What if we could revolutionize patient care through digital health technology? Join us as we explore this fascinating topic with our guest Dipu Patel, the Vice Chair of Innovation at the Department of Physician and Assistance Studies at the University of Pittsburgh. Together, we unravel the potential of digital health technology to bridge social gaps in healthcare and discuss the importance of balancing technology and humanity.
From making doctor appointments to cross-pollination between different professions, we dive into the challenges and opportunities in creating a digital system that enhances the healthcare experience. Listen in as Dipu shares insights on improving digital literacy, adopting a consumer-focused approach, and fostering quality improvement initiatives to create better medical practices.
As we wrap up our conversation, we delve into the world of healthcare collaboration and design, emphasizing the need for a more human-centric approach. We discuss the widening digital divide and the need for leaders to champion better technology and collaboration between medical professionals and other industries. Don't miss this engaging episode, and join the discussion on how digital health technology can transform the future of patient care.
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Hello and welcome to Access Tech. I'm delighted that we're joined today by Dupu Patel, who is the Vice Chair of Innovation at the Department of Physicians and Assistance Studies at the University of Pittsburgh. Now, I'm amazed that I got that out all in one sentence. So welcome, Dupu. It's a real pleasure to have you with us. We've just been talking in the warm-up beforehand and you're doing some really interesting stuff, So perhaps you could tell us what that long-job title actually means and what it is that you actually do.Speaker 2:
Yes, it seems like a very broad title. Thank you, neil, for the kind introduction. Yeah, vice Chair of Innovation in the Department of PS Studies. I'm a professor in the DPS program, where the program focuses on quality improvement, and my specific focus is bringing digital health into the curriculum, and digital health is every kind of technology that pertains to patient care through that larger umbrella of telemedicine, wearables, apps, using your phone to provide care all of those pieces of technology and educating the next generation on how to use this technology in an incorporated. I'll stop there because I don't want to let go too much into it, because I think we're going to have a larger conversation about it, but I enjoy the job immensely. I really love engaging with this space and the people who are in it, because it's such an evolving space. Every day there's something new to them.Speaker 1:
Absolutely. Medicine has become so much more digitized over the last few years. There wasn't capability before to do digital or remote medicine, but the will has changed Through necessity, obviously through COVID, so people had to do it and that's really brought it to the fore that sometimes these services can be better. That said, sometimes there is that flow backwards into analogue health as people go back to in-person visits to their general practitioners and stuff like that. So I think we had a pendulum swing with COVID, which was really useful in terms of driving adoption of new technologies where there had been resistance, okay, and then we've had a bit of a swing back as people felt that they really needed to have those in-person services. But I'm interested because you're looking at more than just sort of dialing into the doctor here. You're thinking about user adoption of devices that might support people, support families, particularly the community that this podcast is interested in, the disability community and people who are acquiring disabilities to raise and so on. There's an awful lot of technology that might help, but that is also quite difficult or challenging for that cohort of individuals to adopt. So what are some of the things that you're looking at that are interesting and that you think have potential?Speaker 2:
Yeah, i think one of the interesting parts about digital health and I think you said it correctly is the adoption of these technologies, just the fact that the options are now visible to people when prior to COVID they weren't. It's not that the technology wasn't there prior to COVID, it's that now these options are available to patients And, as we are innovating in this space and learning more and launching more products, there are new apps and mobile devices and assistive devices that are coming to market at a much rapid pace than they were before COVID. So adoption, along with implementation, has been the driving force in this post COVID world. Now there are parts of it where, as you mentioned that, we saw an increase in telehealth and telemedicine use during COVID out of necessity, and there has been a little bit of a decrease on that. But I do think that patients and consumers want it And I think there's a definite need for it to be viable and sustainable in the long run, because it has the potential to really democratize the social gaps that we have in healthcare and addressing those on a long term basis. When we talk about things like social determinants of health, we are now starting to talk about digital determinants of health, those things about digital health, literacy. How do I use my phone, how do I access the internet? how do I provide information in bite-sized pieces so that I can educate the patient. All of these things are kind of encompassing this larger issue of adoption and