Words alone couldn't move a patient -- but 'digital' was different

“You must exercise.”

No matter how much you tell them or nag them, once they leave the doctor's office, that's it. That's why doctors always struggle to improve patient adherence to prescriptions. However, a doctor has found the answer in “digital.” Professor Park Jae-hyeon of the Department of Rehabilitation Medicine at Hanyang University Guri Hospital is that physician.

Recently, many digital solutions have been developed in the healthcare field, and their clinical usefulness has been promoted, but not a few doctors are hesitant to use them. If so, such doctors are recommended to attend Professor Park's lecture, “Treating patients with digital solutions instead of saying ‘you must exercise’” at HiPex 2024, to be held at Severance Hospital from June 19 to 21. Professor Park will share his knowledge of digital solutions with fellow physicians.

Meeting with Korea Biomedical Review ahead of the lecture, Professor Park said he adopted digital solutions out of necessity.

“In outpatient clinics, I can only explain post-treatment care (to patients with pain) for a short time, so when I taught them how to exercise, they sometimes don't understand them properly,” he said. “Especially nowadays, medical information is flooded on YouTube, so some people do exercises that are not suitable for their pain due to incorrect information. In addition, the exercises and intensity should differ depending on the situation, but there are cases where only one type of movement is used.”

The advantage of digital solutions is that patients can see how much exercise they have done.

“If you recommend exercises, you don't know whether they did well at home. However, with digital solutions, you can see how much exercise they've done and how much pain they've experienced,” Park said.

However, doctors and patients may find digital solutions rather unfamiliar. Professor Park said patients react differently depending on their age and previous exercise experience.

“There is a big difference (in response) depending on age, previous exercise experience, and willingness to exercise. Patients who are motivated to exercise and believe exercise is beneficial like to use digital solutions. On the other hand, some patients don't see the point of exercising and just want to prescribe medication.”

For patients who don't realize the need for exercise or don't have time to exercise, the only answers are to “explain and “convince them.”

“For patients who react negatively to digital solutions, you have to explain (their usefulness),” Park said. “Explain to them that they need to modify their lifestyle with exercise to make their medication more effective. Otherwise, they will relapse. For patients who don't have the time to exercise, I recommend starting with the least they can do, even if it's something simple. Starting with one or two simple things seems to lead to higher adherence than talking about many things from the beginning.”

Improving patient adherence to prescriptions and increasing cure rates would be great. However, Professor Park said there are barriers to this process in the real world.

“The biggest problem is that you can't get additional reimbursement for using digital solutions,” Professor. Park said. “There is no reimbursement factor, so recommending digital solutions is just a service for now.”

He is also cautious about advocating for reimbursement for digital solutions in the current healthcare context, where there are many challenges.

“In the U.S., for example, there are exercise monitoring fees. It's a 'management' or 'prevention' type of reimbursement,” Park said. “It could save health insurance finance in the long run.”

Despite the difficulties of adopting and spreading digital solutions in clinical practice, Professor Park was positive about using them in rehabilitation medicine.

“Currently, older adults are not used to using digital solutions, which is one of the hurdles to their adoption, but as the generation familiar with smartphones grows older, digital solutions will become much more accessible,” Park said.

He continued, “The system has not yet kept up with the evolution of digital solutions. However, if doctors are more interested in utilizing digital solutions in their practice, the system will follow suit, and in the long run, the quality of care will improve.”