Practice Management

Technology’s Role in Transforming Health Care Industry

Technological innovations are helping clinicians and researchers enhance patient care

Virtual reality demonstration in front of group of doctors

Wearables, digital health tools, artificial intelligence, virtual and augmented reality (VR and AR)—these are just some of the technology-fueled innovations that are entering the health care space.

New technology and digital tools are helping clinicians and researchers collect health data and improve patient outcomes. Meanwhile, hospitals and medical schools are experimenting with VR- and AR-based training programs to improve provider performance and communication, enhance patient safety, and reduce clinical errors.

VR and AR

Mindgrub Technologies, a Baltimore-based agency that develops digital and technology solutions, collaborated with a local hospital on a VR training game for operating room nurses. Mindgrub and Susan Finlayson, senior vice president of operations at Mercy Medical Center, initially created a computer-based training game for new nurse orientation sessions, in which participants were asked to find items in a crash cart using a computer mouse. “Whenever it comes down to learning that’s more of a muscle memory thing, it would be so much better to be immersed in the environment,” says Todd Marks, Mindgrub’s chief executive officer.

To that end, the Mindgrub team improved on Mercy’s crash cart training by developing a VR experience. In Crash Cart Blitz, users don a VR headset and handheld controllers and must revive a simulated patient during a crisis using items from a crash cart. “By being immersed in the environment and actually using your hands to reach for the crash cart, it not only allowed you to memorize where everything was, but it also gave you that muscle memory of taking it from the cart and applying it to the patient,” Marks explains.

At Case Western Reserve University School of Medicine, AR and VR are enhancing learning. Students are using these technologies to learn anatomy from a 3-D representation of a body and practice patient interactions through a simulated, immersive 3-D environment. The school’s Clinical Skills and Simulation Center also offers a surgical VR simulation.

New Technology and Digital Tools

Reducing health disparities. Research teams at Duke are working to leverage some of the newer technology-based tools, such as wearables and connected devices, as well as familiar technology like text messaging, to study population health in an effort to reduce health disparities.

Dori Steinberg, the director of the Duke Global Digital Health Science Center, has found that text messaging is often the best tool for disseminating health interventions to medically vulnerable and underserved populations that are often left out of clinical trials. “A strength of ours is developing programs for populations that think they don’t have access to technology, but they actually do,” Steinberg says.

The center’s research focuses on creating evidence-based lifestyle interventions that are accessible to medically underserved communities. But instead of attempting to compete with the booming technology industry by creating a new smartphone application, “I’m going to try to think of ways I can work within that market,” Steinberg explains. “We know some apps are lacking in a lot of things related to behavior change, but we can work with them and add programs on top of them and leverage those data.”

A growing body of evidence shows that behavior change is most effective when digital programs include personal coaching, an idea that Steinberg, a clinical-based registered dietitian, initially resisted. “Coming out of my original face-to-face work, I saw how difficult it is to scale up any program that has a human component,” she says. “But an app alone isn’t going to do a huge amount…; most people will need more support.” This is important for physicians to know if they are recommending digital health tracking tools to patients, Steinberg explains.

Improving patient-provider decision making. Steinberg’s colleagues are exploring how to optimize the digital heath data gathered from wearables and smartphone apps to improve patient-provider decision making. One of those researchers is Ryan Shaw, PhD, RN, who serves as the faculty director for the Duke Mobile App Gateway (MAG) and is the founder and director of the Health Innovation Lab at Duke University School of Nursing. Shaw conducts research on the role of digital health technologies in creating new care delivery models.

Through a collaboration between the MAG team and Duke’s Digital Strategy Office, clinicians can now share digital care tools with patients through the EHR system. These digital tools include copies of printed materials, such as pre- and post-op instructions, educational videos, and mobile apps. An analytics dashboard provides insights into how patients use the digital tools, allowing clinicians to adjust individual care plans.

Monitoring health data. Shaw is also an investigator for the WearDuke initiative, a pilot study in which Duke undergraduate students self-monitor their health data through smartwatches and a companion app. “We would like students to use these technologies to be better informed about their own health, and maybe one day we might be able to predict outcomes for students,” Shaw explains. “We might be able to see early signals when students are having changes in their own health, whether it’s poor sleeping habits or potentially mental health challenges.”

Wearables and connected devices such as glucometers, blood pressure cuffs, and electrocardiograms show great promise for clinicians and patients who are managing chronic conditions. “Physicians are excited about technologies that will give them better insight into patient health after discharge from surgery and in between office visits,” Shaw says.

As health care continues to transition to a value-based payment model, emerging technologies will “likely become an important tool in our ability to deliver enhanced patient care,” Shaw adds.


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