to build

He emphasized the importance of change management efforts to help staff adjust the daily tasks and processes that they have utilized for years.

Lauren Hopkins, MPH, assistant vice president of virtual care and community engagement at WellStar MCG Health, echoed Osborn, adding that gaining that physician buy-in early on is critical to ensuring that new technology is deployed in ways that support clinicians.

"When you try to go in [saying], 'Hey, this is what we're going to do, [we] don't want your input,' then it does not win over any friends," she said during the panel. "And so, you want to definitely approach it [as] this is a two-way street."

Hopkins suggested asking questions during the implementation process, such as "Did we actually achieve what we set out to achieve? And if we didn't, then why? Where do we fall short? How do we have to evolve or recreate what processes?" can help establish a feedback loop between clinicians and administrators in charge of implementing new technology.

Another critical piece of the technology integration puzzle is gaining and maintaining patient trust.

Anjali Bhagra, M.D., M.B.A., FACP, professor of medicine and medical director of the Enterprise Automation Hub and Office of Equity, Inclusion and Diversity at Mayo Clinic, pointed out that the healthcare system is already complex and filled with friction points, so adding a technology layer that patients don't fully understand can erode trust.

"In certain industries where the risks are low, trust is easier to build, but where the risks are high [like] in our area of work, trust is very difficult to build," she said during the panel.

She added that it is critical that patients understand the types of technology being used, the data being collected, and how the data will be used. This will require enhancing patients' digital health literacy.

Further, healthcare provider organizations must employ a long-term strategy when integrating technology. Bhagra noted that healthcare is changing rapidly, and clinician training and workflow could look very different in the near future.

"I think we all need to get comfortable with change…and not getting committed to specific structures or flows and just having that cognitive flexibility [and] more wide partnerships because one workflow that we established today is going to be obsolete in a matter of few months," she said.

Ensuring equitable access to connected healthcare

While connected healthcare technologies promise to enhance patient outcomes and improve patient and provider experience, these benefits are meaningless without access. If healthcare providers do not focus on access during technology integration, they might inadvertently widen existing health inequities.

For instance, if patients lack an understanding of how to use the digital health tools offered to them, the tools' benefits will be squandered.

Boosting Equitable Connected Healthcare Access & Adoption

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At Mount Sinai Health System, a digital engagement team is tasked with providing critical technical support for patients.

"What the engagement team does is … they meet the patient where they are, they hold community events or go on site to help the patient learn about the benefits and how to use their tools, literally helping people sign up for MyChart sometimes and just walking through and answering questions," Eric Kim, senior director of digital experience, Digital and Technology Partners, at Mount Sinai Health System, during a panel discussion.

Additionally, the health system has partnered with a third-party service provider that sends agents into patients' homes to help them set up and learn how to use remote patient monitoring tools.

"Sometimes technology is not the answer -- human support is still needed," Kim said. "And I also acknowledge that there's economic constraints that have to be considered, but I think there is a balance that we can reach between the human and technology-centric workflows."

Sometimes technology is not the answer -- human support is still needed. And I also acknowledge that there's economic constraints that have to be considered, but I think there is a balance that we can reach between the human and technology-centric workflows.

Support for patients facing social determinants of health (SDOH) challenges that prevent them from engaging with digital healthcare can also be found outside the healthcare system.

According to Arianne D. Dowdell, vice president and chief diversity, equity and inclusion officer at Houston Methodist, breaking down silos and including community-based organizations in health equity efforts is essential. CBOs, including libraries and churches, can help individualize outreach and healthcare resources to effectively engage communities.

"You can't do a one-size-fits-all," she said. "And so, for us, it's a matter of truly bringing everyone to the table that has various skill sets, including community [organizations]."

CBOs are at the heart of many communities, particularly marginalized and underserved communities. Thus, Houston Methodist has been investing in and partnering with CBOs for the last 30 years.

For instance, the health system connects patients facing SDOH barriers with CBOs that can help them overcome those barriers.

"Community partnership is just vital to closing this gap," she said. "The hospital can only do so much, but it doesn't absolve us of the responsibility to our patients and the care."

Though the road to true health equity is long, Kim and Dowdell highlighted the highly encouraging progress made in this area, especially in the last four years.

"I've worked in a lot of different industries before joining healthcare, and I think that's a little bit of a blessing and a curse, of kind of bringing that perspective," said Kim. "And I feel like most of the organizations I've worked with said they cared about equity. And I would say that what makes me hopeful is I feel like healthcare generally really does care about it…And so that makes me very hopeful. And I also think that more and more people are talking about this topic and valuing it…And working toward an equitable healthcare system. And I feel like momentum's on our side."

Dowdell echoed Kim, stating, "I think very few people get into healthcare because they don't care about people. This is a people-serving business. We're all servants for each other in this area…. It gives me hope that nobody's just saying, 'Oh, we'll figure it out later.' We're doing it now. We're having conversations, we're thinking about the gaps, and we're making the changes that are needed to propel us to the next level to really get people to their best care at the end of the day."

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.