implementation. So we're at the very beginning of this, where we haven't even reached the peak. So I am very, very excited to be on the upswing of this roller coaster that we're going to be on, and I will say it does come with some challenges. Right, we definitely have. I'm a big believer of technology, but I'm also a big believer of humans in the loop. right, technology needs to be partnered with humans, especially in healthcare, because a bot doesn't have the subjectivity piece as a human would. We do need to balance the technology and everything that it harnesses with the moral and ethical values of we as humans, as a species and then, of course, as a culture that we have. So it's really important that we find that balance, and I think that's the wonderful thing about this dynamic space that we're in is that those conversations are being had right now And we are actively engaging with these terms and we're actively talking about what is right for humanity, and that's the wonderful thing about this space.Speaker 3:
So if someone starts their studies to become a doctor today, in different parts of the world, they might encounter different challenges and they might find that they go into a profession or to a course that still has a very traditional approach into education. So, with technology all around, how can a young person going into the profession is able to at same time follow the path to become a doctor while at the side keeps the pace with that technology, because sometimes that knowledge might have to be acquired outside the natural route to become a doctor. How do you see that challenge?Speaker 2:
I see that at twofold and I'm smiling because part of it is that I have my children teaching me about technology that came out last week or two weeks ago and how to use it. I still don't know how to use all the features of TikTok and whatever, and I smile because I approach this from multiple lenses first as a clinician, second as an educator, third as a consumer and perhaps fourth as a parent. So there are a lot of ways to think about it And one of the things that I, when I teach, is that we need to teach this generation. But in order for us to be able to do that, i need to educate myself in this space before I can pay that forward in terms of knowledge. So part of my motivation and passion in this space is that I'm learning something new And as PAs, we are ingrained to be lifelong learners And I would argue that that's true for all healthcare professionals, that we constantly are looking to learn, and I think learning this space has been really, really rewarding and learning new things to teach the students, to say, think of it this way. And it's what I really like about the DPAS program, because our focus is on quality improvement And quality improvement doesn't stop right. When you do that one project, you move on to the next iterative step on that ladder or on that fishbone diagram, as we use them. But and when I look at it from a clinician lens for me it's what can I do to make the patient experience better? How can I make it easier for the patient to understand what their disease process is? So to your question, antonio, about what are we doing to prepare the next, like how does a student who is considering going to med school or PA school what are they learning? I think they're learning innately And I think our K through 12 education system is really teaching us how to adapt at a higher educational level to these students. In fact, i just learned of an assignment that my son and daughter got last week And I'm like oh, how can I use this to teach my doctorate level students? And so there's gonna be a little bit of give and take because I think our my generation of faculty, who are either in this space or learning this space, we're gonna have to learn it on an expedited basis in order for us to teach the current students we have. But by the time my kids, who are teenagers right now, go into college we'll probably have a pretty robust faculty to who will know this space. But we'll have to continue to iteratively learn this space And my kids are gonna teach their professors a few things as we learn. Because you know, i akin the space that we're in right now, the feeling that I get around it is. I remember and I don't wanna age anyone here, but I remember when the internet first came out And my mind was blown, that feeling of like you want me to put this in here and then it'll tell me everything I need to. I don't remember seven or four. Right, and I think, with AI or the chat key, which has really taken the world by storm here. these are the things that really make me optimistic. We do have some work to do around ethical Parameters and put some guardrails around it, but I think when I, when I speak to health care, the health care space and this sort of technology, i am really optimistic because there is much that needs to be done. Oh yeah, the health care space.Speaker 4:
