Tech Can’t Solve the Biggest Factor for Population Health Success: Trust

October 23, 2020
Kameron Leigh Matthews

The more we rely on technology, the further away we get from focusing on and addressing one of the most critical components of care: Trust between the patient and doctor.

We’ve made a lot of progress when it comes to technology that connects providers with their patients and helps deliver the kind of information that can improve care. For example, McKinsey & Co. projects virtual visits could account for $250 billion, or 20%, of what federal and commercial payers spend on outpatient, office, and home health visits in 2020. (Before the pandemic, telehealth accounted for an estimated $3 billion in spending.) In addition, the remote patient monitoring market is expected to reach $31 billion by the end of 2023, demonstrating just how valuable these solutions are in closing the doctor-patient divide outside of the office.

While that progress should be recognized and celebrated, there is still ample opportunity for improvement.

The COVID-19 pandemic has shone a light on many of the problems we in healthcare have been aware of for years. Inequality in access to quality care. Imbalance in resources. One of the biggest, and most damaging, consequences of many of the problems that exist today is the lack of trust so many communities – especially at-risk communities – have in the healthcare system. That’s a problem that no amount of technology alone can fix, but is crucial to making any real progress in population health.

Tech connects and simplifies

As the pandemic has demonstrated, technology can provide a life-saving connection between patients and their doctors. We’ve all seen how it simplifies and increases the efficiency of the appointment process, adding a new level of flexibility that many of our patients need (and even expect).

In an interview with Becker’s Hospital Review, Kristin Myers, executive vice president, CIO and dean of IT at New York City-based Mount Sinai Health System said that she expects to see academic medical centers continue investing in remote monitoring, health sensors and wearables over the next five years as well as continued disruption by big tech companies in the health IT landscape and discussions around patient privacy and data protection.

The problem is, the more we rely on technology, the further away we get from focusing on and addressing one of the most critical components of care: Trust between the patient and doctor.

Patients are losing trust

In 2018, only 34% of the general public said they had a positive view of the healthcare industry, compared with 80% in 1975. While that statistic is upsetting, especially for a physician, what it means is even more so: Patients who have more trust in their healthcare professionals are more satisfied with their treatment, have fewer symptoms and pursue healthier behaviors.

Trust, though critical to a patient’s health, is fading. And, while we have all of these new tools that make healthcare delivery easier, they aren’t doing anything to build trust. Instead, they may be placing more distance between the patient and her health care team.

Patient-centric health requires trust

As healthcare providers, we have to do much more than treat patients for the symptoms and conditions with which they present, whether in-person or remote. We are responsible for treating the patient as a whole, and, as a system, we are failing. A recent poll by the Kaiser Family Foundation and The Undefeated found that only 56% =of Black people said they mostly trust their local hospitals, compared with 7 in 10 white people.

Now, in the midst of a pandemic that is disproportionately sickening and killing Black Americans, those statistics are worsening. (A new report from the National Urban League finds that Black individuals are nearly three times as likely to contract COVID-19 and twice as likely to die from the virus, compared with white individuals.)

As a physician who has treated patients of all races, backgrounds, and socio-economic status, it’s easy to understand how some communities have lost faith and trust in a system that has left them behind. But in order to serve our patients and help them improve their health outcomes, it’s on us to identify ways to build – and keep – their trust.

Diversify the provider pool

Simply put: Patients need doctors who look like them, who can identify with them. This is not the holy grail, but it is a good place to start. From preschool through college, we need to teach kids of all races and from all corners of America that they can be doctors and nurses. Imagine a future with providers that can find commonality with all patients.

Address financial barriers to care

When someone can’t afford to seek care for their health issues, they enter the system with their guard up. Every solution presented comes with a price tag that doesn’t fit their budget, or an opportunity cost they simply cannot bear. Patients should not have to choose between their health and rent, or risk losing their jobs to seek care.

Improve accessibility to quality care

Why would someone trust a system that’s supposed to provide care to all, but is inaccessible to a large majority? The more accessible quality care is to a community, the more they begin to trust the providers and system that delivers it.

Engage communities

You can’t fully appreciate an individual’s unique circumstances without assessing the community from which they came. And you can’t effectively help them without understanding the resources — including education, housing, and food — they have at their disposal.

We are living in an exciting time, associated with unprecedented advancements and innovations. Technology allows us to follow our patients into their homes and monitor their daily activities. Despite this progress, we are still facing record levels of distrust from the people we took an oath to serve. It’s time we put our energy and passion into driving equity in care for all.

Kameron Leigh Matthews, Family Physician, Co-Director of Tour for Diversity in Medicine, Chief Medical Officer/Assistant Under Secretary for Health for Clinical Services, Veterans Health Administration and Inlightened expert

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