Editor’s Note: Tonya An, MD, currently a surgery resident at Cedar-Sinai Medical Center, led the research efforts on Epharmix from the very beginning along with other early team members. In this article, she recounts her thoughts on patient care and her perspective on Epharmix, both as a researcher on the effort and as a provider caring for patients.
I remember Epharmix in its infancy, when it was just a simple idea championed by a few eager individuals. The idea of digital medicine struck a chord with me: it was a clear solution to my nagging dissatisfaction as a medical student. As hard as we were trying to make people well enough to discharge from the hospital, we pay next to no attention to how they do until they bounce back. As those people were experiencing signs and symptoms of declining health, we certainly were not there to listen and intervene.
If even a medical student could see the inefficiency of the system, then the problem was all too obvious. What never occurred to me before Epharmix was that any one, including a medical student, the lowest person on the totem pole of medicine’s hierarchy, could change the status quo. As a part of the young Epharmix research team, I cold called on attending physicians and shared the idea with them. They got it immediately and shared the enthusiasm like I did. As we started to develop Epharmix systems to address chronic debilitating conditions like end stage renal disease, patients, nurses and doctors alike were excited to participate. On one end, I saw how much patients enjoyed having messages from their healthcare provider and used it as an open channel for communication. The providers gained relevant reports from their patients and were better able to direct their care. Everyone was better off, including the hospital which had fewer hospitalizations.
What makes Epharmix unique is that it continues to be driven by medical students. The entire process, from brainstorming of new applications to development to trial, is run entirely by student teams. I served as leader across several clinical projects and advised the teams based on my experience with the first Epharmix trials. Everyone I worked with was motivated and creative. Despite being only 1st or 2nd year students, they were encouraged to pursue their medical specialties of choice. Through talking to MD’s, nurses, pharmacists, etc, not only did they come up with new ideas, they took ownership of these projects and quickly stepped into very strong roles as team leaders. With their diverse interests, enthusiasm and a little direction, the Epharmix catalog expanded to address dozens of new conditions. It was so rewarding to learn from each other and to feel empowered that we were doing something big and actually affecting the health care landscape, one that we would one day practice in. It was the ultimate multi-disciplinary environment that fostered problem solving and innovation.
I am now a resident physician at a busy level one hospital. I see 20-30 patients on a daily basis and days revolve around trying to get people discharged. Despite the relief of having one less patient to manage, I worry frequently about those people that have gone home after an abdominal surgery: I will not have contact with these patients for several weeks until they come back to clinic, if they do not have to go to the ED before that. Are they having a great deal of pain? Are they able to keep food down? Is their wound developing an infection that needs to be treated with antibiotics? The more I become responsible for the care of others, the more I believe the need for something like Epharmix’s condition specific applications, which provide clinically relevant and timely information that providers need for medical decision-making, especially in-between office visits. Since I can get that data without extra burden on my time, not only do my patients benefit, I can also stop worrying about being in the blind with their conditions and get peace of mind.
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