I Totally agree and I loved interviewing you on my other show. You just, i remember hearing you speak And it was with a group of people and I don't even remember where we met and I was blown away by you. And then you, i interviewed you on my show and I thought, see, you are the future. But this is also so complicated. I know we talked a few minutes before we got on air and and Tony, who actually brought up some really good then I'm gonna also go here. But There's so many things that we have to do to get this right and I know that we as a world learned so much from COVID and Certainly our health care professionals did. God bless them all for what they walked. And then, of course, we have this wonderful Long COVID that our health care is trying to figure out what's going on with that and that's really frightening. I of course many of the audience members now just walked a really hard journey with my beautiful husband with dementia. That Journey for the family and the individual and the health care professionals that supported us, it is the most intense thing I've ever walked, and to think that so many more families are now going to have to walk That because a COVID, you know, hurts my heart a bit, but I Really liked what was that we were talking about before we went on air and Antonio and Neil I'm totally stealing from them, but when we were talking about and I'm using Neil was mentioning PTSD, that was done for the banks. Nope, did it wrong right away.Speaker 1:
PSD to, which is the set of regulations which allow portability of.Speaker 4:
Which is a good thing. I just said that I stole that from Everything's about inclusion, so I'm sorry. So what, neil? Why don't you talk about that bit PSD, the revolution with the banks and how that right?Speaker 1:
Yeah, it's a second revolution. So the idea is to To. People got locked into their bank accounts and people get locked into health care providers too. Sometimes, and Because it was really hard to actually move their data, there was lots of friction builds into the systems That would prevent people from moving because it's hard work and and so what this would allow. The regulations meant that they forced the banks and this is European regulation, it's forced banks to to basically Make that data available to other banks with the permission of the user, so you could basically have a bank account with one bank and another bank account with another, and if you like the The, the app of bank to more than you liked it with bank one, you could choose to use the data from your bank account in bank one in the app of bank two, and so that that portability of data meant that you You could choose where you wanted it and you could also move stuff around much more easily. It made it easier to move bank accounts, it made it easier to you know, have access to information about your money, and so the same kind of interoperability Regulations could be applied to health care, which would mean that people can Use the tools that they're familiar with, that they're comfortable with to access their health data to interact with other things, and it also means is it's a much easier system Once you give permissions for people to build new services upon, and those services that you you can then do, you know, might revolutionize how we care for people, might make a lot easier because you know at the other moment you, despite the sort of The stuff that has happened in telehealth and telemism, the systems are still pretty crappy and and and I just today signed up for a new GP because I moved and I got forced to leave my old GPS eventually and they were gonna chuck me up. General practitioner.Speaker 4:
So we don't know, like me.Speaker 1:
So I had to sign into a new local doctors and you know the websites are horrible And and and they're counter-intuitive. They use language, that is yes, so they're not cognitively accessible, they're not technically accessible. They Presume that you know how to use stuff. They were a mixture of metaphor and garbage, sort of You know. So they've kind of done things like like a digital waiting room and There's there's no real signposting or flow of how to get to various services. Sorry, ranting a bit, but, but these kind of things can be resolved if you allow people to take their data and move it about easily. So I think this is where people was saying the interoperability is really important. But that was a very long, ranty explanation of PTSD 43. Using the really bad digital systems, and you know if I can't use them and I work in it Right right Or our less digitally literate population. you know, not only are they sort of digitally excluded, they're socially excluded, they're medically excluded, and these are the social determinants of health that you were talking about before.Speaker 2:
Yes, i was about to say you have very nicely summarized all the aspects of digital determinants of health that I was talking about Earlier, actually, and I will just say one of the things in in healthcare that A lot of healthcare systems, even the ones that are patient facing or consumer facing, are not designed for the patient in mind. They're designed with either the provider or the payer in mind, right, this is where I see an opportunity for cross industry collaborations to happen outside of healthcare, and one of the things I teach my students is that there is much to be learned from other industries with healthcare, and it's part of quality improvement that you kind of think outside the box in terms of the solutions that you're proposing. So a very simple point that you made me about how making an appointment was such a nightmare because navigating that website was not intuitive for you. Someone who works in the space knows where the buttons should generally be located on a screen And it's not easy to find. Why in this day and age, can we not create a system where you can make appointments, patients can make appointments very easily And some problems to have started having this now and not and are getting better at it. But I'll tell you the reason they are awful is because we're still very new to this And also we just have recently had consumers expect this of us And we don't think that making an appointment with your GP should be a pleasant experience. It should be. Why shouldn't it be? That's the simple first touch point as a customer. You have to come back to this.Speaker 1:
