SURF-IT: Medicine in the Digital Age

By Anna Lynn Spitzer

Irvine, CA, July 11th, 2014 — Modern medicine is an anomaly when it comes to technology. Doctors conduct minimally invasive surgeries from remote locations using robots, but most offices and clinics have no online presence for patients to make appointments, ask follow-up questions or check test results.

Wiechmann: "Medicine is a little bit dysfunctional."

Dr. Warren Wiechmann, associate dean of instructional technologies at the UC Irvine School of Medicine, spoke at this week’s SURF-IT lunchtime seminar about technology challenges and opportunities in the medical field.

Wiechmann, a UCI alumnus who majored in biology and minored in digital arts before attending medical school, has long been interested in incorporating technology into new areas. In his opinion, the medical field is ripe for change.
“To this day, medicine is terrible at managing data and making useful interfaces,” he said, adding that he was about to expose “some of the not-so-secret reasons that medicine is a little bit dysfunctional.”

Wiechmann has successfully integrated technology into medical education; UCI med students use iPads and Google Glass in their training. “With all the cool technology out there, we are going to be creating a different kind of doctors,” he said.

But updating existing healthcare practices is much more difficult. Wiechmann asked the SURF-IT students to think about the last time they walked into a bank to conduct a transaction or called a travel agent to book a vacation. “There are a lot of jobs, industries, functions that are being replaced by the pervasiveness of technology,” he said. “But if you think about physicians, there isn’t really that equivalent for healthcare. If you need to see your doctor, you need to see your doctor.”

Today’s consumers, though, are accustomed to finding services and answers online, and they have different expectations than they used to, Wiechmann told the audience. “That creates a sort of discrepancy. You as a patient are used to being online but if your doctor doesn’t engage in that, it creates a problem.”

Statistics show that 35 percent of the population has gone online to research medical conditions but they follow up with their physicians only about half the time. Doctors worry that patients can come to the wrong conclusions. “That can be dangerous,” Wiechmann said. “It sets up another disconnect right there. We are scared of people getting bad information when there’s good information available.”

Consumer devices that allow patients to check their own blood pressure, heart rate, respiration, blood sugar and other vital signs create a different dilemma for doctors. “When you come in with two months’ worth of blood pressure data, we don’t know what to do with it,” Wiechmann said. 

“So the problem is, you guys are a lot savvier and a lot more connected, and we, as physicians, really aren’t.”

A few medical groups around the country have incorporated technology into the practice of medicine; Wiechmann showed a promotional video for one group that offers same-day appointments, online scheduling and email follow-up. “The solutions they provide aren’t that difficult,” he said.

Other innovative approaches include an online app through which patients can schedule home visits that fit their schedules and mobile phone attachments that relay photos and specific health data to physicians.

Wiechmann shared pictures of a pulse oximeter, a portable ultrasound machine, a thumb sensor that delivers ICU-quality vital signs, an otoscope that snaps photos inside the ear that can be sent to one’s doctor, and a portable EKG to monitor irregular heartbeats. “The interesting thing is all of these are not designed for physicians. They’re aimed at consumers.”

Adoption rates among doctors are low, because “it really disrupts this idea of what you can do in your clinic and what you can bill for.”

The upside, however, is that these tools could make doctors’ offices more efficient, thereby allowing physicians to focus on treating disease instead of doing routine maintenance.

The key, in Wiechmann’s opinion, is finding balance. “To say that you can’t have access to medical data, or shouldn’t be looking up information about your health is ridiculous. But for you to go online and look up information and have no one to guide you is equally as ridiculous.”

He advocates for physicians seeing sick patients, and also spending time creating online resources for their patients. He cited pediatricians, whose blogs contain content that include resources for parents and answers to frequently asked questions. “At least it’s good quality medical information that can point you in the right direction.”

That concept induces fear in many physicians. “We’re really good at taking care of patients; we’re not as good at having a public presence or even curating information,” Weichann said. “It’s a whole other skill set that has to be taught to address these things.”

For those interested in technology development, though, there is a lot of opportunity. It is estimated that over the next five years, 80 percent of what physicians do will be replaced by technology. “Doctors don’t like hearing that,” Wiechmann said, “but it’s pretty valid. It’s a pretty open field; it’s just a matter of where to leverage that best.

“For most people, their routine visits are just routine visits. Do they really need to see someone who’s been to school for 16 years to find out that their blood pressure is good?”