Millennials want the same seamless digital experience in health care that they have in other aspects of their lives. At the same time, having grown up in an online world, they’re keenly aware of privacy risks. They ardently want healthcare providers to increase protection of their personal health information (PHI) and what they see as the often unguarded use of computers in health care. In this guest post, William Tanenbaum, co-chair of a technology transaction group at a law firm, and Randall Stempler, a member of the technology transaction group, draw on their interviews with millennials that reveal a major source of concern for many of them is the fragmented nature of the online systems they use.
Not all millennials have the same views on health care of course. This post focuses on general trends, and therefore references to millennials should be read as references to “many millennials” to take into account the variations. One prevailing conclusion is that millennials view themselves as both patients and consumers, and this will drive changes in online systems and other aspects of healthcare IT.
Reconciling millennial’s desire for a less fragmented digital experience with privacy expectations can be advanced through the use of artificial intelligence (AI) in healthcare IT. Millennials generally don’t yet feel compelled to have a single personal physician as the center of a hub-and-spoke model of medical care. They’re comfortable going to different doctors as medical needs arise. This means that PHI needs to be shared among healthcare providers who aren’t on the same internal network. Deciding which PHI will be transmitted and in which circumstances is challenging. Securing privacy in this framework means deciding who sees what and for what purpose.
This makes privacy contextual. “Contextual” answers the question of “who sees what for what purpose.” And this in turn depends on which subset of a patient’s PHI is needed by a specific provider for the specific medical issue or issues presented. For example, an ophthalmologist usually doesn’t need to see PHI that’s far removed from an eye exam, including a medical procedure that happened 10 years ago that may be embarrassing for the patient in this context. It will be very labor intensive for medical staff to review each patient’s PHI to determine which PHI to send.
This is an area where leading IT vendors believe software can fill this need. This will be the expansion of the use of AI in making the assessments in order to expeditiously handle a large volume of requests and escalating questions for physicians in cases where that’s needed.
AI is a tool, not a panacea. It’s not appropriate in all cases. AI makes rules-based decisions derived from past correlations. Patient symptoms which present novel problems or complex cases aren’t neatly governed by AI rules. Where it’s a new medical problem that requires medical innovation, then rules-based systems can guide but aren’t a substitute for experienced clinicians.
Fragmented online experience
A key issue in current healthcare IT is that millennials frequently find their online healthcare experience is fragmented. For example, they find they’re asked to submit the same information multiple times on hospital and doctor websites, and believe that the information should carry over from one system to another in related healthcare institutions. They also find, and dislike, that after submitting information electronically, they’re then asked to fill out paper forms asking for the same information when they arrive at the physician’s office, and that forms at the same doctor’s office ask for duplicate information on different forms. This goes beyond HIPAA requirements to the inefficiency in capturing medical information.
Moreover, millennials are concerned that data entry errors will occur when a nurse or other staff member keys in data from paper forms. They see improved electronic systems as a way to mitigate this risk, as well as introduce the more seamless interactions they have in more developed consumer-facing IT systems. Millennials will drive adding more functionality to hospital portals and the introduction of more user-friendly patient-facing interfaces on these systems. In important ways, these systems will be the face of the doctor’s office to millennials.
As with other generations, millennials also like to use online systems to make appointments, receive test results and reports, and provide communications channel with their doctors. A differentiator here may be the desire of millennials to use these portals to send and receive as many communications as possible through electronic systems. We can also expect to see a demand for smartphone apps to move online communications from the desktop to mobile devices, such as to change appointment times and handle more routine issues, and hospital IT systems will need to evolve to use this functionality.
Data security concerns
All this introduces data security concerns to which millennials are sensitive. Criminals pay more for PHI than credit card numbers because the first page of a medical chart is identity theft on a platter. Healthcare IT will improve portals used by hospitals and doctors, and will implement technology that introduces better privacy protection. Improved IT for data protection will result. That function will increase as criminals continue to attack hospitals.
Further, millennials believe that their privacy and sensitive medical information is at risk when providers leave it up on computer screens where it can be read by anyone who can see the screen. This is an issue that good technology hygiene can solve. On the other hand, millennials are probably more comfortable having their doctors type notes during an appointment, even if this means facing away from the patient. Millennials see this as adding efficiency to health care.
Millennials are empowered by IT to go public with their dissatisfaction. Many use websites such as Zocdocs and Ratemds as part of selecting their doctors and hospitals. They can write negative reviews on these sites, and non-medical sites such as Yelp, and this, in turn, influences others who use these reviews in making their medical choices. Here’s where medical professionals and millennial patients view medical treatment through different lenses. Many providers focus on the quality of medical treatments and not the inconveniences patients believe they endure when they see their doctor. For example, many reviews focus on waiting room times and indifferent or worse communications by office staff, as well as delays in communication. IT can reduce the inconvenience and help eliminate negative reviews.
Millennials will improve healthcare IT by driving the increased use of AI, eliminating fragmentation and adding functionality to patient-facing IT systems. This in return will reduce negative reviews, and help doctors and hospitals manage and improve their digital presence.
William Tanenbaum is co-chair of the Technology Transaction Group at Arent Fox LLP and leader of the firm’s healthcare IT practice. Randall Stempler is a member of the Technology Transaction Group.