Authors
- Wasson, John H. MD
Article Content
THE AUTHORS of "Connected Access": Titrating the Right Dose of Access in the Digital Age (Vigilante & Khan, 2019) present a useful process diagram that sketches how "route of administration" of digital/connected access and human care delivery might vary in tune with the needs of patients. In support of their model, the authors correctly point out that face-to-face care is an anachronism, a point my colleagues and I have made in several publications (Schwartz et al., 1999; Wasson et al., 1992). What the authors cannot anticipate is the degree to which reimbursement and the guilds that control current care delivery should and will adapt to this emerging reality. Less understandably, the authors fail to point out that few digital health applications currently address the needs of patients who would benefit the most and many applications respond poorly to dangerous information (Singh et al., 2016).
Absent standardization, quality control, and attention to what really matters many digital health applications will not be useful at any dose (Bhattacharyya et al., 2019). To address this limitation my colleagues and I recently identified and prospectively tested 5 measures that can standardize the assessment of what matters, guide administration of appropriate remedies, and monitor changed in patients' quality of life (Wasson et al., 2018a, 2018b; Wasson, 2019b). There is no barrier for incorporating these 5 measures in digital health applications.
In summary, the message of "Connected Access" reminds us of the direction health care is moving. Whether the emerging "Connected Access" health care will be more cost-effective than the wasteful status quo remains to be seen (Wasson, 2019a).
REFERENCES
Vigilante K., Khan M. M. (2019). "Connected access": Titrating the right dose of access in the digital age. Journal of Ambulatory Care Management, 42(4), 262-267. [Context Link]
Bhattacharyya O., Mossman K., Gustafsson L., Schneider E. C. (2019). Using human-centered design to build a digital health advisor for patients with complex needs: Persona and prototype development. Journal of Medical Internet Research, 21(5), e10318. [Context Link]
Schwartz L. M., Woloshin S., Wasson J. H., Renfrew R. A., Welch H. G. (1999). Setting the revisit interval in primary care. Journal of General Internal Medicine, 14(4), 230-236. [Context Link]
Singh K., Drouin K., Newmark L. P., Lee J., Faxvaag A., Rozenblum R., Bates D. W. (2016). Many mobile health apps target high-need, high-cost populations, but gaps remain. Health Affairs (Millwood), 35(12), 2310-2318. [Context Link]
Wasson J. H. (2019a). Insights from organized crime for disorganized health care. Journal of Ambulatory Care Management, 42, 138-146. [Context Link]
Wasson J. H. (2019b). A brief review of single-item and multi-item quality of life measures for Medicare patients. Journal of Ambulatory Care Management, 42, 21-26. [Context Link]
Wasson J. H., Gaudette C., Whaley F., Sauvigne A., Baribeau P., Welch H. G. (1992). Telephone care as a substitute for routine clinic follow-up. JAMA, 267(13), 1788-1793. [Context Link]
Wasson J. H., Ho L., Soloway L., Moore L. G (2018a). Validation of the What Matters Index: A brief, patient-reported index that guides care for chronic conditions and can substitute for computer-generated risk models. PLoS One, 13(2), e0192475. doi:10.1371/journal.pone.0192475 [Context Link]
Wasson J. H., Soloway L., Moore L. G., Labrec P., Ho L. (2018b). Development of a Care Guidance Index Based On What Matters to Patients. Quality of Life Research, 27(1), 51-58. doi:10.1007/s11136-017-1573-x [Context Link]