December 9, 2019

Tim Layman: Patient Care: What Does the Future Look Like?

By Timothy Layman
Interim Chief Executive Officer/Chief Nursing Officer, Highlands-Cashiers Hospital


As we approach the New Year 2020, it seems like just yesterday we were celebrating (or worrying about) Y2K. Healthcare has experienced remarkable change in the last two decades, from the introduction of telemedicine, a treatment modality whereby a patient can receive treatment even if the provider is in a remote location, to the expansion and refinement of electronic health records that serve as a centralized digital filing system for a person’s entire health history.

As we look toward the next 20 to 30 years, what might healthcare look like by 2050 and beyond? The most significant theme I see as I envision care is connection – between patients, their physicians, caregivers, and team members. The connection will be enabled and supported by many innovations, from wearable medical devices to telemedicine capabilities that will exist in your own home.

We’re already seeing an uptick in the use of wearable technology that monitors health metrics and risks for conditions, as well as helps people live healthier lifestyles. There is a wearable device that keeps track of your daily movement, nutritional choices, and sleep each day, among other features.

Another wearable device provide owners with apps that support health, but even perform fitness tracking tasks, and yet another has a line of highly sophisticated fitness monitoring tools that analyze the overall stress on your body from running, cycling, or other types of workouts. These devices even track the oxygen level in your blood and can measure the length of your stride while running. For example, should you experience an irregular heartbeat known as atrial fibrillation (AFib), which can lead to stroke or heart attack, the watch will alert you, allowing you or someone you’re with to immediately call 911 for help. It will also notify you if you experience an unusually low or high heart rate so you can contact your physician.

These innovative wearable devices are also monitoring patients with epilepsy and predicting seizure activity, so they can connect with providers when needed, while high-tech blood glucose monitors are allowing people with diabetes to test their blood sugar without pricking their fingers. These devices will undoubtedly become even more advanced in the coming years, as will their ability to allow people to partner with their physicians.

Patients and caregivers will increasingly be able to connect to care, thanks to telemedicine capabilities, in a myriad of ways. Telemedicine already touches our lives. For example, our virtual clinic allows you to “see” a board-certified Mission Health provider for common ailments like sore throat and urinary tract infections (UTIs). A more severe issue might be when a patient at Highlands-Cashiers Hospital arrives with signs of stroke; our ED physician can consult with a neurologist at Mission Hospital, and together, the physicians can interpret test results and assess whether the patient should transfer to Asheville. These are things we already do, but the future promises many more applications that will further increase collaboration among different regional, national, and global health systems.

Patients’ smartphones and the growth of patient portal use are also allowing patients to connect more closely with their providers. Rather than booking an in-person appointment, you can ask your doctor a question about a prescription, report a symptom, or ask for clarification about a test result via email or text.
As more people explore treatment this way, the majority of care will shift from taking place in care settings like hospitals and move to patients’ homes; it’s hard to imagine right now, but it’s the way things are headed. In addition to connecting to your care when a problem arises, technology will increasingly enable patients and their caregivers to team up on preventive care, health problems can be avoided before they happen.

Sharing a patient’s medical data can sometimes feel cumbersome at this point – to both patients and their physicians – but health records of the future will be inclusive of all of the patient’s latest test results, surgical history, routine exam results, etc. This means data will easily flow among institutions, whether officially connected – like within a health system – or not.

We’re in the midst of a transformative time in patient care; there is no doubt about it. The innovation and modernization of health care modalities and other industry norms will prove to empower patients and caregivers alike, allowing the patient to participate in their care.

I’m also happy to announce a permanent CEO/CNO for Highlands-Cashiers Hospital. Thomas Neal, RN, MBA, MHA, was previously CEO for Community Health Systems (CHS), and served both the Berwick Hospital Center in Berwick, Pennsylvania and West Virginia’s Greenbrier Valley Medical Center. Thomas’ work and initiatives favorably impacted patient care and safety at Berwick Hospital Center, and he has specialized experience with primary care physician recruitment. He started serving our communities on December 1st. We welcome Thomas and know he’ll be an asset to both HCH and the Plateau.

I appreciate my time as interim CEO/CNO here at HCH and will return to my “home base” at Angel Medical Center in Franklin. Thank you for your support during in this time of transition..



Timothy Layman, DNP, is the Interim Chief Executive Officer and Chief Nursing Officer (CNO) of Highlands-Cashiers Hospital. Layman holds a PhD in Nursing Practice from Yale University, a MS in Nursing Administration from LaRoche College and a BS in Nursing from Pennsylvania State University. Before coming to Angel Medical Center and Mission Health, he served as Vice President for Innovation and Entrepreneurship at Thomas Jefferson University. Layman currently serves on the faculty of Thomas Jefferson University and Yale University.