Comment: Democratisation without compromising care

The large-scale adoption of telemedicine and the advent of artificial intelligence in healthcare have some of us very excited. These recent developments may be the very keys we’ve been searching for to unlock that holy grail of healthcare: democratisation.

What’s going right

Let’s check off some of the keys we’re holding. Today’s technologies:

• Offer patients and providers greater access to information while keeping it secure, despite the efforts of some bad actors.
• Enable the use of data in an intelligent way, enhancing our decision-making capabilities and enabling prediction and prevention.
• Extend and expand care, making it more available and accessible to underserved communities.
• Build engagement and empowerment in patients and increasingly make them our primary focus.

I don’t want to downplay this: there is so much to be gained by continuing down the path of healthcare innovation and democratization.

Likewise, I don’t want to downplay the very real possibility of these keys being misused to open a veritable Pandora’s box.

What could go wrong

Innovation has the potential to make the healthcare system more positive and effective for patients, but it could also lead to the compromise of high-quality data and compassionate care.

Let’s look again at our keys to see what we know so far:

• Sharing information inherently leads to less personal privacy, and while healthcare organizations try their hardest to keep data secure, bad actors are occasionally successful in stealing, selling, and misusing information. This leads to less trust in the system and its data.
• Artificial intelligence and machine learning don’t doubt their conclusions. We know that an AI fed enough of its own outputs may return nonsense. Mischaracterized and wrong information isn’t useful for decision-making, and again, erodes trust in the system.
• The technologies that extend care can also introduce more barriers to care. Digital illiteracy, a lack of Internet access, and resistance to change could exacerbate disparities instead of minimizing them.
• Compromising data and care quality diminishes trust and pushes patients further away from the care they need.

The master key

So, where do we go from here? How do we continue to democratize healthcare while refusing to compromise on the quality of that care?

We have one more key, and it’s the master key: We empower healthcare experts to lead the way.

No one is better positioned than our doctors, nurses, allied health professionals, etc. to effectively introduce and employ these technologies in their communities—and no one is better suited to their critique.

One example

I am the founder of TeleScan. Our software is the piece of the prenatal care puzzle that connects local providers with sonographers who are the best of the best. (I mean this literally. Our sonographers are among the most highly credentialed in the nation for the OB/GYN modality.)

When we first introduced TeleScan to the sonography community, there was a lot of resistance. Of all the misgivings I confronted, most were centered on patient care. Critics were worried about poor-quality images, missed anomalies, poor diagnostics, and a lack of compassion. These concerns are consistent with the risks we acknowledge above.

What turned this conversation around?

We showed skeptics that sonographers are involved at every step of care. They guide, provide feedback, and make requests of the local healthcare provider at the ultrasound machine during the exam. Humans skilled in ultrasound are still at the center of reviewing patient images and utilizing their experience and expertise to develop a report. More than 50 sonographers assisted in the initial product design, and several continue to provide our development team with constructive feedback. The result is a high level of quality that often surprises providers and patients.

This is only one example. I know many others have similar stories.

Unlocking healthcare equity

So, where do we go from here? My answer is we move forward—with one eye on our innovations and one eye on this important truth:

Keeping true expertise at the centre of innovation is what will keep patients at the centre of our healthcare system.

Written by Blanca Lesmes, CEO of BB Imaging and TeleScan.