How Could Digital Technology Make An Impact On Primary Care?

I truly hope that very soon I do not have to make an appointment at the GP when I suspect signs of a disease, but my GP will send me a message that she spotted something irregular in my latest test results and my digital health data, so I’d better visit. Let me show you in detail how primary care should be carried out in the future!

Digital health should become an organic part of primary care in the future

I live a fairly healthy life. I use data to improve my lifestyle and to make better decisions by optimising my sleep pattern, my physical, my cognitive or my emotional abilities; and I had several genetic tests. What is the reason behind all my activities? I want to live a long life and work until the very end while being fit in body and soul. And I’m ready to sacrifice energy, time and money to reach it.

Data and digital technology is my guardian and my spear-hand in order to achieve my goals. Just look at my Excel spreadsheet experiment and all the stunning results I could achieve in one year! My GP also thinks that for example activity trackers have a ‘placebo effect’. When you know that your steps are counted, it increases your motivation, boosts your performance and you feel healthier. Thus, I believe digital technology should have a bigger impact on healthcare for making people’s lives better.

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Although it is obvious that change starts with the individual, a lasting impact can only be reached when the direct environment also resonates with such changes. When people start to turn to digital technology to live a healthier life, the best response would be to advance the closest health sector to the individual, namely primary care in order to reflect the requirements of the 21^st century.

So what does primary care look like now? What should be changed?

Healthcare today is not proactive, but rather reactive medicine. Patients usually visit the GP when they already have some serious problem; and since doctors are overwhelmed with tasks, they can only focus on treating acute illnesses. There is not enough data about the patient, and about the possible illness; most GPs and hospitals do not incorporate the latest proven scientific research into their practice. How could they? Data processing systems are usually not that efficient.

Doctor shortages are a global phenomenon. The World Health Organization (WHO) estimates that there will be a worldwide shortage of around 10 million physicians, nurses, and allied health workers by 2030.

At the same time, the need for healthcare services is rising. Illnesses are becoming easier to catch, civilizational diseases such as diabetes and obesity are on the rise; while aging societies need more and more care. The result? Long waiting hours at the GP or for appointments and surgeries, pricey, long, sometimes unnecessary procedures, random patient management, and unequal doctor-patient relationship.

How could we change it?

We need more data and a 180-degree attitude change! Data is essential for getting to know the patients, their situation, and their diseases as well as how to heal them completely and efficiently. Digital technology could help a lot in this respect. Healthcare trackers, sensors and wearables could serve with a swarm of useful biometric data in getting to know the health parameters and vital signs of patients and diagnosing their illnesses.

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In January 2016, a man checked into a hospital’s emergency room in Camden, New Jersey. Because his heart was beating irregularly, doctors suspected he had atrial fibrillation. That is the most common type of arrhythmia, which can increase the risk of stroke. But to decide how to treat him, they needed to know exactly how long his heart had been acting up. That’s when one of the physicians noticed a Fitbit Charge HR on the patient’s wrist, and it had the answers they were looking for.

This was one very early example of how useful data extracted from wearables could be. That’s why such events should not happen on a randomised basis, but GPs, as well as hospitals, should rather incorporate data from healthcare trackers, sensors, and even fitness wearables into their practice on a systemic level.

What should the first encounter with your GP’s office in the future look like?

Somewhere in the 2030s. Adam scrolled down on his phone and asked Mimi, the healthcare chatbot about the selection of GPs in the neighborhood, where he just moved in, a very neat area in Amsterdam. Based on Adam’s preferences, Mimi offered three possible choices, and he selected one. The chatbot made an appointment for him for the next day. By the time, he went there, his previous doctor sent over all the necessary healthcare data about him after he consented to the necessary forms about data privacy. Adam could also take all the results of his genetic tests to the GP – data about drug sensitivity, his risks for monogenetic conditions or multifactorial diseases or mutations -; as well as the data from the health trackers, he uses for measuring his physical activity, blood pressure and tracking his sleep.

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Adam went to the GP’s office, which rather looked like a business meet-up; and had a very friendly chat with his new doctor, who already knew about his previous knee-replacement operation as well as his peanut allergy. Then she asked a couple of further questions about his health and examined him thoroughly: ECG, blood test, knee X-ray, etc. The whole exam was less than an hour. Afterwards, the doctor gave Adam a summary of the current state of his health and estimated his risk for different diseases. Based on this information, the doctor and Adam worked out a prevention plan to avoid these health risks and set out the parameters of a personalised healthy lifestyle. They agreed to set up various targets concerning his physical activities, his dieting habits as well as factors reducing stress.

