Key findings 1 Where is the digital divide? 2 What’s the appeal of digital tools? Most US physicians are using a few digital Physicians want digital healthcare tools to tools today and expect to use more in the do what they do better near future. Heavier users tend to be Improve practice efficiency PCPs and physicians in large and Increase patient safety complex practices. Age is less of a Improve diagnostic ability factor than practice size and setting. Reduce burnout Improve physician patient relationship 3 What do physicians 4 How do they want require for adoption? to be involved? Physicians require digital tools to fit within Whether employees or owners physicians their existing systems and practices want to be part of the decision making but they look to others as well Coverage for liability Data privacy is assured by experts IT experts for technical issues such as data safety Linked to EMR Practice leaders for buying decisions Billing/reimbursement
Survey instrument Definitions Digital healthcare: Digital health encompasses a broad scope of tools that engage patients for clinical purposes; collect, organize, interpret and use clinical data; and manage outcomes and other measures of care quality. This includes, but is not limited to, digital solutions involving telemedicine and telehealth, mobile health (mHealth), wearables (e.g., Fitbit), remote monitoring, apps, and others.
Remote monitoring and 7 Remote monitoring for Clinical decision support Patient engagement efficiency management for improved care
Specific tools Tele-visits/ Point of care/ Consumer access to clinical virtual visits workflow enhancement data EHR app store: Imagine that you could improve or extend the features in your EHR by purchasing apps from an app store that would securely integrate into the EHR workflow. This would be a special app store just for clinicians, not an existing store (i.e., Google Play, iTunes). The apps would add capabilities like improved data visualization, decision support, improved documentation in the patient record and integration with other tools and services. Questions Ove
rall Involvement in Digital Individual tool deep dives EHR app store evaluation Health (Ask for up to two relevant Current use of EHR solutions, not currently being used) Impact of on ability to provide care Interest in purchasing from app store Overall motivators/attractants (definition above) Overall motivators/attractants towards solution Decision maker for app store purchases Overall functional requirements Rank of top 3 Importance of app selection criteria Specific digital tools motivators/attractants Physician profile Familiarity Overall functional requirements of Current use solution adoption Age, gender, state, specialty, practice type, practice ownership, years in Relevance for practice Rank of top 3 functional practice, hours of patient care, Enthusiasm requirements professional organization membership) Timeline for incorporating into practice Level of disruption caused by Enthusiasm for tech in professional Ideal level of involvement in Digital solution setting Health, in general Ideal level of involvement with Influence on tech decision making decision to incorporate solutions
Physicians need tools to fit within current systems Look to tech experts to insure privacy, security What Requirements Must be Met by Digital Health Tools?
Is covered by my standard 52 29 Malpractice coverage, malpractice insurance data privacy and Data privacy/security is assured by 50 32 my EHR vendor workflow integration Is well integrated with my EHR 48 33 are essential Data privacy is assured by my own practice/hospital 47 34 Physicians should be Can be reimbursed for time spent using it 43 32 able to be reimbursed It is supported by my EHR vendor 40 36 for time spent
Physicians want extended capabilities in their EHRs but look to practice leaders to make buying decisions Apps that extend your EHR system’s capabilities and are securely integrated into the EHR workflow Likelihood for practice to buy?
21 20 21 22 21 20 32 Extremely Likely 33 32 33 33 31 Very Likely 31 Somewhat Likely 32 31 30 30 33 16 15 16 14 16 16 Who will make the buying decision?
Digitals tools are used by all types of physicians Younger physicians are slightly more likely to use more PCPs and those in larger, more complex practice digital tools. Tenure is a small predictor of use but not settings use and want to use slightly more digital tools enthusiasm.
Using now Enthusiastic to use Using Now Enthusiastic to use Avg=1.9 Avg=3.1 Avg=1.9 Avg=3.1 % of sample % of sample 28-40 (22%) 2.1 3.0 Practice Specialist (50%) 1.8 3.0 Physician 41-50 (35%) 1.9 3.3 PCP (50%) 2.0 3.4 age 51-65 (42%) 1.7 3.1 Solo practice (15%) 1.5 2.7 Male (69%) 1.9 3.1 Single specialty (41%) 1.7 3.1 Gender Female (31%) 1.9 3.3 Practice Hospital* (12%) 2.1 3.2 setting Multi-specialty (27%) 2.2 3.4 up to 10 (28%) 2.0 3.1 Med School/Fac (3%) 2.1 3.8 Years in 11-20 (39%) 2.0 3.3 practice 21+ (33%) 1.6 3.1 1-3 (22%) 1.4 2.8 Practice 4-8 (26%) 1.9 3.2 size Skeptical/Hesita… 1.2 2.2 Tech 9-27 (26%) 1.9 3.1 enthusiasm Neutral (46%) 1.8 3.2 28+ (25%) 2.3 3.5 Eager/Early (39%) 2.3 3.5 Full owner (25%) 1.7 2.9 Member AMA member… 2.2 3.3 Owner Part owner (25%) 1.8 3.1 status Non-member… ship 1.8 3.1 Employee (50%) 2.0 3.3 Q20. Which, if any, of these do you currently incorporate into your practice? Q22. Which, if any, of the solutions below are you enthusiastic about? *Hospital includes Ambulatory Surgery Centers and Urgent Care Base: Total Physicians (n=1300)
Key definitions in the study Digital tools in general Digital health encompasses a broad scope of tools that engage patients for clinical purposes; collect, organize, interpret and use clinical data; and manage outcomes and other measures of care quality. This includes, but is not limited to, digital solutions involving telemedicine and telehealth, mobile health (mHealth), wearables (e.g., Fitbit), remote monitoring, apps, and others. Seven specific tools Remote monitoring for Smart versions of common clinical devices such as thermometers, blood pressure cuffs, and scales that efficiency automatically record readings in the patient record so you do not have to type it Remote monitoring and Apps and devices for use by chronic disease patients for daily measurement of vital signs such as weight, management for blood pressure, blood glucose, etc. Readings are visible to patients and transmitted to the physician's improved care office. Alerts are generated as appropriate for missing or out of range readings Clinical decision support - Modules used in conjunction with the EHR or apps that integrate with the EHR Clinical decision support that highlight potentially significant changes in patient data (e.g., gain or loss of weight, change in blood chemistry) Patient engagement Solutions to promote patient wellness and active participation in their care for chronic diseases (e.g., adherence to treatment regimens) Tele-visits/ An audio/video connection used to see patients remotely (i.e., simple acute illness, adjusting therapy, virtual visits etc.) Point of care/ Communication and sharing of electronic clinical data to consult with specialists, make referrals and/or workflow enhancement transitions of care Consumer access to Secure access allowing patients to view clinical information such as routine lab results, receive clinical data appointment reminders and treatment prompts, and to ask for prescription refills, appointments and to speak with their physician EHR app store Imagine that you could improve or extend the features in your EHR by purchasing apps from an app store that would securely integrate into the EHR workflow. This would be a special app store just for clinicians, not an existing store (i.e., Google Play, iTunes). The apps would add capabilities like improved data visualization, decision support, improved documentation in the patient record and integration with other tools and services.
Remote Monitoring for Efficiency Smart versions of common clinical devices such as thermometers, blood pressure cuffs, and scales that automatically record readings in the patient record so you do not have to type it