The Missing Link in Patient Care: Why Digital Engagement is No Longer Optional
Joshua Tamayo-Sarver, MD, PhD, FACEP, FAMIA
It is no secret that the electronic medical record tortures physicians while they try to care for patients. Even as a patient, I use my patient portal somewhat to check my results or communicate ineffectively with my clinician, but mostly I do it to build frustration tolerance with terrible technology, an important skill as a healthcare consumer. Yet, as a physician, I have not heard from any colleagues who switched practice locations or hospitals because of the EHR. As a patient, I continue to go to a fabulous physician with a terrible patient portal. But I have noticed something that is worth thinking about: my children are digital-first natives, and the electronic interaction with their physician isn’t just a computer system to be tolerated; it is an extension of the physician’s bedside manner. And we, apparently, have terrible digital manners in healthcare.
The Digital Divide in Healthcare Retention
Patient retention is a critical metric for healthcare organizations, not just for financial sustainability but also for ensuring continuity of care and better outcomes. Yet retention remains a challenge, particularly when patients feel disengaged or unsupported after leaving a clinical setting.
Digital engagement offers a solution, but healthcare has been slow to adopt it effectively. Thinking back to my experiences, it is no wonder: if the digital experience does not materially affect patient acquisition, patient retention, clinician recruitment, or clinician retention, then why would a health system invest serious resources into digital interactions? On the other hand, based on my anecdotal observations of my kids and their peers, I think that these dynamics are about to change. Look at industries like retail and banking, which have mastered personalized digital interactions, and banks are now judged more on their slick websites than their marble lobbies of yesteryear.
Lessons from Other Industries: Personalization at Scale
Think about how Netflix knows exactly what you want to watch next or how Amazon anticipates your shopping needs before you do. These companies have set a standard for personalized engagement that healthcare desperately needs to emulate to both differentiate for patient acquisition and improve care for a digitally native population. In healthcare, this could mean carefully tailored outbound communication that anticipates patient needs. For example, all four of my kids played sports. They all needed physical exams from their physicians to play. They needed those annually. It would have been great to get an anticipatory reminder to schedule their annual sports physical.
But let’s be clear: this isn’t about turning healthcare into an e-commerce platform. It’s about using technology to humanize care at scale. People don’t interact with the healthcare system because it is satisfying; they are trying to accomplish something. Get the physical done so their kid can play soccer. Control their blood sugar so they don’t wake so often at night to urinate. Get in great shape so they can attract a date. This is about helping align healthcare with what people are trying to do. So much of our dreams and aspirations are based on a foundation of being healthy in body and spirit, it is astounding that we struggle to make that a firm connection in patients’ minds.
Barriers to Adoption: Why Aren’t We There Yet?
If digital engagement is such an obvious solution, why hasn’t it been universally adopted? The reasons are complex but surmountable:
1. Fragmented Systems: Many healthcare organizations operate on siloed platforms that don’t communicate with each other, making seamless digital engagement difficult. My bank is my one stop shop for banking, loans, investing, insurance, etc. They can provide wraparound services so that when I sell a car and get a new one, they can offer financing, insurance, etc with the click of one or two buttons. Given our fragmented healthcare system, we need to create virtual integration to offer the same comprehensive care.
2. Data Privacy Concerns: Patients are understandably wary of sharing sensitive health information digitally, especially given recent high-profile data breaches.
3. Provider Resistance: Clinicians often rightly view digital tools as adding to their workload rather than streamlining it. More digital access to the clinician does not increase the clinician time or create more clinicians. Digital tools that are increasing “access” to communication is not the same as increasing “access” to clinician time.
4. Equity Issues: Not all patients have access to smartphones or reliable internet connections, raising concerns about exacerbating health disparities.
Overcoming these barriers requires systemic change and leadership willing to prioritize innovation over inertia. Perhaps more importantly, the investment in true and delightful digital engagement will change when that digital engagement starts to affect the healthcare system’s core business concerns: patient acquisition/retention and clinician recruitment/retention.
The Future of Patient and Clinician Acquisition/Retention is Digital
The truth is, the days of crappy digital engagement tools for both patients and clinicians is numbered. The blip of telehealth during the pandemic was a warning shot across our bow. Because we will not be able to fix our systems overnight, the systems that invest in the digital experience for patients and clinicians today will be the healthcare heavyweights of tomorrow.
Dr. Joshua Tamayo-Sarver, MD, PhD, FACEP, FAMIA, develops and deploys technology solutions in the healthcare ecosystem as a clinician, business leader, software engineer, statistician, and social justice researcher. As the Vice President of Innovation at Inflect Health and Vituity, his unique formula of skills has helped develop over 35 solutions and scale multiple new healthcare products, including the first AI occult sepsis tool with FDA breakthrough designation. Dr. Tamayo-Sarver oversees corporate venture, internal incubation, and advisory services for AI-driven healthcare solutions, blending consumerism and clinical quality to fit the delicate balance of patient desire, user experience and quality medical care. A Harvard graduate, he holds degrees in biochemistry, epidemiology, and biostatistics, as well as a medical degree from Case Western Reserve University. He is a Mentor in the Emergence Program at Stanford University.
