Telemedicine: The future of health care is already here
Technology that enables telemedicine is set to change the medical field for patients, doctors, and investors.
- Digital technologies that disrupted industries like communication and transportation are steadily changing health care, too.
- Virtual health care will save consumers money while growing the industry by billions of dollars.
- Non-visit care combined with smartphone apps will give patients more power over their health care.
Progress in health care over the last 200 years has typically resulted from technological development, as new devices and medicines became available. Today, as technological innovation disrupts entire sectors of the economy, doctors and health care professionals are more than willing to adopt, and even promote, new approaches to health care.
Yet there is still much more room for growth. Telemedicine or "virtual check-ups" is one such area. Mobile devices and other computing advances have already drastically changed how we do business, communicate, and live our lives. The ways we receive medical care have started to follow suit.
Michael Dowling has a birds-eye view of the evolution of patient care. The president and CEO of Northwell Health, New York State's largest health system, Dowling reflects on the availability of thousands of health-care-related apps in his recent book, Health Care Reboot: Megatrends Energizing American Medicine. He notes that some apps connect to wearables that calibrate blood pressure, heartbeat and medical implants that can monitor breathing, glucose levels or other health indicators. Many of these apps alert doctors when a patient needs a check-up, blood work or prescription changes.
All of this is resulting in a new shift toward technologically driven health care that will improve how patients are cared for. In his book, Dowling writes:
.. the in-person visit in health care—what is now the first step in many medical encounters—might be someday thought of as a last resort, after first exploring options to safely and effectively resolve a patient's needs remotely.
The future of telemedicine or virtual health care
Telemedicine allows A&E doctors at Dole Hospital – which doesn't have a neurology department – to obtain an immediate diagnosis for their patient by a neurologist in Besancon hospital, seen over the doctor's shoulder. This system allows doctors to exchange medical imagery and the patient's file.
(Photo by: BSIP/UIG via Getty Images)
Dr. Eric Topol of the Scripps Research Institute is an ardent proponent of increasing the role of technology, especially smartphones, in the way that health professionals conduct business. In his book, The Patient Will See You Now, he emphasizes that clinicians and medical organizations need to put technological solutions at the forefront of health care strategy and delivery.
Noting that "the culture of medical practice is famously conservative," Topol concedes that it will be a challenge, but the opportunities are too great to pass up.
Major players in the health care field are already implementing telemedicine. Dowling states in his book that:
At Kaiser Permanente, 52 percent of 'the more than 100 million patient encounters each year are now 'virtual visits,'' via text messages, calls, email, or video conferencing.
Dowling adds that health care technology falls within two primary categories: facilitating the delivery of care and consumer interactions.
Continuing technological advancements will spur non-visit health care and improve value-based health care solutions. Companies such as Apple, Amazon, Facebook, Google, and Microsoft have already publicly expressed interest in continuing to grow their health care presence. For years, Apple has been consolidating medical records on iOS through extensive partnerships with major medical centers – including Johns Hopkins, Cedars-Sinai, and Geisinger Health System.
One of the more noteworthy entrants is Haven, a nonprofit collaboration between JP Morgan, Berkshire Hathaway, and Amazon. Haven's goal is to improve health care services and lower costs for the three companies while making primary care easier to access.
Technological health care solutions in action
Erica Jensen, with her 5-month-old daughter, Charlee Jaques, by her side, video conferences with her doctor, Dr. Marie McDonnell, from her mother's home.
(Photo by Dina Rudick/The Boston Globe via Getty Images)
Amazon made another big splash last year when it announced that it had acquired PillPack, an online pharmacy. PillPack is a high-profile example of a telemedicine solution that brings the Silicon Valley spirit into the medical arena. PillPack's digital pharmacy platform manages patient data and controls logistics for delivering and managing customers' medical needs.
Innovations continue to unfold every day. In April 2019, Northwell Health launched an Emergency Telepsychiatry Hub that provides around-the-clock mental health care. People in crisis no longer have to wait long hours during crucial times of need. Patients have benefited from drastically reduced waiting times to speak to someone who can help them – members of an expansive team that includes 23 psychiatrists and 9 behavioral health practitioners with master's level training
Already, the new telemedicine service has brought the wait time down 90 percent to an average of 45 minutes. Northwell is increasingly integrating these services to many of its hospitals and centers. Jonathan Merson, MD, medical director of Northwell Emergency Telepsychiatry Hub Program, stated, "It's a technology that has no boundaries and the goal is simple: No patient experiencing a behavioral health emergency should have to wait to be seen."
Telemedicine will save billions
Telemedicine services are not only smart, they are also necessary. The American Association of Medical Colleges has already projected that there may be a shortage of some 40,000 primary care physicians (PCPs) in the coming decade. Increased virtual services will alleviate this shortage and allow already-overworked clinicians to focus on giving advanced care to patients in more critical situations.
Another consideration is the economic value of telemedicine services. An Accenture analysis found that the use of telehealth services could generate up to $10 billion annually over the next few years.
