Digital health: A day in the life of a physician

In this audio presentation, Bain partner Chuck Farkas discusses how digital health technologies will affect the lives of physicians.

Digital health won’t just transform the back office. It will change the daily lives of people throughout the healthcare system—from doctors, nurses and clinical investigators to patients, including both the seriously ill and the very healthy. 

Presentation transcript: A day in the life of a physician

Slide 1. Digital health: Physician

Hi. I’m Chuck Farkas, and I’m a senior healthcare partner at Bain & Company’s Boston office. I’ve spent most of the last 32 years working in the healthcare industry.

Slide 2. Have you ever spent a day with a physician?

Have you ever spent a day with a physician? Try spending a day with each of 50 physicians. What’s striking is that, even though their patients have the same diseases and they’re dealing with the same themes, every day is different, and every patient is treated differently. Could you imagine if we made cars that way, or animal crackers that way? No wonder we have the challenges we have in healthcare today. Digital health is changing all of that. Let me talk to you a little bit about that.

Slide 3. A day in the life of the physician

Let’s look at a day in the life of a physician, and I’ll go through this fairly quickly and come back to each element in more detail. The day often begins with rounding and is followed by seeing patients in the office. Then, it very often involves consulting a specialist, checking lab tests and results from electrocardiograms. Somewhere in there, there’s a pharma detail, there’s helping a patient get to the right resource to deal with a chronic disease or immediate need. There’s checking on a patient who’s been in surgery. And, at some point, probably at the end of the day, there’s continuing medical education. All of this today is done in sort of a random way. In the future, in a digital future, it will be done in a very, very different way. Let me walk you through that.

Slide 4. Rounding

Let’s look first at rounding and see how that’s going to change, from monitoring to making the rounds and reviewing the latest tests and scans. Today, the doctor often starts at one end of the floor. In some institutions, it’s still paper-based; in others, they might go to a computer terminal in the room. But today, they start when they’re actually in the room with the patient. In the future, on her mobile device, a doctor will have all of that patient’s information in advance, typically screened through some form of artificial intelligence to identify priorities and issues for the doctor to focus on. As the doctor actually makes those rounds, she’ll be able to take her notes digitally. She’ll be able to compare her notes to her notes from prior visits, identify changes and be reminded to check up on things that she noted in an earlier rounding. And, finally, she’ll be able to create email reminders for the nursing staff so that when she’s gone, they’ll be reminded to take the steps that she wasn't to be sure that patient has. Finally, as she makes the rounds, she’ll be regularly updated on new test results for any of her patients, and for any results that are abnormal or out of line, they’ll be a priority, and she’ll be able to save time as she does this, she’ll be able to focus on the most important issues and she’ll be able to deliver much better care.

Slide 5. New patient diagnosis

The doctor spends most of her day in her office with new and with existing patients. How she spends that day is changing dramatically. How did you find your doctor? Did you ask friends? Did you ask family? Did you look for references? The way you find a doctor is much more likely to be like the way you find a restaurant today—with ratings, with pricing, and with the availability of an appointment. And as that happens, the doctor is going to have to spend much more time being sure that what’s online about her is right. When that new patient gets to her office, the process will be different as well. There’s likely to be a kiosk or a computer terminal, where that new patient makes sure that her new doctor has her up-to-date electronic medical record—that the information is up to date, that the insurance information has all been entered, and that the things that are broader to the doctor are very clear, so that by the time she walks into her doctor’s office, the doctor knows why she’s there and knows all of the preexisting conditions and the preexisting medications that patient is on, so that when the doctor finally treats that patient, she will be able to take advantage of all of that information. She’ll also use artificial intelligence and standard protocols to design that patient’s treatment plan, and all of that will go into the system, and the pharmacy order will appear at the pharmacy. The information the patient needs will be available to be downloaded onto their mobile device.

Slide 6. Remote specialist consultation

Many of the doctor’s patients require a specialist. Most doctors will tell you their biggest frustration is finding the right specialist and then getting time with that specialist. Digital technology is changing all of that. Physician use of social networking is growing dramatically and is becoming an important source for making those connections between primary care physicians and specialists. Video technology is making it easier to reach that specialist and to engage in a dialogue faster so that the patient gets the care they need in a timely way.

Slide 7. Lunch

For the doctor, the information flow doesn’t slow over lunchtime. She gets updates from the lab, often generated by computers, and she gets instant messages from her nursing team about patients.

Slide 8. Pharma detail

With her busy schedule, she really doesn’t have time to see a pharmaceutical sales rep. On the other hand, she still needs important information about new drugs and consultation about how to deal with and dose difficult cases. So, instead of seeing a rep, she goes to a computer and views and interactive presentation on a new drug. She video chats with KOLs involved in the development of that drug, and she often agrees to incorporate that new drug into her prescribing patterns. But she does it all online.

Slide 9. Remote care delivery

The doctor isn’t just concerned about managing patients in her office. She has to concern herself with patients who have chronic diseases and might be at home, as well as her patients who might experience an acute episode when not in her office. Digital tools let her do both—remote monitoring devices to help her keep track of how patients are progressing in their homes, whether it’s management of their HBA1C or their blood pressure, or their depression. For those with acute episodes, she’s in a much better position to direct them to the right site of care, keeping them out of the emergency room and sending them, instead, to a walk-in clinic or to another doctor’s office who might have an available appointment, but getting those patients to the right care at the right time at the lowest possible cost.

Slide 10. Surgery, part 1

Some of the doctor’s patients will need surgery. She sees it as her responsibility that they choose the highest-quality, lowest-cost providers possible—and at the same time, making sure that the surgery that they get is, indeed, appropriate. Digital technology will help her with both. It will both identify the best providers in their area and will help her review the medical literature to make sure that that arthroscopy or that lamonectomy or other procedure is really needed.

Slide 11. Surgery, part 2

Digital technology plays a prominent role in the surgery itself. It will be used to make sure that all of the right supplies are in the room, that the right staff is in the room, and that everyone is aware of the patient and the procedures that will be performed. During the surgery, the technology will be used to manage checklists, to make sure that step by step the patient receives the right treatment using the right tools and the right instruments, guaranteeing better quality and lower costs.

Slide 12. Continuing medical education

At the end of the day, the doctor is done seeing patients. She can now catch up on all of the information she needs to do her job well, like CME, which she can do on her mobile device,

Slide 13. By 2020, digital health will have cut costs

So this is a day in the life of a digital doctor—different from the life of a doctor today, but not in the distant future.

Slide 14. Contact us

If you’d like to know more about how digital health will impact your healthcare business, please don’t hesitate to call me, Chuck Farkas, or any of my colleagues in the Healthcare practice at Bain & Company.