As Nebraska health care providers incorporate more and more technology into even routine patient visits, the dynamic between doctor and patient is changing … and not necessarily for the better.

32-year-old Lincoln resident Rob Allen started the new year, in his words, “horribly, horribly, horribly out of shape.”

He knew something needed to change, but had trouble getting into a new rhythm. His personal trainer suggested an app, “My Fitness Pal,” that helps him track his diet and how much he exercises. For example, Allen can scan the barcode of items at the grocery store and the app will provide data on the nutritional content of the food.

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Courtesy image This image shows one the fitness app LIncolnite Rob Allen uses to help him improve his health. He said the social components of the app foster a sense of encouragement and accountability.

“I ended up losing like 40 pounds in the first six months of the year,” he said, “and the app had a lot to do with that.”

Allen is part of a new paradigm for health care, experts say.

“When it’s your health, and your illness, you should be accepting responsibility for doing as much research as you possibly can,” said Deb Bass with the Nebraska Health Information Initiative, a network connecting electronic data from health care providers statewide.

“We grew up treating disease, not encouraging wellness,” she explained. “We have generations of individuals that trust whatever their doctor says is absolutely right, and they don’t question it, and they don’t ask (questions). They also don’t respect or accept the responsibility for their wellness.”

Bass said American healthcare is shifting to a more wellness-based, preventative care approach. People increasingly want – and expect – their medical information to be available to them anywhere at any time, and as a result, they’re much more engaged in their personal health.

“I really think it is a trend,” said Dr. Peter Loeninghoener, who runs a clinic in O’Neill in north-central Nebraska. “I think that’s the way healthcare is going to go. And if we are in an age where we’re supposed to be making it more efficient and less costly, (patients) have to take an active role.”

But despite Rob Allen’s success with his fitness app, he said it couldn’t do the job of his personal trainer; he called it a supplement, not a replacement.

Yet some are concerned that technology has started to replace person-to-person treatment. As health care providers use more and more technology in their daily work, some experts worry it’s leading to distracted doctoring, so to speak, where doctors and nurses spend more time looking at a computer screen than the patient in front of them.

“I think as we put more and more technology between us - the health care provider and the patient - we distance ourselves,” said Dr. Dmitry Oleynikov, professor of surgery at the University of Nebraska Medical Center.

The world’s collective medical knowledge might be greater now than ever before, but not all changes are progress, he said; in the past, there was a greater emphasis in medicine on the human condition.

Today? It’s about data points.

“My patients – whether they’re young or old – want me to look them in the eye,” Oleynikov said, “and to explain to them, in terms they can understand, what is going on, and have the opportunity to ask me questions.”

As health care technology evolves, the idea is to make it fade into the background. One way would be to use voice-recognition software; another is to switch from desktop computers to portable tablets when interacting with patients, said Cheryl Thompson, associate professor in the College of Nursing at UNMC in Omaha.

“I think the tablets may offer a better technology over the laptops or the PCs in the room, just because you can hold it in your lap,” she said. “And once you get familiar with it, you can interact with it less and you can still maintain eye contact.”

Christopher Novak, vice-president and director of operations at Lincoln-based EHR company MacPractice, said interest in table versions of their software soared when Apple released the iPad.

“The day that iPads came out, we had requests for, ‘How can I access this information outside my office?’ That’s something we’ve been working on and building apps and sending out releases ever since.”

In the end, Kearney nurse Kayleigh Johnson said, it’s all about finding the right balance.

While her clinic uses electronic health records and has an online patient portal where you can book an appointment, they purposefully chose not to have an automated phone system.

That way, your first interaction with the clinic is with a person, and not a machine.

At least, for now.