I have to come back to this Because essentially what I was going to say was that these digital systems that they've made are just literally digitizing the crappy analog system that they already had. So it was always crap getting an appointment at the doctors. You'd have to hang on the phone or you'd be in a queue and there'd be vomiting babies and farting old people And it'd be a time that wasn't inconvenient. And then they'd be like I don't know, i don't know, i don't know, i don't know, i don't know. It'd be a time that wasn't inconvenient. And then they digitized it and get this right. You have the opportunity to run a. So they run the website 24 seven, but you can only make an appointment via the website ensuring their office hours? Yeah, Why, why can you not use a digital system to take that load off the bookings? It doesn't matter that you can set a parameter. This is, you know it's. it blows my mind that I think a lot of it just goes we're not open, we're closed now. That shouldn't matter.Speaker 2:
It just goes to show you that a lot of people especially the newer implementations of this were have basically said here's how we do it on paper And then we're just gonna put it online. We're going to do the same thing online And it's not the same right. And also, we have lived in this digital world for now well over 25, 30 years. I would say that most people know how to navigate a basic website not everyone, of course. There are, but the my point is that, even if you know it, or you don't know it, why is there not a education around that right? This speaks to digital health, digital literacy period. Forget the health part right now, because that's where we're going to come to that. But how? what are we doing to say, you know, like I'm probably in that my in terms of ages and whatever, i'm in that sweet spot of ages where it's like it's moving so quickly that I need to really stay on top of it to keep up with the technology. But if you think of the like my parents, who don't know, you know, if you move the send button from the top right to the bottom right, it just changes everything for them And that's a huge thing for them. So why are we not spending our time educating patients on this and making things easier for them? It is really about and I think part of it is because healthcare systems have never had to think about consumer experience. They see patients, but they forget that patients are consumers of care, and so if you approach a solution or a problem with a solution through the consumer lens rather than a patient lens first, then your user design and that experience was is going to be much, much more thoughtful, with more of a human element to it. And I think you're right, because I've tried to make appointments online and they're they're awful, they're awful.Speaker 4:
No, we don't do this We. I'm sorry, antonio, i know you have a question, but I just want to say we know how to do this. We went through this when we first started the internet. We else we learned not to just take old tarred presentations and put them online. That's not. We know how to do this. Over to you, antonio.Speaker 3:
But no, if I look to some of conferences in the space of healthcare that are taking place around me, the only people that I see there are doctors. So there's no cross pollination between expertise and professions. Yes, so everyone is comfortable in, oh in having that website where booking can only be done from nine to five because you are in the kind of a group thinking there's nobody, there's no patients there to challenge that. So how can we improve the cross pollination through different professionals to actually improve the medical practice?Speaker 2:
I think part of it is what what we're doing in the program that I teach in right focusing on quality improvement, consumer experience improvement and really looking at what are the small changes that we can make that have huge impact across the system And I can certainly speak to. We just graduated our first cohort in in the program And there was one person's project that she changed one thing. It was just about educating the clinician on one preventive measure screening. Just say, put this, just think about this and see if your patient needs it. Right, that one change in the system, like just saying I'm going to teach you about it and then I want you to think about it. This was to clinicians and where she worked. We have 600 families. Just a screening. We don't even have it. We haven't even gotten to a diagnosis yet. Right? And to go back to Neil's point around earlier where he was saying there's so much that we can do to improve that experience, this will also improve cost, because we all know that cost and health care are skyrocketing And no matter. You know, what has happened is that we've gotten used to throwing solutions that are band-aids And we're not fixing the system on a holistic level. Now, each system. Each country has its own system. We have a single payer in the UK. There's in the States. It's a different system. Eu is another system within a system. right Like so. There's lots of other ways to do it, but this is a solvable problem. It's a matter of will, because the people are there, people want it, the technology is there And, i think, covid. If there is a silver lining from the mess and the horror of COVID, this might be it in health care Is that we are now finally having these conversations to change our habits and change our thinking, and that it's not scary or sometimes it is scary, but we need to have a conversation so we can improve care for all of us involved. And, by the way, i'm a consumer of care, as are all of you, and we all have those horrible experiences in health care, and most of which I will tell you. When patients complain, they complain because they didn't feel, seen or heard It, oftentimes not about the care. Right, it's not that I didn't get the antibiotic. I mean, there's a little bit of that, but like I didn't get the, i went in for this and I wanted this and I didn't get it. It's more about how you made them feel and whether they felt heard about their complaints.Speaker 4:
