Technology has been a part of healthcare for quite a long time, with an increasing presence following the implementation of the Electronic Health Record (EHR). However, the adoption of telemedicine and telehealth has been slow with many barriers put in place by regulations, laws, and reimbursement issues. The adoption of working remotely has also long been met with resistance from management who were concerned about losing control. This all seemed to be the likely future of technology until COVID-19.
A Pandemic as a Forcing Function
Who could have imagined that one of the silver linings of this pandemic would be the rapid removals of barriers to telemedicine and working from home? In a recent webinar hosted by the Institute for Healthcare Improvement (the IHI), president emeritus and senior fellow at IHI and former administrator of the Centers for Medicare & Medicaid Services, Dr. Don Berwick, exclaimed, “As far as telemedicine goes, we can’t put this genie back in the bottle!”
When I asked my good friend, Tom Dahlborg, President of Dahlborg HealthCARING Leadership Group and author of a new book (see below), what he saw as the positives coming out of this new landscape in healthcare, he cited many. “This allows for individualized patient care. It also increases access to care, even specialty care, in remote, rural locations.” In a webinar I watched on Telepsych, one psychiatrist has not seen one of her patients in-person in over ten years. She described the huge benefits to those who would normally have to travel long distances for therapy and counseling, but also for those patients suffering from debilitating anxiety and agoraphobia. Tom added a caution that this expanded use of technology shouldn’t be assumed to be a replacement for in-person healthcare visits, emphasizing, “Both…. And.”
Changing the Where and the Way We Work
In a response to the pandemic, many organizations went to all or a majority of their employees working remotely. (And our gratitude to the many essential workers who continue to put themselves in harm’s way by performing their services!) Tom advised, “This is an amazing opportunity for us – managers and their employees both – to go into the inquiry mode. What’s working? What isn’t? And this needs to be a discussion with each employee to personalize the experience. And it includes exploring how the employees relate to each other in the absence of informal communications around the water cooler or in the employee break room.” I shared some “better” practices that I’ve picked up from some webinars. Encourage the team, including the manager, to have one after-hours virtual “get together” where they don’t discuss work. Alternate that with one for just the employees minus the manager. Or schedule a virtual coffee break during the day. We recently participated with my brother and sister-in-law on an AARP virtual game of Trivial Pursuit against another team. The use of virtual “breakout rooms” allowed each team to communicate with the other members to agree on the responses. (Not that we’re competitive at all, but our team won!)
Overcoming the Concerning Aspects of Technology
The loss of physical connections and a human touch can affect any of us, but nowhere has this been more devastating than in long-term care where centers have either voluntarily or through mandate eliminated in-person visits, communal activities, and even hugs from caregivers. As many of us ramped up our technological prowess, many seniors – especially those with cognitive impairment – were left feeling confused and isolated. The long-term care industry adopted a term usually associated with infants, “Failure to Thrive Syndrome,” as residents began to experience significant depression and serious weight loss. Prior to the pandemic, many nursing homes reached out to teens in their local communities to serve as IT Navigators to help the residents master the basic elements of Skype, FaceTime, and other applications allowing for virtual communication. However, with in-person visits being severely limited (if allowed at all) and caregivers stretched even more thin, the residents often find themselves alone in their rooms with no contact with families and friends.
As we begin to get control of this virus, we need to consider both the blessings and the curses of technology and plan accordingly.