Asynchronous digital medicine: How digital health technology is moving the care paradigm

care paradigm

Healthcare delivery is evolving rapidly, with new digital technologies and tools emerging every day. One of the most significant shifts in recent years has been the adoption of asynchronous digital medicine and care delivery, which allows healthcare providers to offer care to patients on a flexible schedule without the need for real-time, face-to-face interactions.

Asynchronous care delivery is becoming increasingly important as the demand for healthcare services grows. It allows patients to receive care from their providers without needing to leave their homes or take time off from work, and it offers healthcare providers greater flexibility and efficiency in delivering care.

The evolution of one:many care paradigms

One-to-many care refers to a healthcare model where one healthcare provider, such as a physician or nurse, provides care to multiple patients simultaneously. This approach is not new and has been used for decades in settings where there is a high demand for healthcare services and a shortage of healthcare providers, such as in community health clinics or hospitals with limited staffing resources. Historically, we’ve seen the one-to-many care model in action in very crude, low fidelity ways, such as a healthcare provider leading a group therapy or health coaching session or conducting a health education class.

Face-to-face interactions with healthcare providers are no longer a “need-to-have”, but a “nice-to-have” for receiving high-quality clinical insight. With the advent of digital health technologies that allow for secure messaging, e-consults, and remote monitoring, digital health platforms and tools such as telemedicine and health applications are allowing the seamless treatment of multiple patients in different geographies and time zones asynchronously. In one fell swoop, healthcare providers and their care teams can now monitor multiple patients’ progress remotely and provide personalised feedback at their convenience, with access to securely shared connected health data.

Asynchronous digital healthcare in action

I personally experienced a one:many care paradigm utilising in-patient digital medicine first-hand back in July 2022, when I delivered my first child. I was struck at how all of my vital signs, collected electronically with digital sensors at the bedside, were being routed to my nurse sitting in front of a computer in the nursing triage area. My nurse was able to view a dashboard of vital signs for upwards of 10 patients on the maternal and foetal medicine ward simultaneously. This dashboard was also visible to other nurses on a shared TV screen within the ward, in the event that my nurse needed to attend to a patient’s bedside, in which case another adjacent nurse could temporarily provide a remote monitoring backfill in their absence.

Out-patient care is being digitally transformed as well. On a recent ski trip to Crested Butte, Colorado, I met a travel nurse in the hotel hot tub. She needed to get out of the tub to attend a scheduled virtual consultation with a patient. This example of modern medicine in action struck a chord with me, as beyond a one:many paradigm, digital health has also returned some healthcare providers to a proper work-life balance. Without a doubt, this woman was living her best life and avoiding the burnout of the traditional clinic setting by making digital medicine work for her and her patients. All at once, I was envious, intrigued, and curious about how she would appear professional to the patient. I can only surmise that she was going back to her hotel room with enough time to get out of her bathing suit, dry her wet hair, and “clean up” nicely before joining the virtual consultation.

Beyond one:many - Empowering patients with self-guided care 

Outside of the in-patient and out-patient use cases above, digital health is also moving beyond one:many care by allowing health applications to provide self-guided support and management to improve health outcomes. With educational materials, interactive chatbots, and virtual assistants, wearable devices, clinical decision support algorithms, reminders, and symptom tracking, patients are more empowered than ever to manage their health on their own time.

Enabling greater access

Healthcare is no longer confined to the four walls of a care facility, which is a win for democratising access to care for a larger swathe of people. Digital health applications can reduce clinician burnout, reduce healthcare costs, and generally improve quality of life for patients who are able to receive care in between picking the kids up at day-care and going to the grocery store. Digital health solutions have demonstrated a reduction in hospital readmissions and emergency room visits, especially for low-income underserved populations with chronic or mental health conditions.

Digital tools can also increase health literacy by providing patients easy-to-understand information about their health condition, which can allow them to make better decisions about their care. The icing on the cake? Increases in digital literacy affording greater health literacy can also translate to patients becoming more engaged in their care. A study of patients with cancer undergoing chemotherapy found that those who used a digital app to track their symptoms to communicate with their doctors felt safer and were more likely to adhere to their treatment plans than those who did not use the app.

While we still have a long way to go to achieve true health equity with access for all, digital health technology that enables asynchronous care practices in a one:many virtual-first care model is a great start. While there is no magic bullet and true care transformation will take time, the health equity and access that digital health affords can fundamentally translate to a reduction in health disparities, better health outcomes, and more preventative care practices, which can keep humanity healthier and happier at home in this post-pandemic world.


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Emily Lewis
Emily Lewis
18 May, 2023