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The following material has been edited for clarity and brevity.
Kim Shea spoke with doctor, dentist, and public health expert, Dr. Sailee Bhambere. Dr. Bhambere’s desire to better serve and educate her patients compelled her to help design health tools and technological innovations that improve the health and well-being of people all over the world. In this conversation, she talked about the transformation of healthcare technology due to COVID-19, the digital health resources that can help you manage your physical and mental health, and the many ways AI can improve the medical field.
A New View: How Dr. Bhambere Began Working In Digital Health
Kim: Can you tell me how you came into this and what your background is?
Dr. Bhambere: I am a trained dental surgeon. While I was working with patients for years, I realized that as a doctor and as a healthcare system as a whole, we're really limited in how much service or how much time we can give to our patients.
I thought, “What are the other resources that we can utilize to give our patients more time and more attention? How can we be there for them even when they're not in the hospital or in the clinics?” That's how I started working more in the digital health space. I realized how much we can utilize digital health resources for our patients and their health outcomes.
Kim: So are you talking about an avatar or something, or somewhere people could get information from the avatar? What was your vision in terms of how you could utilize that?
Dr. Bhambere: Well, my primary motive is to make people and our listeners aware of how they can utilize digital health technology for their individual health. They can use simple tools like mobile phones, or the internet, or telehealth consultations, or remote treatment. I think these are very simple and very accessible options available to us right now. It turns out not many people utilize them, because many of us do not realize that they are there for us to use anytime we need it.
COVID’s Transformation Of Telehealth
Kim: I’m sure you noticed that there has been a change in patient perspective and health technology buy-in during the pandemic. Are people interested in this? I know a lot more telehealth visits are getting authorized by insurance companies, but in terms of buy-in, what are you seeing?
Dr. Bhambere: There actually has been a massive shift. Whether it's in policy, or government, or the hospitals, or our patients, there's been a huge change. Before COVID, it was always like, ‘Okay, let's stick to conventional healthcare.” The insurance companies wouldn't pay for telehealth visits. The doctors or hospitals wouldn't want to use them.
As unfortunate as the whole situation has been, what COVID actually did is accelerate the adoption of digital technology by at least 10 or 15 years. For example, I think around mid-March of 2020, the government announced a COVID emergency and within a week, CMS came up with so many good regulations that extend telehealth or teleconsultation benefits to almost all of their Medicare beneficiaries.
Before COVID, I think 10,000-15,000 patients utilized telehealth services a week. After COVID, it went up to about a million. So, there was a 120%-130% increase. The buy-in has been amazing. Previously, as healthcare professionals, we have been a little more conservative using these services, but now we're more open. 70%-80% of doctors now want to utilize telehealth and have remote consultations. About the same amount of healthcare professionals say they want to utilize it even after COVID.
That just tells you about the immense shift in buy-in. This cannot happen unless everyone comes together and everyone takes a step with the patients, the government, the payers—everything has to happen together.
Kim: I also work with CMS and with Medicare and reach out to people with mental health. It used to be that you had to live in what they considered a rural area in order to receive telehealth services for mental health. It was very limited as to who could be seen. Once there was the shutdown, anybody could be seen pretty much anywhere. All of a sudden, it didn't matter. What mattered was making sure that people got their needs met for their mental health.
Dr. Bhambere: You bring up a very good point. Previously, it was so restricted in terms of what the payers or CMS allowed. I think with COVID, they added about a hundred more allowable services to almost all of the beneficiaries. You can get it from whatever location you like. Now, it's all opened up and a lot more practitioners have been included in this, not just the doctor or nurses. Occupational therapists, speech language pathologists, physical therapists… all of them can utilize this and there's a good chance that patients get reimbursed for it.
Kim: Do you think that this will continue going forward once COVID is resolved enough?
Dr. Bhambere: Yeah, I do think a major part of the change is here to stay on regulatory levels. A lot of them were—or are—temporary. They were made to last a period of a year or as long as the emergency lasts. But a lot of states and healthcare authorities are seeing that these services have really been beneficial for them. They’ve been beneficial for the patients and they want to continue with that.
