What needs to happen to move the needle on secure provider-to-provider communication?
Patient privacy concerns over healthcare data are at an all time high. What most patients don’t realize is that each day, physicians use SMS — a decades old technology — which has no capacity to meet the security standards set out to govern PHI (protected health information.) SMS is the original protocol used to support texting, a phenomenon that has taken over interpersonal communication. Unlike other messaging platforms like iMessage and WhatsApp, SMS texting is ubiquitous and it’s the thing that allows people to send text messages to anyone regardless of whether that person uses an iPhone, Android, Blackberry, Nokia, or any other device. Just as texting changed communications in our everyday lives, it’s changed healthcare in positive ways. Texting has allowed quick consults and coordination that were impractical to have in person because of scheduling constraints while avoiding the interruption that comes with a phone call.
Since we all now know that doctors are people (and not some separate Olympian species), its obvious that they use text messaging to communicate in their personal lives and this is what has hindered the adoption and compliance of alternate “secure” texting platforms. Expecting someone to use one application in one context and another application with IDENTICAL utility in another context is more than impractical — it indicates a complete disregard for how people behave. The fact is that no degree of security or policy is going to overcome a person’s instinct for convenience.
So what is the solution? One answer is that secure communications platforms need to do more than standard texting with the same level of convenience that texting offers. And not just a little more. A lot more. Investor and entrepreneur Peter Thiel says that a solution needs to be 10X better to replace the status-quo and that’s a heavy lift when were talking about sending quick snippets of text. Better fonts and emoticons aren’t going to get us there.
To be 10X better, the utility of these platforms need to retain the convenience of texting but enhance care coordination. That means creating patient-centered channels that thread discussions based on who is being treated. It means expanding the text and photos supported today to include audio, voice and video chat. It means communication platforms that extend beyond institutional walled gardens and encompass the wide-spectrum of providers that are involved in 21st century care.
We need solutions which start with the PCP and specialists but extend to dietitians, nutritionists, psychologists, behavioral health specialists, social workers and, ultimately, the patient being treated. We need solutions that not only put the EHR in the hands of caregivers, but highlight the data most applicable to those specialties to increase the speed and efficiency of everyone’s work. We need solutions that offer diagnostic guidance and provide the capability to capture patient consent.
And of course, this all needs to be secure.
The 10X requirement isn’t an easy one to meet in most industries, but this case is special. Perhaps the greatest hope for a healthcare revolution is in its greatest weakness. Healthcare technology has been so overwhelmed in the adoption of EHRs for Meaningful Use requirements that it has fallen not just years but decades behind the rest of the tech world. The tools to do everything identified above not only already exist, but are widely used outside of healthcare. Look at companies like Asana, Slack, and Trello. Look at payment platforms like PayPal, Stripe, and Bitcoin. Solutions from companies like Palantir can mesh data into results in ways that border on magic. We have Google and we have Watson. We have the tools. So the real answer to the question “what needs to happen to move the needle on secure provider-to-provider communication?” isn’t a technical one. It’s an issue of will.
The global community of caregivers and patients need the will to adopt technology that already exists. Bold entrepreneurs need the will to build companies to enter the healthcare market with solutions built on these technologies. Investors need the will to finance these companies and we need politicians with the will to legislate for innovation. Mostly, as a society, we need the VISION that, although along the way there will be many failures and mistakes, we can have the worlds most amazing healthcare system… we just need the will to demand it.
