What are the five focal points of the future of digital medicine, and what is mission and practice drift?
The five focal points: structures, data sovereignty and protection, privacy/confidentiality/identity, patient empowerment, and the doctor-patient relationship. Mission and practice drift means that datafication creates new goals and practices, so data collection changes how people act, e.g. up-coding when algorithms suggest billing codes that earn more.
The five focal points (Brennpunkte):
- Structures
- Data sovereignty and data protection
- Privacy, confidentiality and identity
- Patient empowerment
- Doctor-patient relationship
Structures: digitalisation is not copying analogue practice into computers and replacing paper with chips. It creates new structures and ways of organising that change care on the level of action and of relationships (Swiss Academy of Medical Sciences, 2018).
Mission and practice drift: through datafication, new goals and practices arise, and data collection can change human behaviour. Example: up-coding, where algorithms suggest diagnosis codes that bring higher revenue, so the coding starts serving billing rather than describing the patient.
Another example is radiology: diagnoses are increasingly machine-supported and rely less on direct exchange with other medical professions. Authors speak of the "loneliness" of radiologists, which can come with a loss of contextual information about the patient.
Go deeper:
Wikipedia: Health care fraud — includes upcoding as a billing practice.