Of course, there is still going to be a little bit of back and forth on that, but I think a lot of this change is here to stay. If anything, there has been so much improvement in the mindset on all different levels that will benefit us forever, even after COVID.
Mental Health & Digital Health Technology
Kim: I brought up mental health because that's something I do in my business, but what are you seeing in terms of mental health management? You had suggested there's some improvement with mobile health apps and other digital services?
Dr. Bhambere: 60%-70% of mental health services that patients receive now are through telehealth or remote consultations. Patients, as well as doctors, are realizing that it's an amazing way to connect.
Nobody has to go out and nobody is at risk for COVID or anything. You don't have to travel. It’s much more convenient for the doctors and the patients, which actually increases patient satisfaction when they're getting mental health services.
Apart from that, you can also utilize a lot of mobile health applications right on your cell phone. There are so many amazing apps that can help with mental consultations, diet, sleep, and overall health. There are other apps that you can use to connect with a lot of other people suffering through similar situations. Having all of these services and all of these options at your fingertips is really amazing.
Like I said, the whole point of our talk is for people to realize that it's all there. All they have to do is take that leap of faith. Even if you're being super pessimistic and not sure how digital health or mobile applications or anything can help you with your mental health, just look at it this way: something is better than nothing, right?
Kim: Exactly. Are these apps able to meet the needs of people using different languages or different skill levels? I know with my business, a lot of our patients are older and they're not comfortable using that technology. It's been very limiting for them. I'm thinking there may be the same issue with language. Are you seeing anything like that?
Dr. Bhambere: That's actually a very good question. When the designers of these applications or any digital health services start developing these for the patient, they know that language or the user population age are going to be major hurdles. They start taking steps early on. They add translations and they add different voice options. Most of the content that applications or digital health services use is made to be easy to read and easy to understand, even with very basic skills or a very basic language understanding. Many, many applications are also available in different languages.
Of course, age is a major factor when using digital technology. What I've seen a lot of good applications doing is they focus on the caregivers. With an older population, there's often a daughter, a granddaughter, a grandson, or someone else who can help them with it. There are a lot of options for the caregivers to contribute and help the elderly population use this technology. Things have been made in a way that you're not putting a lot of burden on the caregivers to help. It's a little bit of technology use on their side and a lot of benefits for the elderly population.
How It Works: A Lesson In AI Machine Learning
Kim: I'd like to know more about artificial intelligence and machine learning. How do you see that as helping disease management going forward?
Dr. Bhambere: There’s so much being talked about in terms of having fewer healthcare resources, which leads to physician burnout, or not being able to give enough time to each patient. I think AI machine learning is actually really helpful in this.
Most of the applications or technologies that have been used recently for mass level diagnosis and screening utilized AI and machine learning. A recent example is the diagnosis and screening of COVID-19 patients. The surveillance that was done and the contact tracing for COVID-19 used artificial intelligence.
Artificial intelligence is basically like borrowing an extra brain—a very intelligent one. It can even help doctors in hospitals with decision support, triaging the patients, or monitoring the patient’s clinical care.
Kim: Are you saying that the machine is actually learning from the input that it gets or is it somebody inputting that information?
Dr. Bhambere: Putting it in simplistic terms, the tool or the product that you're using has been made and there's been so much data that has been used to build it that it has learned from the data and the trends. The different things that it learns through that data teaches it how to better diagnose.
Just to give you an analogy, if a doctor has worked with 10,000 patients, he or she is going to be much more efficient at the work he or she is doing. Because they've seen so many patients, they've seen so much data related to these patients, right? That is what AI machine learning is.
We’re not talking about thousands. We’re talking about millions of trends and data patterns—sometimes more. That's what the AI learns from and how it improves the accuracy of what it's doing.
Kim: So, the benefits include maybe reducing errors, and increasing the overall health benefits for the patients. Then, you just have fewer mistakes and better diagnoses and care.
