Today’s healthcare is in flux.  The old theocracy presided of white-coated priests is passing away and in its place a bold new philosophy of shared decision making and patient primacy has taken root.  At the core of this change is a group of outspoken disruptors who are setting an agenda for change through social media.

Nick Adkins is a key member of this group.  His fanaticism for change (and kilts) is well understood within the community.  As the COO of ReelDx, he’s working to bring innovation in the form of video technology into all aspects of healthcare.  His provocative call to action can be heard ringing through the twitter sphere –  “#healthcare, it’s not going to #disrupt itself. let’s do it! #GSD” 

1. What is this disruption word we keep hearing about?

Disruption is the massive seismic shift which is happening NOW in the way providers & patients interact with each other.  As Bill Bunting (@wtbunting) put it best “shift happens”.

2. Why does Healthcare need disruption?

Because all the constituents are drowning in data, regulations, cool new technology, and most importantly – everyone wants the same thing: a shared experience.

We all want to know and feel that we are in this together. That it isn’t an “us” vs. “them” world.  As we say on twitter – #EINPower “the power of one”.  ht @nxstop1

3. There’s so much inertia (a.k.a. tradition) in healthcare.  How might we break through these barriers?

Begin with listening to the heart speak of patients. It’s a common message. It’s a shared message that we all resonate with: we all want to be heard and seen.

Social media has really transformed the way we communicate. It’s helped foster transparency and connection.

The successful hospital systems and payers…..they already get that, and you can already see who some of the early movers/winners are regarding engaging patients/consumers/providers with each other — see for example, @MyUHC @FollowMercy @KPShare

4.  What parts of healthcare shouldn’t be disrupted?

Don’t mess with the billing codes any more. ICD10 should be enough. More than enough. My personal fav = V9542XA

ICD-10 Code: ‘V9542XA’ (V95.42) Diagnosis – Forced Landing Of Spacecraft Injuring Occupant, Init Encntr (Forced Landing Of Spacecraft Injuring Occupant, Initial Encounter)

5.  What will access to healthcare look like in 15 years?  How will the patient/provider relationship change?

I’m not sure we have to go out that far to see some very real substantive change.

There’s so much awesome change happening right now in #healthIT #digitalhealth #mhealth that sometimes it feels like we spend too much energy focusing on what is coming vs. actually seeing (and implementing!) what we already have today.

IF WE ALLOW IT….and that’s the key….. technology can help us all get along and be the awesome people that we all are. Sharing and caring really is the end goal.  

6.  You obviously believe strongly in telehealth.  How is ReelDx’s business model different from other forms of telehealth?

Yeah, the pros for #telehealth #telemedicine are huge. This is the the way healthcare is being delivered – today! You remember when @AlGore invented the Internet, email was born and it changed the world. We were then able to communicate asynchronously and at scale!

What we’ve done at ReelDx with our API is open up our platform to developers around the world who want to plug in asynchronous store and fwd video management into their software/apps.

Using the API allows telemedicine to scale and be extremely more convenient for both providers and patients. Providers can see virtual patients between physical patients. Patients can see their doctor between their daily life activities, then they can easily share the visit with their family and care team so that everyone is engaged and on the same page regarding the treatment plan.

It’s all no brainer stuff right?!  

7.  Is there a sustainable business model for providers in combining traditional visits and telehealth?

Absolutely! Providers who don’t combine are already experiencing patient attrition.

Doctors are having to compete with innovators like @MDLive @DrOnDemand @HealApp @GetPager and that’s spawning some really cool uptick in customer service/experience. 29 states already have parity re reimbursement for telemedicine so providers get paid for virtual visits.

The shift is happening. It’s unavoidable at this point.

Our phones have completely changed the way we live our lives, there’s just no going back at this point. Providers who want to keep their patients are going to have to adopt and fully embrace tech.

For some providers, they are probably already extinct and just haven’t accepted it. Evolution or extinction….yeah, it’s like that.  

8.  What about privacy?  How do we balance the right to privacy with the gains of new technologies?

We each have to answer that question for ourselves. What one person defines as protected health information #PHI, may not be the same definition for another. Some patients post everything on Facebook. Why? Because they can! It’s their data!

While #HIPAA was born with some great intentions, unfortunately it has been used at times as a mechanism to stifle change, thwart technology adoption, and hold on to control. See @ReginaHolliday and @AneeshChopra as two (of many) champions who are leading the revolution re each of us having the right to have access and control of our own data.

 9.  Are you concerned about cybercrime in healthcare?  What strategies are you using to secure data?

It doesn’t keep me up at night.

The platform by ReelDx is a cloud based, HIPAA compliant video management system designed to provide end-to-end secure video management.

Many steps have been taken to ensure the system is secure and meets the strictest security standards.

  • All data is encrypted at rest and in transit between systems.
  • Data is only accessible via strictly enforced security rules.
  • Upon request data is deleted completely as per HIPAA regulations.
  • Data is not allowed out of the secure platform under any circumstances.

At the core of the platform is a proprietary secure video sharing system. By default a video is only accessible to the user that uploaded the video. Any attempt to access or stream that video without the owning users credentials will by default fail.

When a user wishes to expose a video to another party an explicit nomination and sharing operation must be used; this ensures that every person to access a video has explicitly been given rights to do so.

10. What are your favorite healthcare IT books?

The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age”, @Bob_Wachter

The Innovator’s Prescription: A Disruptive Solution for Healthcare”, Clayton Christensen

The Patient Will See You Now: The Future of Medicine Is in Your Hands”, @EricTopol #PWSYN #FTW

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