Ideally, the GPs of the near future will rather act as health coaches. They will interpret health data if something is not clear, give advice when results are not optimal, and spot and check irregularities based on data as soon as possible.

What happens in practice?

I always wished Adam’s story could be mine. For years, I have been looking in vain for a GP who thinks the same way about prevention and digital health as I do. Finally, a few years ago I found her. She believes in the equal-level collaboration I’m evangelizing rather than the old hierarchy of the doctor-patient relationship. And she is a data freak just like me.

So, when we first met, I brought to her

the results of my genetic tests: what drugs I’m sensitive to, what metabolic conditions I carry, what major mutations I have (e.g. Leiden that increases my risk for deep vein thrombosis), and what risks I have for multifactorial conditions.
data sets about my health parameters in terms of sleep quality, physical activity, blood pressure
major lab markers from the past years in an Excel spreadsheet so she didn’t have to look through thousands of data points, just what really mattered
the need for a long-term prevention program.

What was my GP’s reaction?

Instead of jumping out of the window in fright from the data tsunami, she got curious and excited about discovering my health background. First and foremost, she examined all the available information based on my data as well as the data in the healthcare system. Then she drew up my family tree with the major diseases and causes of death, carried out a full physical examination, checked all my tests and lab markers, examined my lifestyle, and then came up with the risks for different major conditions based on international data and evidence.

What was the final verdict and how will my GP and I work together in the future?

At the end of the process, we agreed upon a prevention program concerning when and what kind of health tests should I undergo. This is a difficult issue by the way. We could have a full-body MRI every year, but it is expensive and so far there is no strong evidence that it prolongs life, so we said no. You really need to be considerate and sane while deciding upon a regimen of tests for the long term. She also gave me pieces of advice about my lifestyle. As I exercise 30 minutes per day on average and have never smoked, I could only slightly improve my diet and alcohol intake. But now we know what to keep an eye on:

I have a higher chance of thrombosis
I have to be careful with certain drugs in the future because the probability of having serious side effects after taking them is high (e.g. statins for high cholesterol)
My chance for melanoma and basal cell carcinoma is very high, so I have to do an annual dermatology checkup
I also have to keep my BMI under 25 because I have a high genetic risk for obesity and insulin resistance

We meet twice a year if I have no issues. In the meantime, I keep on living a physically, mentally and emotionally active life and measure data. When something is different, I let her know.

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This is what primary care should look like globally. She doesn’t order a huge range of additional tests just because she could. We made all these decisions based on evidence. Moreover, she is eager to use the data I bring to the table.

Digital health at its best.

So, how could we help GPs to incorporate digital health into their everyday practice?

There are many factors that hinder the introduction of digital technologies on the most basic level of healthcare. As my GP said, the major nemesis is lack of time. Busy physicians find it difficult to incorporate into their everyday practice to work with digital information. Also, there is no separate allocated time to visit your doctor only for preventive visits. So, first of all, we need to make time and space for digital technologies in healthcare. She also mentioned another important factor, the compatibility issue. Medical programs used in the GP’s offices might not be compatible with the health trackers’ own software.

My GP agrees with me that in the last few years, there has been a growing interest in health prevention and active involvement in health from the patient’s side. It is not a surprise that there are already examples that patients are bringing their healthcare trackers or sensors to their medical professionals to check their data – and not the other way around.

Lifestyle medicine needs to become mainstream

You might not have heard of lifestyle medicine before now, this field is relatively new, and even its Wikipedia entry is far from being very extensive. However, it is a very important new way of practicing medicine. In layman’s terms, we could say that its goal is to support patients to live healthily as long as possible, focusing on prevention instead of treatments.

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The American College of Lifestyle Medicine (ACLM) initiated the steps to establish the standards shaping lifestyle medicine as a field of its own. ACLM defines it as “the evidence-based practice of helping individuals and families adopt and sustain healthy behaviors that affect health and quality of life”.

The field draws parallels to nutrition and dietetics but involves a more holistic approach. The ACLM describes six pillars of lifestyle medicine:

predominantly whole, plant-based nutrition, rich in fibres and nutrients
regular and consistent physical activity that can be maintained on a daily basis
recognising and coping with stress
avoiding substance abuse
ensuring quality sleep
social connectedness to ensure emotional resilience

For those healthcare professionals and students with an inclination toward technology, lifestyle medicine might be the area they are longing to specialise in. It’s one where they actively contribute to patients’ lives while using novel technologies for general healthcare purposes. If you are interested in lifestyle medicine, we introduced this field in more detail here.

