Avatar of Dr. Yaa Kumah-Crystal at Vanderbilt University Medical Center to potentially use in future … [+] patient interactions

Dr. Yaa Kumah-Crystal

Avatars, virtual waiting rooms, virtual scribes, in-home testing devices, “syndromatic” facial analysis using AI and machine learning, screen-sharing, and sentiment analysis… There are many exciting innovation possibilities on the horizon that will make telemedicine even more productive, informative, helpful and dare I say fun and personable, than current, in-person doctor visits. Several weeks ago I heard Dr. Yaa Kumah-Crystal, MD MPH, Assistant Professor of Biomedical Informatics at Vanderbilt University Medical Center, speak at the Disruption Lab’s excellent series on the Future of Health Care. Dr. Kumah-Crystal defined telehealth as “care unbound by distance, physical location or setting.”

While many of the ideas Dr. Kumah-Crystal shared have a long way to go, they paint a picture that’s exciting to imagine, and can be instructive and inspiring to a range of industries outside of healthcare.  The guiding objective for these ideas is how to make telemedicine even better than current in-person care, in certain instances.  While telemedicine visits have been reimbursed by most insurance companies at the same rate as in-person visits since the onset of Covid due to restrictions and the need to encourage care, going forward telemedicine may have to prove its comparable worth for insurers to maintain parity payments. What follows are some of the more exciting, creative, effective possibilities Dr. Kumah-Crystal shared.


It can be hard for patients to understand verbal explanations by physicians of their conditions, or through wall-charts or plastic models of body parts in their offices. With screen-sharing, it’s easier for doctors to show more still visuals that can be easier for patients to understand, or even short, explanatory videos.

Chart Photos

It can be difficult for physicians to match patient names with what they look like between or before visits. While not a common occurrence, there can be errors in writing prescriptions for the wrong person. What if each person’s photo always appeared in their telehealth chart?

Syndromatic Facial Detection Using AI, Machine Learning & Pattern Recognition

One way physicians diagnose is looking at the patient’s eyes, face and tongue. AI and Machine Learning benefit from millions of observations, correlations with diseases, and pattern recognition. Using image recognition of the patient, computers have more data points to draw upon than any one physician, and therefore the conclusions can be even more accurate.

Virtual Waiting Rooms

Waiting rooms can be boring and not a great use of a patient’s time. What if once a patient was logged in for their appointment, while they were waiting for the doctor online, there was content tailored either to their interests, or even better, relating to the issue they came to see the doctor about.

Remote Monitoring Devices & Virtual House Calls

What if patients had in their homes, simplified yet effective versions of routine monitoring devices normally found in a doctor’s office, such as a stethoscope or a device for looking in the ear, nose and throat. These readings could be digitally transmitted to the doctor to interpret.

Sentiment Analysis Based On Facial Expression

The patient experience, while historically not given enough attention, can become easier to assess by analyzing facial expressions in response to each step of their care journey, from filling out forms (even digital ones), to speaking with the doctor, to understanding new terminology, to understanding a bill. Anonymized facial expression analysis could help interested doctors’ offices realize what areas of the end-to-end patience experience they most need to improve.

Better Understanding How Patients’ Everyday Life Affects Their Health

Imagine how effective it would be for a patient to show their doctor how they organize their medications, the foods they eat, or how they exercise, right from their home.  The patient could take the doctor or physical therapist for a virtual tour of their medicine cabinet, their refrigerator or pantry, or their exercise routine.


It’s been shown that people can feel more comfortable sharing personal things with through avatars of themselves and people they’re interacting with.  Avatars of doctors can seem more approachable and easier to talk to about difficult subjects.  Advances in avatar creation has enabled them to be even more realistic, with movements like raising eyebrows, smiling, and other facial expressions.

Virtual Scribes

Since the advent of electronic medical records, physicians have found themselves spending more and more time, both during and after patient visits, typing notes about the patients’ symptoms and condition.  It’s hard to make eye contact with the patient while doing it.  Virtual scribes that use voice recognition to hear and transcribe/diarize the entire conversation, free doctors to make eye contact with patients so they feel they’re being paid better attention and getting better care.  Patients can then receive a copy of the notes with a patient dictionary or glossary of terms, so they can more easily understand unfamiliar terminology used by the doctor.

Improved Accessibility and Speech Captions

Due to Covid concerns and patients and physicians wearing masks in-person or online, the sound can be muffled and patients can’t read lips to help decipher the speech.  With virtual visits, there could be captions to what was being said to be sure nothing was missed.  For hearing impaired patients this is even more essential.

Text Check-Ins Between Visits

While there will always be circumstances that require in-person visits, some can be replaced by text check-ins, including photos.  Telemedicine is envisioned as only a partial replacement for in-person care.  For seniors, the disabled, and individuals without good transportation options, the ability to not have to physically come into an office is not only easier, it can increase medical provider/patient communication, and therefore improve outcomes.  This could correlate with a different compensation mechanism that rewards how well the patient does, rather than basing compensation solely on office visit and procedure fees.

Doctor/Patient Portals

With digitized remote monitoring devices like glucose monitors, heart monitors, and scales, doctors can check-in periodically to monitor the data for aberrations that might warrant attention.  The software can be programmed to alert the doctor when aberrations occur and is therefore a 24/7 kind of monitoring that’s more effective than waiting for a scheduled visit to discover an issue.


We live in a very exciting time for medicine because of the combination of  advances in science, technology, creativity, and increased focus on customer experience, speed and efficiency.  What’s key is bringing together individuals with different expertise to jointly problem solve and imagine more effective processes, independent of legacy procedures and systems.  

I’ve heard Scott Friedman, another speaker at the Disruption Lab series on the Future of Health Care, who is a Professor and Chief of the Division of Liver Diseases at Mount Sinai Hospital in New York (considered by many to be the most innovative medical center in New York), speak about Mount Sinai’s new BioMedical Engineering and Imaging Institute.  Launched in September 2019, its goal is to develop novel medical inventions in the fields of imaging, nanomedicine, artificial intelligence, robotics, sensors, medical devices, and computer vision technologies that include virtual, augmented, and extended reality.  Mount Sinai’s pioneering FlexMed medical school program allows applicants to apply who don’t have traditional science majors and they’re not required to take the MCAT for admission.  It encourages a student body with broader set of interests and skills such as engineering, computer science, software engineering, or robotics, that will help graduates create the healthcare of the future. 

There’s much to be learned by other industries in the way healthcare, due to necessity, is adapting to a post-Covid, more contactless, more visual, virtual, and data driven world.  Covid was the accelerant for changes that were long needed, causing us to think sooner, more intensely, broadly, and imaginatively about what the future can hold.