Without needing to expand the workforce, telemedicine can assist and augment medical professionals' activities. Personalization and efficiency will benefit the individual patient as the tools for controlling their own medical records and care plans allow them to become more engaged.
What health conditions can be treated via telemedicine?
Telemedicine is being used by rescue services in Hesse, Germany, to better treat patients in urgent conditions.
(Photo by Arne Dedert/picture alliance via Getty Images)
Telehealth is also useful for people whose frailty or chronic condition make it difficult to visit a doctor's office. There have been significant developments in what some medical providers are calling remote patient monitoring tools. For example, smart phones or tablets of people with Type 2 diabetes can automatically log blood glucose data from their monitoring device. Physicians can check these analytics any time and adjust treatment as needed.
Telemedicine is also more efficient than office visits or house calls for non-chronic health issues. A quick follow-up by video conference can ensure a patient is following their physician's directions. Medication management – confirming compliance with prescription doses and schedules, ensuring there are no troublesome side effects – is another helpful application of telehealth.
The technology that drives telemedicine is only in its infancy, but it will gain increasing prominence in the medical field and public sphere as innovations skyrocket and new startups enter the arena. As people grow accustomed to the ability to chat to their doctors without passing through a waiting room, to receive instant attention based on data from their medical devices, and to control their health from the palm of their hand, the life-saving convenience of telemedicine will be realized. That future is already under way.
New research suggests you can't fake your emotional state to improve your work life; you have to feel it.
What is deep acting?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTQ1NDk2OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTY5MzA0Nn0._s7aP25Es1CInq51pbzGrUj3GtOIRWBHZxCBFnbyXY8/img.jpg?width=1245&coordinates=333%2C-1%2C333%2C-1&height=700" id="ddf09" class="rm-shortcode" data-rm-shortcode-id="9dc42c4d6a8e372ad7b72907b46ecd3f" data-rm-shortcode-name="rebelmouse-image" data-width="1245" data-height="700" />
Arlie Russell Hochschild (pictured) laid out the concept of emotional labor in her 1983 book, The Managed Heart.
(Photo: Wikimedia Commons)<p>Deep and surface acting are the principal components of emotional labor, a buzz phrase you have likely seen flitting about the Twittersphere. Today, "<a href="https://www.bbc.co.uk/bbcthree/article/5ea9f140-f722-4214-bb57-8b84f9418a7e" target="_blank">emotional labor</a>" has been adopted by groups as diverse as family counselors, academic feminists, corporate CEOs, and each has redefined it with a patented spin. But while the phrase has splintered into a smorgasbord of pop-psychological arguments, its initial usage was more specific.</p><p>First coined by sociologist Arlie Russell Hochschild in her 1983 book, <a href="https://www.ucpress.edu/book/9780520272941/the-managed-heart" target="_blank"><em>The Managed Heart</em></a>, emotional labor describes the work we do to regulate our emotions on the job. Hochschild's go-to example is the flight attendant, who is tasked with being "nicer than natural" to enhance the customer experience. While at work, flight attendants are expected to smile and be exceedingly helpful even if they are wrestling with personal issues, the passengers are rude, and that one kid just upchucked down the center aisle. Hochschild's counterpart to the flight attendant is the bill collector, who must instead be "nastier than natural."</p><p>Such personas may serve an organization's mission or commercial interests, but if they cause emotional dissonance, they can potentially lead to high emotional costs for the employee—bringing us back to deep and surface acting.</p><p>Deep acting is the process by which people modify their emotions to match their expected role. Deep actors still encounter the negative emotions, but they devise ways to <a href="http://www.selfinjury.bctr.cornell.edu/perch/resources/what-is-emotion-regulationsinfo-brief.pdf" target="_blank">regulate those emotions</a> and return to the desired state. Flight attendants may modify their internal state by talking through harsh emotions (say, with a coworker), focusing on life's benefits (next stop Paris!), physically expressing their desired emotion (smiling and deep breaths), or recontextualizing an inauspicious situation (not the kid's fault he got sick).</p><p>Conversely, surface acting occurs when employees display ersatz emotions to match those expected by their role. These actors are the waiters who smile despite being crushed by the stress of a dinner rush. They are the CEOs who wear a confident swagger despite feelings of inauthenticity. And they are the bouncers who must maintain a steely edge despite humming show tunes in their heart of hearts.</p><p>As we'll see in the research, surface acting can degrade our mental well-being. This deterioration can be especially true of people who must contend with negative emotions or situations inside while displaying an elated mood outside. Hochschild argues such emotional labor can lead to exhaustion and self-estrangement—that is, surface actors erect a bulwark against anger, fear, and stress, but that disconnect estranges them from the emotions that allow them to connect with others and live fulfilling lives.</p>