21st-century doctors can have a hospital’s worth of diagnostics in their bags

The breathtaking development of portable diagnostics tools also supports the transformation of primary care. Digital stethoscopes, card-sized ECGs, portable ultrasounds, and portable vision tests – among others – make a thorough checkup a breeze, and you don’t have to leave your doctor’s office for it.

We listed 7 of these ultra-portable diagnostic tools in this article. So if we have all these amazing devices readily available, why don’t we see them everywhere?

Firstly, it’s simply because many aren’t aware of the existence of such devices. Doctors are often busy with their daily routine and keeping up with the latest research about what technologies like CRISPR can offer but don’t keep in touch with the technologies available right away. Some might even think that those devices aren’t for sale or are expensive. But in fact, they have been approved by regulatory bodies, are readily available on the market, and aren’t as expensive as their traditional counterparts.

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For instance, the EyeQue Personal Vision Tracker costs $35, less than a designer frame! The Littmann Master Cardiology stethoscope costs around $230 while the Eko Core Digital Stethoscope is priced at $330. These aren’t promotional adverts but mere comparisons and we’ll expect the price to go even lower as technology progresses.

Additionally, there still is a reluctance to adopt new technologies. Many think of these devices as the end of the art of practicing medicine, when in fact, they are present to help doctors build better relationships with their patients by getting faster results with more data. Such devices need adopters to make digital health a global reality and it would be better sooner than later.

Healthcare should be put in perspective on a systemic level

Doctors are traditionally trained to cure illnesses, Dr. Vernes says. I believe this attitude has to change, as technology is at our heels, and we need to keep pace with it. Also, my GP mentioned that the Hungarian system does not reward doctors’ efforts in preventive medicine. This phenomenon is a systemic problem and could be prevalent in other countries as well. She explained that the reimbursement is procedure or capita-based and not outcome-based. The healthcare system is not “thinking” in terms of prevention mostly because positive results only show after years or even decades on the population level.

Now, that’s the attitude we need to change. You cannot and should not think in the short term in healthcare, because the result will be the usual “firefighting”. We all have to think in perspective about the future of healthcare, and that future must come to terms with digital technology.

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Frequently Asked Questions

What does a holistic medicine doctor do?

A holistic medicine doctor treats patients holistically. They might use traditional techniques such as herbs or acupuncture, but they also integrate them into western medicine.

They aim to treat an illness rather than just treat symptoms. The patient should feel better following treatment.

The doctor should not only focus on curing the disease but also help prevent future illnesses.

“Holistic” is a term that refers all aspects of a person’s life.

What is Alternative Medicine and How Does It Work?

It is a healing approach that focuses on prevention instead of treating. It encourages people to be informed consumers and actively participate in improving their health.

Alternative medicine is any method of diagnosis and treatment that doesn’t use conventional (allopathic) medical methods.

What’s the Difference Between Naturopathic Medicine & Holistic Medicine.

The two main types of medicine are conventional medicine and complementary/alternative medicine. Conventional medicine is based on surgery and drugs as the primary treatment. Complementary/Alternative Medicine (CAM) uses natural therapies such as herbs, vitamins, acupuncture, and massage to treat illness and promote health. The CAM is not intended to be a replacement for conventional treatment. It is meant to assist patients who wish to have control over their own healthcare and choose what is best.

Naturopathy, on other hand, is used as a complement to conventional medical treatments. It treats the whole person, including mind and soul. There are many different forms of naturopathy, including Chinese Medicine, Ayurveda, Traditional Native American Medicine, and Functional Medicine.

It is important for you to know that some CAM modalities can overlap with conventional medicine. For example, herbal remedies can be prescribed by doctors and naturopaths alike. Naturopaths, however, tend to recommend lifestyle changes rather than prescription medication.

Naturopathy is often called “complementary” because it complements conventional medicine, not supplants it. Naturopaths may prescribe medication as needed.

There are some differences in naturopathic medicine from other CAM modalities.

Naturopaths are not qualified to prescribe or diagnose medication.
Naturopaths can refer patients to specialists and work with their family physician.
Naturopathic doctors are licensed by the provincial licensing boards. CAM practitioners, however, are self-regulated.
Naturopathy emphasizes prevention, wellness, and education about diet & exercise.
Naturopaths stress the importance of lifestyle factors. This includes nutrition, exercise and stress management.
Naturopharmacists are specialists in the use and treatment of specific conditions using botanicals and minerals.
Naturopodists are trained to provide individualized care based on each patient’s unique needs.
Regulators such as the College of Naturopathic Physicians of Ontario license Naturopaths.
Naturopatrists are licensed by provincial regulatory bodies.
The Canadian Association of Naturopathic Doctors has registered Naturopaticians.
The College of Naturopaths of British Columbia licenses Naturotherapists.
The United States National Board of Medical Examiners has licensed Naturobiotic Therapists.
The Australian Health Practitioner Regulation Agency licenses homeopaths.
Holistic refers to the belief in all aspects of one’s life, including spiritual, physical, and emotional. Holistic doctors will examine all aspects of your health, not just one.

