The Role of Technology in Combating Unwarranted Variations

Uniformity in medical diagnoses and treatment is essential, as it ensures that conditions are treated the same way, cultivating some sense of equality in medicine. Still, it is challenging to achieve such uniformity as all patients are different, with varying symptoms and medical histories. Furthermore, it is unrealistic for all healthcare providers to treat patients in the exact same way. 

In the past, patients would blindly trust their doctors and assume their diagnosis to be correct, but today we utilize second opinions and feel free to question such decisions. But even if we question our doctors, patients still see variations in diagnosis and treatment, resulting in some complications. Fortunately, developments in technology can help us understand why these variations occur and help us to eliminate them for more unified and improved patient care. 

Variation in Treatment Decisions


When a patient is diagnosed, their healthcare provider will then decide on treatment and care, whether they should undergo long-term treatment, a procedure, medication, or any other variation of care. What works for one patient may not work for another with the same medical condition. For example, a patient could be allergic to the traditional prescription for a condition or be ineligible for a recommended procedure, so they must receive alternative treatment - but this is not the kind of medical variation we are referring to. 

The unwarranted variations in medical practices that we are discussing refer to physicians treating similar circumstances or diagnoses in different ways. This means that if two patients are diagnosed with the same condition, they may be treated through various methods. One patient may be prescribed medication, while the other may be recommended to undergo a procedure. 

This does not necessarily refer to an individual doctor with varying treatment in their own patients, but rather an overarching look at how all physicians vary treatment of patients with the same condition. Furthermore, these variations typically do not stem from mistakes, but instead, doctors believing in and preferring varying treatment methods. The concern with variations in treatment is that they are unwarranted and can result in increases in physical and financial harm to patients receiving one form of treatment over another. 

Research shows that there are four categories of unexplained variations in medical practices: underuse of effective care, overuse of finite resources, misuse of preference-sensitive treatment, and variable outcomes attributable to the quality of care. We will discuss these four categories of variations and solutions and how healthcare providers can standardize treatment for improved universal care through technology. 


Underuse of Effective Care


The underuse of effective care refers to when healthcare providers neglect to give patients medically necessary care or follow proven healthcare practices. This could be failing to perform a procedure on a patient that is protocol, such as an annual breast cancer screening mammogram for women. Studies show that only one in 20 women receive such an exam each year, leading to an increased risk of breast cancer. Another example is failing to give beta-blocking drugs to a patient having a heart attack, which can result in death or long-term damage. 

Underuse of effective care can be extremely harmful to patients, resulting in the deaths of 91,000 Americans each year because their physicians fail to provide the necessary care. Patients living with chronic conditions such as high blood pressure, diabetes, and heart disease are particularly susceptible to the damages of such a phenomenon. 


Overuse of Finite Resources


While the underuse of care can be extremely harmful to patients, so can the overuse of finite resources. In terms of medical practices, overuse refers to a provider giving a drug or treatment to a patient without medical cause. This could mean treating patients with unnecessary medications such as antibiotics for a simple infection or ordering an unnecessary procedure - which could be as drastic as surgery. 

Another way that resources could be overused is when a physician fails to follow the most effective options, that of which may cost less or cause fewer side effects. Such overuse of resources can significantly increase the cost of healthcare for patients and worsen or prolong their condition. This is often seen in ear infections, where antibiotics are prescribed without being medically necessary. 


Misuse of Preference-Sensitive Treatment


Misuse is a medical error in which a patient does not entirely benefit from treatment due to a preventable problem or when a patient is harmed by treatment. Medical misuse is a severe problem in the healthcare industry, resulting in 44,000-98,000 deaths per year caused by preventable errors. Examples of medical misuse may include prescribing a medication that a patient is allergic to, which should have been - and likely was - listed on the patient’s medical records. 


Variable Outcomes Attributable to Quality Care


Beyond the underuse, overuse, and misuse of medical care, occasionally, there are just variations in the treatment a patient receives. One healthcare provider may be more inclined to prescribe medication, while another chooses to wait it out before prescribing. Alternatively, one provider could recommend physical therapy while another suggests an operation. 

Variations in treatment occur all the time, and it depends on the providers and the patient involved. That being said, variations in medical care can prevent patients from receiving the proper care they need - particularly in the most efficient and cost-effective manner. For this reason, healthcare providers need to establish some form of uniformity and standardization when treating patients of a similar condition. 


Overcoming Unwarranted Variations


Thanks to recent advances in technology, reducing these variations in treatment is possible. Technology such as a telehealth portal enables healthcare providers to enter a community of physicians and doctors, introducing them to a platform where standardization can occur. With a telehealth platform, providers can easily connect, collaborate, and communicate with one another - no matter their time zone, location, or specialty. 

As a result, providers are exposed to a broader range of teachers and peers where second opinions and consultations can be facilitated. Through more communication, providers can determine the best means of treatment for a condition and ideally eliminate the variations in treatment that many patients experience

In addition to cultivating a platform for collaboration, many telehealth platforms are compatible with AI capabilities, furthering providers’ ability to standardize care. With AI, the telehealth application can recognize historical patterns and patient history to create diagnoses and treatment options. While providers will use this as a resource rather than a concrete diagnosis, it can significantly help to standardize treatment. If providers use the same platform and the same data is fed into the AI program, physicians will receive the same treatment suggestions. 

These technological capabilities can serve as “guard rails” for healthcare providers, nudging them into the right direction for treatment. As there is no one-size-fits-all approach to treatment in medicine, a telehealth platform can help standardize patient treatment without offering a cookie-cutter solution. For every condition, there is no treatment that will work for every patient. That being said, a telehealth solution can guide healthcare providers in the right direction while avoiding harmful and unwarranted variations in treatment.


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About the author - Alexandru Artimon

Co-founder of Medicai. Over 15 years of experience with deep expertise in enterprise healthcare systems software architecture. Graduated Computer Sciences, also has a Masters degree in parallel computing and cloud computing. Alex writes about developing large-scale enterprise applications using state-of-the-art software technologies in healthcare.