In this series, AMS Healthcare addresses the challenges facing healthcare today – particularly in light of the COVID-19 pandemic. The AMS Community promotes compassionate care, development of the leadership needed to realize the promise of technology and the understanding of how our medical history influences the future of our healthcare. A new piece will be posted every Friday on Healthy Debate.
Now that we are several months into the COVID-19 global pandemic and the crisis in Canada is slowly ceding, we can begin to reflect on how and if digital technologies and virtual care have enabled compassionate healthcare.
We believe, now more than ever, that we need to deliver compassionate healthcare. This includes, and perhaps is particularly true, for healthcare mediated by technology.
One of the rapid changes to healthcare brought about by COVID-19 is the incredible scaling of digital technology use for healthcare provision and delivery, offering immediate solutions to some of the challenges posed by the pandemic. Digital care has enabled ongoing care by acting as a form of “personal protective equipment” for both patients and providers. Health providers have been able to virtually meet with patients from their homes, allowing patients to avoid travel and clinical or hospital settings, thus preventing unnecessary exposures to infection. Systems-level adaptations such as temporary billing codes for virtual care have accelerated the shift from face-to-face to virtual.
While the use of digital technology for healthcare has increased significantly during the pandemic, so have uses for purposes like social events, conferences, meetings, and staying in touch with family and friends. The need for meaningful human connection, we believe, has been amplified as we have been forced to remain physically apart. In the healthcare context, people seek this sense of connectedness and care with providers. It has been our experience that connectedness and a sense of alliance with health providers is related to feeling that humanistic and compassionate healthcare have been delivered. However, much remains to be understood about the technology and human factors that mediate a sense of connection.
We understand compassion to be an active form of empathy. While empathy can be registered internally as a state of feeling, compassion compels us to act on this feeling, to be with another who is suffering.
There are several ways in which digitization can impact compassionate care. Technology allows for access to care that may not otherwise have been available, allowing us the potential of being with. Pathways and options for care are increased, such as enabling patients to be seen in their own homes, allowing for the presence of family members, etc.
However, virtual care can present other barriers and distractions that can impede humanistic aspects of care. For example, poor connectivity and delays with audio have been shown to negatively impact the sense of emotional connectivity. Video precludes human touch and diminishes the cues available for communication. Further, structural barriers such as poverty, overcrowding and lack of access to digital technologies can further exacerbate health disparities, which is the antithesis of compassionate care.
With the increasing reliance on technology to deliver care, healthcare providers must have an understanding of how income, gender, culture, health literacy, access to technology and other factors play a role in the ability to use and benefit from technologies for healthcare-related purposes. A Digital Health Equity Framework has been developed recently that can help healthcare providers consider these health equity factors.
Digital compassion occurs within a broader ecosystem that supports care at all levels. In other words, digital compassion occurs at the individual, patient/provider dyad and organizational and social levels.
For example, at the individual or patient/provider levels, automation and algorithmic responses supported by artificial intelligence (AI) can be leveraged for more efficient care delivery and better decision-making abilities. Support systems leveraging AI techniques and personalized data can help find drugs for patients that match their clinical profile faster and with fewer side effects, saving many months of trying a course of drugs to see which may be effective.
At the organizational level, technology and digital platforms can support education, training and coaching as it relates to care. For example, a Digital Mental Health Certificate program offered through a digital platform is under development to support healthcare providers with the knowledge, skills and ability to deliver care virtually to Canadians.
With the increased use of technology, it is more important than ever to ensure that care is delivered in a way that provides a human experience. To do so, patients, providers, organizations, designers, researchers, educators and others will need to work together to ensure digital compassion is realized. Given the rapid adoption of these technologies and that they are likely to continue to play an ever-increasing role in the delivery of care, there is a need to focus on how we do so in compassionate ways.
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