Medical technology development requires physician input

Physicians have access to many digital tools that can enhance care delivery. But identifying the technology that makes care more efficient and building new tools that are based on physician perspectives from the start are critical to developing a digital practice environment that works for physicians and patients, AMA Executive Vice President and CEO James L. Madara, MD, said in his address at the 2016 AMA Annual Meeting.

“Today … we have really remarkable tools,” Dr. Madara said, “robotic surgery, new forms of radiation therapy, emerging biologics. And we live in a time of rapid development in the digital world.”

“But you know something, appearing in disguise among these positive products are other digital so-called advancements that don’t have an appropriate evidence base … or that just don’t work well or that actually impede care, confuse patients and waste our time,” he said, “from ineffective electronic health records (EHR) to an explosion of direct-to-consumer digital health products to apps, some of which are of poor quality.”

Even digital products that might otherwise be helpful often lack a way of enriching the patient-physician relationship, Dr. Madara said. This environment is “something I might  call our digital dystopia.”

Digital tools can be useful and hold the potential for magnificence, he said, but physicians today are tasked with separating the useful from the harmful by “inserting ourselves into the processes from which digital tools emanate.”

“[A] more promising digital future can be envisioned that enhances the physician-patient relationship, produces better and more efficient care,  and allows more time for physician-patient interactions,” Dr. Madara said. “We need to be directly involved to make it happen.”

Dr. Madara gave three examples of how physicians are actively pursuing the development of new products that are informed by “the granular understanding of the physician-patient environment” that only physicians can bring to the table:

• Incubating ideas at MATTER. “We’re forming interactions with the emerging companies that produce health-related goods and services,” Dr. Madara said. For example, at MATTER, the Chicago-based incubator for emerging health care companies, the AMA has created a space where physicians can inform entrepreneurs of their needs at the creation of innovative ideas. “We do much better if new products and services are deeply informed by our actual problems and needs,” he said. This way, ideas are developed with those needs in mind and are much closer to implementation from the start, rather than requiring redesign to fit physician needs after the fact.  
• Prototyping tools at Health 2047. “In January, we launched an innovation studio in Silicon Valley called Health 2047,” Dr. Madara said. Health 2047 takes many of the problems identified by AMA studies and applies rapid prototyping and design to achieve tools based on practice and patient needs. “Emerging prototypes will be iterated with physicians until the tool gets it right,” he said. “This effort is attracting high-level talent in Silicon Valley.” “Digital tools that would simplify and better organize our lives and adapt to the natural variations in our practices … would free more time for patient interactions,” he said. “That’s what we want.” 
• Transforming practices. “While shaping the future, we also need to address the current state,” Dr. Madara said. This includes identifying work flow and practice adjustments that can produce higher professional satisfaction. “Digital modules, which we call STEPS Forward™,” he said, “are available to all physicians.” Since its announcement last year, more than 70,000 users have accessed these practice improvement strategies. New modules are being produced and tested, and the Centers for Medicare & Medicaid Services has recognized them as a form by which physicians can be acknowledged for practice improvement under the Medicare Access and CHIP Reauthorization Act. “The future is not about eliminating physicians,” Dr. Madara said, “it’s about leveraging physicians by providing digital and other tools that work like they do in virtually all other industries—making our environments more supportive, providing the data we actually need in an organized and efficient way, and saving time so we can spend more of it with our patients.”