What are the health benefits of complementary and alternate medicine?

Complementary and Alternative Medicine (CAM) refers to medical practices that are used by patients who do not feel they are receiving adequate care from allopathic medicine. These include herbal medicines and mind-body therapies, such as acupuncture or massage therapy, homeopathy (traditional Chinese medicine), chiropractic care, biofeedback and hypnosis. Many CAM practitioners use treatment methods that aren’t part of conventional medicine’s standard system of diagnosis and treatment. Many CAM therapies can also be integrated with elements of mainstream medicine. For example, some forms of acupuncture are performed with needles, while others involve acupressure or moxibustion with heat.

Some CAM therapies are effective in pain relief, stress management and relaxation. These CAM therapies can also increase your overall well-being and decrease fatigue. Some CAM therapies are used to treat specific conditions, including fibromyalgia. Other CAM therapies may simply be enjoyable experiences.

There is no definitive definition of CAM. However, most definitions include at a minimum one of the following:

An holistic view that considers body, mind and environment.
The belief in mind-body interaction and influence
The belief that illness results from an imbalance between the individual and his/her environment
It is important to treat the whole person, not just the symptoms.
Combination of Eastern philosophy with Western science
Integrating mind, body and spirit into treatment methods
Use natural products over synthetic chemicals
Touch of healing
Mindfulness
Meditation
Acupuncture
Yoga
Herbal remedies
Homeopathy
Chiropractic care
Massage therapy
Hypnotherapy
Spiritual healing
Biofeedback
Nutritional counseling
Energy healing

In addition to its potential benefits, there are risks associated with certain CAM therapies. Misuse of CAM therapies can lead to serious injury or even death. Some have side effects, which should be balanced against their perceived benefits. If you are considering using any CAM, discuss these issues with your doctor before deciding whether to try them.

Statistics

A 15-year systematic review published in 2022 on the global acceptance and use of CAM among medical specialists found the overall acceptance of CAM at 52% and the overall use at 45%. (en.wikipedia.org)
The use of alternative medicine in the US has increased, with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America. (en.wikipedia.org)
category.[111]Edzard Ernst characterized the evidence for many alternative techniques as weak, nonexistent, or negative and in 2011, published his estimate that about 7.4% were based on “sound evidence.” However, he believes that may be an overestimate. (en.wikipedia.org)
In the 17% in which they disagreed, a third reader agreed with one of the initial readers to set a rating. (en.wikipedia.org)
According to the World Health Organization, 80% of people use herbal medicine worldwide. (webmd.com)

External Links

How To

How do I deal with my girlfriend who trusts alternative medicine?

The internet advises those dealing with a loved one suffering from mental illness. However, there is very little information on alternative medicine and how to deal with them.

It appears that there is a large divide between the two groups. There are two types of people: those who doubt conventional medicine and those who are open to its benefits.

What happens when you come across someone who believes in alternative treatments for mental health issues?

You might feel confused and frustrated because you don’t know how to respond. You might feel confused and frustrated if your partner tells you that he’d rather see an acupuncturist than his physician. Or when he suggests to you that he would prefer to eat gluten-free foods than take antidepressants.

Asking questions is crucial. It could save you lots of heartache later.

But how do you ask these difficult questions without offending him? What if he says that he doesn’t trust doctors? Are you going to tell him to not trust anyone?

Or, what if she tells you that she believes antidepressants don’t work? Tell her that you don’t believe she’s right.

Here is where things get tricky. If you point out her error, it could cause you to upset her further.

Or, you can suggest she sees a psychiatrist. This could cause more problems than it solves. You might be angry with her for suggesting it. She might think you are trying to control her mind.

What should you do?

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If you or another person is suffering from a medical issue and you are concerned, consult your doctor or seek out other medical professional treatment as soon as possible. Do not disregard medical advice from a professional or delay seeking it due to information you seen on the blog or website or in any of the linked materials. If you’re experiencing an emergency medical situation, dial 911 or seek emergency medical assistance on the closest phone immediately.