By Art Papier
The COVID-19 pandemic continues to place incredible pressure on healthcare professionals to deliver quality care. Our frontline healthcare staff, nurses, doctors, and emergency providers face long hours, a shortage of PPE, and personal health risks as they rush to save lives and reduce harm. Meanwhile, clinicians who are not on the COVID-19 frontlines have suddenly shifted to telemedicine delivery systems while navigating patient anxiety, fear, and doubt along the way.
When patient anxiety and fear combines with limited access to clinicians, the result is delayed delivery of high-quality care. It is more critical now than ever before that we equip all healthcare workers with the right technology and tools. Tens of thousands of doctors are now using telemedicine for the first time. In this new setting, they must maintain their exacting standards of diagnostic and therapeutic accuracy as they evaluate and educate patients from afar.
As a physician and as the CEO of a medical informatics company, I’ve been advocating for widespread adoption of clinical decision support tools at the point of care for 20 years and I’ve seen first-hand the impact they can have on public health preparedness.
This is not my first encounter with a global health crisis. In the weeks following September 11, 2001, the United States was threatened with bioterrorism attacks via anthrax in the mail system and other methods. Recruited by DH Henderson, MD, a physician who successfully led the WHO’s global effort to eradicate smallpox, my then-young startup produced the CDC’s website on smallpox vaccination adverse reactions in anticipation of a massive vaccination program. My team successfully implemented a point-of-care approach to broadly improve diagnosis within emergency departments. At the time, city, county, and state health departments were trying to ensure that frontline clinicians had the most current clinical diagnostic knowledge.
Our argument was as straightforward then as it is today: since no one can predict what the next public health crisis will be, the only sensible plan is to prepare for everything. Testing and diagnosis of COVID-19 will soon be widespread, but other medical problems will still need to be handled. What I advocated for in the early 2000s—and what hospitals should be doing now—is focusing on using tools that improve diagnosis and patient management broadly. We need to be proactively preparing for all diagnoses and infectious disease events.
This begs the question: How do we keep doctors in the trenches up to date with rapidly changing information? We do it by giving them a tool that handles everything—from the emerging infectious disease to the common everyday condition.
If accurate diagnoses are to be made during high-stress situations such as the current pandemic, then uniform, standardized, high-quality diagnostic information is needed. Rather than “hunting and pecking” through multiple pages of Google search results, utilizing professional, problem-oriented systems can not only help physicians triage cases of COVID-19 (or biological agents as in 2001), but can also help them quickly and accurately treat patients presenting with other conditions that still require care.
Lastly, a clinical support tool can reduce bias and other medical diagnostic errors that may occur with increased frequency during a healthcare crisis. With a singular diagnosis being top of mind—especially an infectious disease—premature closure, cognitive biases, and unconscious decisions can lead to harm.
Using a reference tool at the point of care can arm clinicians with the knowledge to diagnose infectious disease accurately no matter their location, specialty, or level of experience. It’s as if the diagnosing physician, nurse practitioner, or physician assistant has an instant second opinion right at her fingertips.
Nobody can predict what the next public health crisis will be, but we do know that another one is inevitable. The only sensible thing to do is plan for everything and arm physicians and other providers with professional diagnostic, testing, and therapeutic knowledge in the exam room.
Art Papier, MD, is CEO of VisualDx, and Associate Professor in Dermatology and Medical Informatics at the University of Rochester