The Wall Street Journal (WSJ) recently featured a report on healthcare tech. It discussed the so-called obvious and non-obvious, including developments in telemedicine spurred by COVID-19 and whether AI can replace human therapists. For the latter, there is a long road ahead — the WSJ notes that diagnoses and treatment in mental health implicate complex nuances that are not (yet) within the grasp of AI. But other realms of healthcare, including physical, occupational, and speech therapy, as well as what we often consider “ordinary” patient/physician interactions, are squarely within the growing interest and acceptance among telemedicine users.
Telemedicine numbers reported by the WSJ are remarkable: in 2019, the Cleveland Clinic conducted 37,000 telemedicine visits; in 2020, 1.2 million. Nearly three-quarters of telehealth appointments are shorter than 15 minutes. This might not seem like a tremendous gain over the 62% of “in-person” visits that are less than 15 minutes, but then consider that a telehealth appointment does not come with a long wait in the doctor’s waiting room, or (especially in rural areas) a long trip to the office itself. Last month, NTCA urged the Federal Communications Commission to include rurality as a metric when evaluating applications for COVID-19 Telehealth Program funding.
And, yet, encouraging data also implicates the need for attention to the “human” side of telehealth. For example, as the WSJ explores, a patient in a physical waiting room is within view and earshot of a receptionist. In contrast, a virtual waiting room can benefit from some type of indicator or interaction that assures the patient that s/he is in queue. Likewise, doctors are reminded to tell patients that if seems that they are not making eye contact, it is because they are looking at the patient on-screen, rather than at the camera.
These “human” adjustments can benefit the technical (or clinical) side of healthcare by making telemedicine more welcoming and thus more acceptable to the patient. To be sure, technology is still learning where telemedicine is clinically effective, and where it is not. Can a patient demonstrate range of motion in a shoulder for a post-surgical consult? Yes. Can a dermatologist examine a patient’s scalp? That is a less-certain proposition, because (1) the patient may have difficulty manipulating a camera to the right spot, and (2) smartphone cameras are trained to focus on hair, not the skin beneath. And some aspects straddle both the technical and the human sides of the telemedicine experience. Is the interface intuitive to those who may not use technology on a regular basis, such as the elderly? How can telemedicine ensure that it is accessible to persons with disabilities? These questions will loom as broader conversations about digital equity and inclusion emerge.
A report from Ericsson offers encouraging data about broadband adoption among the elderly: internet usage has increased. This is an important step toward closing the digital divide in elderly populations. That divide is closing organically, as adopters who were middle-aged 20 years ago are now the so-called “young old” (in other words, people don’t stop using the internet when they turn 65). But digital inclusion efforts should still include the elderly and include among its metrics populations who stand to benefit from greater telemedicine adoption. And these must include not only measures to extend deployment and affordability, but literacy, as well. With literacy comes familiarity; with familiarity, a greater sense of a comfort and accessibility.
These lessons are not restricted to telemedicine. Retailers are learning the importance of creating a human experience, even in a world soldiered by bots. Technology can enhance productivity, open efficiencies, and improve outcomes, but accommodating the human need alongside the technical requirement will facilitate a greater realization of these benefits. We see these efforts among locally operated rural broadband providers who facilitate digital literacy courses for the elderly, connect remote students, and collaborate with local healthcare systems, connecting technical proficiency with the human touch.
I am encouraged to share at this point Whitman’s “The Learn’d Astronomer.” Although not directly on-point, it offers an analogous perspective to the need to balance the human and clinical sides of our endeavors. Addressing those aspects in tandem will ensure that the technical functions meet the human needs, and that the human users will embrace the technology.
When I heard the learn’d astronomer,
When the proofs, the figures, were ranged in columns before me,
When I was shown the charts and diagrams, to add, divide, and measure them,
When I sitting heard the astronomer where he lectured with much applause in the lecture-room,
How soon unaccountable I became tired and sick,
Till rising and gliding out I wander’d off by myself,
In the mystical moist night-air, and from time to time,
Look’d up in perfect silence at the stars.
