Producing a ''WOW'' Effect with Digital Health

By Prof K. GANAPATHY

Technology enabled remote healthcare or Telehealth, is a major component of digital health. In this communication an attempt is made to discuss, what is seldom discussed in digital health – how to produce “customer delight”.

The last few years have witnessed an exponential, radical transformation in the digital delivery of healthcare. Some clinicians of the 20th century are concerned, that increasing digitisation could affect the centuries old, sacrosanct, doctor patient relationship. Nothing, can be farther from the truth. Imagine if a virtual personal touch is added, while deploying AI enabled peripheral medical devices and customized personalized software!

Yesterday, the emphasis was on excellent disease management. Today, it is on preventive healthcare and very early diagnosis. Tomorrow, it will be on keeping people healthy and promoting wellness–the eWay. I am optimistic that digital health will eventually help reduce physical footfalls to brick and mortar hospitals! (hospital CEOs will have no problem, as procedure related admissions will increase!)

The emphasis today is on technology. Digital doctors are becoming experts in deploying ICT (Information Communication Technology), handling connectivity issues, video conferencing systems, apps on smartphones, digital manipulation (pun intended!) UPI, EMR, PHR, HIS etc.

Studying AI, they are already becoming future ready. These super smart young doctors need to remember that technology is only a means to an end and not an end by itself. A fool with a tool is still a fool! SoP’s and protocols are at best, guidelines. In healthcare one size does not fit all. We need to cater to the specific wants and needs of the individual beneficiary, whom we are seeing on a screen. The smart screen could be 10cms or 180cms.

We need to get into the mind of the beneficiary. Building patient rapport, confidence and trust is vital in a teleconsultation. 5G, 200 Mbps bandwidth, user friendly intuitive software at both ends, real time access to all relevant medical records, super smartphones or giant screens will certainly help, in making the experience of a virtual personal touch, truly memorable. Customer delight will not or should not be, the prerogative of virtual shoppers.

However, infrastructure alone will not suffice. Communication is a dynamic, complex process, a multi-dimensional, multi-factorial phenomenon closely related to the environment in which an individual’s experiences are shared. Self learning chatbots and humanoids competing with humans, to display empathy and sympathy’ perhaps maybe available in the foreseeable future - only if the powers-that-be give appropriate weightage to this.

Healthcare is personal. To get 10/10, those treating you from a distance must introduce themselves, make eye contact and communicate what they are doing and why. Recommending cutting-edge, technologically advanced treatment alone, in a teleconsult is insufficient. Patient’s goals and requirements also needs to be factored. Patients do not care how much you know. They want to know how much you care. 80% of communication is nonverbal, through body posture, voice intonation, the way one looks/sits, attire used, movement of hands and arms and spontaneous smiling.

A meta-analysis of publications on Digital Health showed that the top 100 papers received 49,653 citations. The analysis confirmed that introduction of digital technologies in healthcare improves access to medical services and their quality, optimizes use of healthcare resources and improves patient safety.

Interestingly. while many diseases and health conditions were discussed in these publications, analysis of authors keywords did not reveal a single article on importance of good doctor patient relationship in a virtual teleconsult.  Even in the global strategy on digital health for 2020–2025 released by WHO, this was not emphasized. The few papers stressing the importance of “webside” manners with the traditional “bedside” manners have rarely been cited.

Exercising clinical judgement and clinical wisdom contextually, customized for the individual beneficiary, in every single teleconsult, would probably convert tens of thousands of beneficiaries to be evangelists par excellence, to promote digital health. I am convinced (the sceptic would ask for evidence, which I do not have!) that a converted patient would indeed offer close competition to digital marketing tools and the Social Media, in bringing digital health centre stage.

The National Health Mission, Govt of Tamil Nadu has formed patient support groups. This is a community-based intervention to promote compliance and adherence. Proliferation of scores of patient support and advocacy groups pan India covering common and the rarest of the rare diseases, clearly indicates that ultimately every healthcare modality, should be patient-centric, for it to be successful. Digital health enthusiasts – are you listening ? wake up! This could be the Midas Stone which all of us are waiting for! Ensure that the healthcare provider using your fantabulous tools listens, listens , listens to the patient – talks to him for 200 seconds before bombarding him with links galore!

The unbelievable progress of digital health globally and particularly in India (one wag opined that AI stands for And India, Always India, Anytime India) should be supplemented with what a doctor has always stood for – "To cure sometimes, to relieve often, and to comfort always”.

In my lifetime using Haptic technology, I may perhaps be able to actually wipe the tears off my patient, in another continent virtually. I need to understand that even for Gen Alpha born in the digital health era, a comforting word will still make all the difference. This may not necessarily be included in a CDS or come up as a pop screen on the display. This must come spontaneously from the heart!!

Today, distance is meaningless. Geography has become history! If only the term digital health or DH could be renamed CCDH (Compassionate, Caring Digital Health) the planet in the post DH era would be a still better.

Additional Tips to Produce a Wow Effect During a Teleconsultation

Above are the two examples of teleconsultations with very limited technology 20 and 22 years ago

Happy reading to our steadily increasing number of readers. Please feel free to send your bouquets and brickbats to  📧 ganapathy@digitalhealthnews.com