Dr. Bhambere: Exactly. It’s really nice for both the patients and the medical professionals.
A small example could be if a doctor is looking at an x-ray and trying to diagnose a cancer tumor there. If you have an extra brain with you, which is what AI machine learning is, it's going to help the doctor diagnose and reduce the amount of error.
You're getting a very reliable, very intelligent helping hand for the medical professionals, which is going to improve their efficiency and their own mental health. A healthy doctor is always good for a healthy patient.
Almost everything that happens in healthcare can be made better by using AI. It can be used to enhance the procedures and to enhance the accuracy of the diagnosis. Of course, it may take a while to be adopted, but basic implementations have already started for COVID-19 and for decision support by doctors, so it’s really there to stay.
Rise Of The Machines? AI’s Reliability, Tools, and Buy-In
Kim: Can patients trust that, do you think?
Dr. Bhambere: Due to the immense amount of data that is used to build these AI tools and machine learning tools, they are really, really reliable. In fact, because it enhances the decision making of the doctors, it can increase the reliability of the services that the patients receive. Patients can definitely trust it.
Kim: You said this isn't quite happening just yet. When do you see this as becoming more fully implemented as an everyday tool for everybody?
Dr. Bhambere: It has been implemented in bits and pieces at the moment. Because COVID was an emergency situation and there was a huge population to work with, we really saw this massive implementation for COVID-19 patients. But AI tools can be utilized for different disease areas, different types of patients, and different services.
Everyone on every level has realized how much we can utilize technology data and machines to make our lives better. What would have otherwise taken another decade or two is probably just a couple of years down the line now.
Kim: Is there buy-in from the hospitals and government? I don't know what the cost of this would be globally. Is everybody able to play this game?
Dr. Bhambere: Even though the technology or products or tools are available at the moment, buy-in is what takes time. In terms of the cost or the infrastructural factors, those things are going to take a couple of years. But the more and more we use the technology, the more and more inexpensive it becomes. A tool specially built for one or two entities versus something that's been commercialized on a global level is going to have a different cost.
The Future Of Digital Medical Services
Kim: I'm just thinking about when electronic health records became kind of the norm. All the facilities and staff were having to be trained on it and doctors were having to use it and change the way that they'd been taking notes. I believe that a number of people just said, “We're done. I'm old enough. I'm retiring. I'm not going to make this transition because it's more challenging.” Do you anticipate there would be something like that happening with this AI?
Dr. Bhambere: There's always resistance to change. That is absolutely true. In many cases, it is for legit reasons. I think the way the technology adoption happened after COVID-19, with or without our choices, forever changed something in us. It revealed how flexible we are or how we can learn something if we actually want to do it.
A lot of medical professionals who previously wouldn't opt for telemedicine consultations had to do it during COVID-19. A lot of them realize that it's not as impossible as they thought. As we start to understand the benefits of new technology, we as medical professionals and as patients become much more interested in learning it. It will take a little bit of time, but the benefit is definitely much greater than the effort that we have to put into it.
The same applies for the amount of money or the expenses that go into it. Like you said, when the EMR adoption happened, people were not very interested, but gradually everyone in the health systems and in the government realized how it can save a lot of money, make things much smoother, reduce errors, and benefit patients in so many ways.
It’s the same for AI machine learning technology. In the long run, it is going to be much better for the doctors, for the patients, and for the administrative part of healthcare.
Kim: It's very exciting about the possibilities that could make all of our lives much better and that you're a part of it.
Dr. Bhambere: I feel extremely passionate about this whole thing and that's why I come talk. I'm not trying to sell any specific product or any company. I actually make it a point not to mention any specific brands or companies, because the whole point here is to convey what you just said: there's so much potential here. All we need to do is just understand it and know that it's there.
Interview Links
Get in touch with Dr. Bhambere on Linkedin.
Click Here to read Dr. Bhambere’s research papers.
Send Dr. Bhambere a message.
Resources
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