Don't fake it till you make it<p>Most studies on emotional labor have focused on customer service for the obvious reason that such jobs prescribe emotional states—service with a smile or, if you're in the bouncing business, a scowl. But <a href="https://eller.arizona.edu/people/allison-s-gabriel" target="_blank">Allison Gabriel</a>, associate professor of management and organizations at the University of Arizona's Eller College of Management, wanted to explore how employees used emotional labor strategies in their intra-office interactions and which strategies proved most beneficial.</p><p>"What we wanted to know is whether people choose to engage in emotion regulation when interacting with their co-workers, why they choose to regulate their emotions if there is no formal rule requiring them to do so, and what benefits, if any, they get out of this effort," Gabriel said in <a href="https://www.sciencedaily.com/releases/2020/01/200117162703.htm" target="_blank">a press release</a>.</p><p>Across three studies, she and her colleagues surveyed more than 2,500 full-time employees on their emotional regulation with coworkers. The survey asked participants to agree or disagree with statements such as "I try to experience the emotions that I show to my coworkers" or "I fake a good mood when interacting with my coworkers. Other statements gauged the outcomes of such strategies—for example, "I feel emotionally drained at work." Participants were drawn from industries as varied as education, engineering, and financial services.</p><p>The results, <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fapl0000473" target="_blank" rel="noopener noreferrer"><em>published in the Journal of Applied Psychology</em></a>, revealed four different emotional strategies. "Deep actors" engaged in high levels of deep acting; "low actors" leaned more heavily on surface acting. Meanwhile, "non-actors" engaged in negligible amounts of emotional labor, while "regulators" switched between both. The survey also revealed two drivers for such strategies: prosocial and impression management motives. The former aimed to cultivate positive relationships, the latter to present a positive front.</p><p>The researchers found deep actors were driven by prosocial motives and enjoyed advantages from their strategy of choice. These actors reported lower levels of fatigue, fewer feelings of inauthenticity, improved coworker trust, and advanced progress toward career goals. </p><p>As Gabriel told <a href="https://www.psypost.org/2021/01/new-psychology-research-suggests-deep-acting-can-reduce-fatigue-and-improve-your-work-life-59081" target="_blank" rel="noopener noreferrer"><em>PsyPost</em> in an interview</a>: "So, it's a win-win-win in terms of feeling good, performing well, and having positive coworker interactions."</p><p>Non-actors did not report the emotional exhaustion of their low-actor peers, but they also didn't enjoy the social gains of the deep actors. Finally, the regulators showed that the flip-flopping between surface and deep acting drained emotional reserves and strained office relationships.</p><p>"I think the 'fake it until you make it' idea suggests a survival tactic at work," Gabriel noted. "Maybe plastering on a smile to simply get out of an interaction is easier in the short run, but long term, it will undermine efforts to improve your health and the relationships you have at work. </p><p>"It all boils down to, 'Let's be nice to each other.' Not only will people feel better, but people's performance and social relationships can also improve."</p>
You'll be glad ya' decided to smile<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="88a0a6a8d1c1abfcf7b1aca8e71247c6"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/QOSgpq9EGSw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>But as with any research that relies on self-reported data, there are confounders here to untangle. Even during anonymous studies, participants may select socially acceptable answers over honest ones. They may further interpret their goal progress and coworker interactions more favorably than is accurate. And certain work conditions may not produce the same effects, such as toxic work environments or those that require employees to project negative emotions.</p><p>There also remains the question of the causal mechanism. If surface acting—or switching between surface and deep acting—is more mentally taxing than genuinely feeling an emotion, then what physiological process causes this fatigue? <a href="https://www.frontiersin.org/articles/10.3389/fnhum.2019.00151/full" target="_blank">One study published in the <em>Frontiers in Human Neuroscience</em></a><em> </em>measured hemoglobin density in participants' brains using an fNIRS while they expressed emotions facially. The researchers found no significant difference in energy consumed in the prefrontal cortex by those asked to deep act or surface act (though, this study too is limited by a lack of real-life task).<br></p><p>With that said, Gabriel's studies reinforce much of the current research on emotional labor. <a href="https://journals.sagepub.com/doi/abs/10.1177/2041386611417746" target="_blank">A 2011 meta-analysis</a> found that "discordant emotional labor states" (read: surface acting) were associated with harmful effects on well-being and performance. The analysis found no such consequences for deep acting. <a href="https://doi.apa.org/doiLanding?doi=10.1037%2Fa0022876" target="_blank" rel="noopener noreferrer">Another meta-analysis</a> found an association between surface acting and impaired well-being, job attitudes, and performance outcomes. Conversely, deep acting was associated with improved emotional performance.</p><p>So, although there's still much to learn on the emotional labor front, it seems Van Dyke's advice to a Leigh was half correct. We should put on a happy face, but it will <a href="https://bigthink.com/design-for-good/everything-you-should-know-about-happiness-in-one-infographic" target="_self">only help if we can feel it</a>.</p>
Archaeologists discover a cave painting of a wild pig that is now the world's oldest dated work of representational art.
- Archaeologists find a cave painting of a wild pig that is at least 45,500 years old.
- The painting is the earliest known work of representational art.
- The discovery was made in a remote valley on the Indonesian island of Sulawesi.
Oldest Cave Art Found in Sulawesi<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="a9734e306f0914bfdcbe79a1e317a7f0"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/b-wAYtBxn7E?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
The Persian polymath and philosopher of the Islamic Golden Age teaches us about self-awareness.
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