And I will also say that it just seems unnecessarily complicated. Yeah, i knew that. We were told oh good, we have a little puppy joining. Sorry, my fur babies are. That's something we learned during COVID is that people have lives And sometimes we have dogs and children. And yeah, they have lives. So hello to your puppy. But I think it's such a mess Like, for example and I'll do a rant like Neil did My daughter with Down syndrome. She's really struggled with her weight since she had a medical emergency And there is actually a drug that has been approved that would be very good for her. My doctor, her doctor, has written this up a thousand ways to get the insurance company to approve and the insurance company keeps denying it And things like that make me so mad because I don't go to the doctor to talk to the stupid insurance company. So here in the States and I know it's not just in the States, but it is such a mess We do not control our health records as individuals, we do not get to have a say, we don't get to have the prescriptions that are actually going to help us, and I realize once again we can just go on a total complaint session here. Also, the medical profession. I'm going to say this is not just about doctors. We appreciate you doctors, but there are so many more professions in the medical profession field that we just ignore that we need in all this. So I think all this mess is just widening our digital divide And we have to have the will, as you said, to really stop stack and crap on the old technology. It doesn't work. Medical professionals, please come into join these conversations the rest of the world is having And we need leaders like you, which is why, once again, i'm so impressed with your work And we need leaders like we are here on Access Chat talking about these topics, because it seems you have these isolated conversations where only the doctors get to say what they think.Speaker 2:
Well, yeah, and I will just say and thank you, deborah, for pointing out that medicine is a team sport And I think patients need to. You're right. We always use the term doctor Sometimes it's used generally for all healthcare providers, but it really is. Every profession that is in healthcare adds value to the patient who is in front of them, and we all bring a certain level of expertise, knowledge and life experiences with us to provide the best care. Doctors are absolutely part of this ecosystem, but so are PAs and MPs and PTs and OTs and social workers and mental health workers. God bless the mental health workers. We need more of them. Really, there is a lot of When we were in the hospital for months.Speaker 4:
Yeah, the people that came into my daughter's room to help that never get acknowledged. And what I started doing was I just started taking names And every time somebody was kind to us And when we left that I wrote a letter to the CEO of HCA and said let me tell you who was involved in my daughter's care and how much we appreciate the people that would let us into the hospital when it wasn't open up. They would. There are so many people, there's so many positions and any of these positions, if they're not taken seriously, we all lose. So I just want to.Speaker 2:
And I think that that mindset of the traditional set of medicine where the position is at the top and the hierarchy of what it is changing Traditions take time to kind of evolve and shift in their thinking And I do think it has changed for the better. Is there work to be done? Absolutely. Is there more collaboration that needs to happen? Yes, but I'm saying not only is there a need to be collaboration within the health care community and the professions, but I'm saying I want to talk to the guy who runs the manufacturing plant. I want to talk to the guy who runs the consumer user design experience, because there are lessons to be learned from all of these aspects. I want to talk to the engineer who is designing the EHR or the appointment booking software. There should be just as much as the engineer is designing this. The clinician should be there. The patient should be at the table providing their input. I mean we all know that certain colors speak better to the human eye and are more warm and welcoming than other colors are. I mean companies put millions of dollars into designing their logos and copyrighting the color and all of that. Why are we doing that in health care? It's the most human of all industries. We should be doing that Right.Speaker 1:
Yeah, absolutely. This is such a fascinating conversation. We could go on for hours. We definitely do need to have you back, but we have reached the end of our time, which is a real shame, because I know that we've got more questions to ask. So thank you, tihu. We also need to thank Amazon and my great techs for keeping this caption and keeping us on air. We look forward to continuing the discussions on Twitter. It's been a fascinating chat. Thank you so much.Speaker 2:
Thank you so much. I really appreciate it.