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Daniel Barchi put this forward on LinkedIN.

The future of medicine is not better appointment scheduling or more convenient telemedicine. The future of medicine is asynchronous. Patients with symptoms will initiate care with a secure text/chat with their physician or a care coordinator. Over the course of a few hours, the appropriate labs/imaging tests will be arranged. Over a few days and a series of messages, the clinician and the patient will get the results, answer questions, and decide on a course of care. All of this will happen in a timeframe shorter than symptom to initial visit happens today. #AsynchronousMedicine #AsynchMed #medicine

Today we explore.


Today in health, it asynchronous healthcare. Is it the future of healthcare? And I also want to point out some real leadership here. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health, a set of channels dedicated to keeping health it staff current and engaged.

We want to thank our show sponsors who are investing in developing the next generation of health leaders. Gordian dynamics, Quill health tau site nuance, Canon medical, and current health. Check them out at this week.

All right this morning, I'm flipping through LinkedIn and Daniel Barr cheese. Post jumped out at me, Daniel parch. He is the CIO for New York Presbyterian. Someone we've had on the show several times, someone whose leadership I really appreciate. And he had a short, succinct post, which I thought was really fascinating. Let me give it to you.

The future of medicine is not better appointment scheduling or more convenient telemedicine. The future of medicine is asynchronous.

The future of medicine is asynchronous. Patients with symptoms we'll initiate care with a secure text chat with their physician or a care coordinator. Over the course of a few hours, the appropriate labs imaging tests will be arranged. Over a few days and a series of messages, the clinician and the patient will get the results.

Answer questions. And decide on a course of care. All of this will happen in a timeframe shorter than symptom to initial visit happens today. And he has hashtag asynchronous medicine and async med and medicine. , there's, there's so much to like about this post. First of all, it's very succinct. I like how direct it is.

We're very well communicated. The other thing is I like the leadership that it displays a CIO weighing in on what he thinks the future of medicine. I remember a couple episodes back. I talked about having a point of view or what your, I believe statement says, this is Daniel Barchie. I believe statement it's something to build on. It's something that his team can rally around.

And it's forms the foundation for a conversation. And to that point, there are 58 comments on this post already in 19 hours, since he posted it. And as you would imagine, some are pro some are against. And, , that is to be expected.

Some are viscerally opposed to it. , talking about the breakdown of the, , the relationship with the primary care physician

and how they expect the care outcomes to go down as a result of it.

I love it. Put it out there. Start the conversation within your house with some outside of your health system. And so let's just give you a couple of the responses here. , David Curry, this will certainly work for those who are connected to a healthcare organization are assured of payment. For the services, but what of those without the security to whom do they reach out Medicare for all first? Okay. So, , again, I love the fact that the conversation is out there. We can have the conversation around some of these things.

There are several problems with the general public, having a relationship with. They're local healthcare provider and some of those are cost related. So from our access related, ,

And some of them are because it is just so convoluted to get to that appointment. So many stories of, you know, I called in for an appointment and it's. You know, six weeks out. Well, if you're, if you have an illness, obviously six weeks is not going to work for you. And beside the political statement that's in here. This is a question that needs to be.

Answered. Right. What about those people without insurance? What about those people? Who are under-insured and those kinds of things. , next comment. The asynchronous messaging is long overdue as part of our healthcare model, especially when many patients are already comfortable with text messaging.

It was a matter of meeting the patient where they are. However, like every tech implementation, it is not one size fits all and also comes with some downside over utilization in the form of over-testing

excessive imaging from the bots that do the initial triage will add to the problem of waste and healthcare costs. Ah, interesting. You know, the difference is that bots don't get paid based on the number of tests and don't get paid. Based on the number of images.

And to a certain extent. What it's about is who writes the algorithm and how the algorithm is designed and what is designed to really optimize for. So just something to consider here, you know, when I go back to Daniel's. , comments here. It's interesting that he starts with the future of medicine is not right. It's not better appointment scheduling or more convenient telemedicine.

That's a slap at all of those people who say we just need to make the current system. More accessible easier and that kind of stuff. And he's saying. Let's let's leap frog that which is, , people getting care on an asynchronous level, which means. There's more touch points. There's more ability to impact their overall health.

I told you there were some visceral responses out here. , here's one of them get a physician willing to listen to you, examine you and be ready to help you and your family. Pay the physician, a fair fee to help you not land in trouble. And pull you out of it when you do. Stop hassling doctors with your insurance card. Save that for severe illness.

Such doctors used to be called primary care physicians and internists. The future of health of communities will be terrible. When people go to AI bots or worse telemedicine for $28, $25. Sorry, need to get my glasses rechecked to the university approved telehealth provider consultation fee. For the generation of billable documents and have numerous blood draws, including blood and saliva tests for cancer causing gene defects.

The current fad, widely promoted by specialty societies.

Go to the malls to get the carotid and peripheral vascular us sponsored. By local surgeons and hospitals, and get easy prescription without many questions or frequent reassessment of the need for these drugs. This is big city, patient oriented USI medicine that has messed up the health of the masses over the past 30 years.

Keep this note handy and revisit it in 10 years. From now,

You know, it's interesting when I read that, because when I read that I love the leadership that Daniel's put out there. You put it out there, you get the conversation started and , you have the, the back and forth that happens. And I read this and I say, you know, to a certain extent, I get it. I understand what, what this person's saying. And I don't necessarily disagree with a lot of it.

, you know, if we are going to, , AI bot driven medicine, it is better to revisit your physician as often as possible. The problem is it breaks down. It breaks down when there's a shortage of clinicians. And we have a shortage of clinicians and it is only growing. And so to not explore other solutions.

Is almost not even an option. Right. We have to explore options that require less clinicians moving forward. As I said, there's a couple of things. A hundred percent agree. I think building care models and financial models to support this. It's going to be much needed. ,

, you get the picture. I, you know, I just wanted to point this out. I think it's a great, I believe statement. I believe the future of medicine is asynchronous medicine. And if you believe that, what platforms would you put in place? What conversations would you be having with your clinical staff and your leadership?

And how would that impact your budgets? How would you test this out? What would a, a good. , , pilot, I hesitant, boy, I really hesitated to use that word. It kind of surprises me. Cause pilot has gotten such a bad rap recently, but I think there is, I think there's probably multiple pilots that you could run with this and say, all right, let's see how this goes. Let's see how effective this can be.

So I'm, I'm actually really excited that Daniel put this out. I think it's gonna be part of the conversation and is now part of my vernacular. It was not really in my sights. Before, and I will start to have conversations with people about it. To try to flesh it out as well. All right. That's all for today. Great leadership from Daniel and a great concept for us to start.

Mulling over. If, you know, someone that might benefit from our channel, please forward them a note thinking subscribe on our website this week. or wherever you listen to podcasts, apple, Google, overcast, Spotify, Stitcher. You got the picture. We are everywhere. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders.

Gordian dynamics, Quill health tau site nuance, Canon medical, and 📍 current health. Check them out at this week. Health. Dot com slash today. Thanks for listening that's all for now

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