Diagnosing a Sick Healthcare Industry
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Patients in today’s health system aren’t feeling well -- and that’s exactly the problem. Our system is designed to focus on treating those who are already sick instead of preventing illness in the first place. That’s one of the reasons why five percent of Americans generate half of the nation’s health care costs.
Getting ahead of illness is no small feat. It will take nothing less than upending a medical system built around financial incentives that reward more procedures performed, pills prescribed and patients processed. While the effort required to move America’s health care in a better direction is significant, entrepreneurs have an unique opportunity to crack the code and play a critical role in the solution. Recent laws including the Affordable Care Act (ACA) and the Medicare and CHIP Reauthorization Act (MACRA) are accelerating a shift away from the old model of health care, where doctors were paid for treating a single episode of illness, to a model that focuses on paying for the quality and end result of care that patients receive.
The shift in the laws that govern our health care means that doctors, nurses and caregivers in general will need a wide variety of new technologies to practice proactive care and engage patients around their unique health situations.
Face-to-face with the sick-care cycle.
Several years ago, for a number of reasons, I decided to make wellness a priority in my life. I became the ideal patient -- someone who was actively invested in his own health and motivated to partner with their doctor to participate in a long-term plan for wellness. What I discovered surprised me.
First, there was no structure in place to support this kind of relationship with my doctor. Medical practices are designed to treat sick patients at volume -- not to spend time helping healthy people stay well. Financially, there was a very real opportunity cost my physician incurred when he used precious appointment time on me, someone with no serious health issues, instead of on a sick patient who required more intensive -- and more billable -- care.
Second, my doctor knew my name, but had an incomplete idea of who I was from a medical point of view. What I encountered was sporadic and inconsistent communication between my doctor and my previous care teams, probably because there was little incentive for them to communicate. As a result, my doctor’s edition of my medical history was missing some chapters, such as specialists I had seen previously, prescriptions and lab tests I had taken, and other important information.
A proactive approach to wellness.
This story isn’t unique to me. In fact, most of health care remains disconnected and is not aligned with the goals of health maintenance and disease prevention. Because of this, I had to make my wellness a priority -- cobbling together my medical records from various past care teams to try and give my doctor a single, comprehensive view of my health. I was also making healthy lifestyle changes and tracking my progress with a number of mobile applications, but there was no one wellness application available that would enable me to share this data with my doctor. Similarly, there was no single platform that would allow me to connect my various applications together and share my findings with my care team -- not just my doctor, but my spouse and my exercise partners.
It’s this fragmented and incomplete care experience that opened my eyes to the need for health care innovation on a massive scale. Our health system needs to stop looking at patients in the rearview mirror and start focusing on what can be done today to support long-term patient wellness. Progress on this front is already underway. A new movement called population health is taking shape to transform this disconnected system focused on treating sick patients to an integrated system focused on improving health and wellness.
A $3 trillion challenge in need of solutions.
Our nation spent $3 trillion on health care in 2014. How we got here is a tale of runaway costs, inefficiencies and a system that is structured to provide reactive care. But for entrepreneurs, and everyone affected by our fragmented health system, population health is a golden opportunity to disrupt the sick-care cycle. It’s a chance to create a system where information sharing leads to better care, where the goals of reducing costs and improving health are in alignment, and where the patient has a dramatically better care experience.
Here are some health care innovations I believe will contribute greatly to this shift:
Can you securely send messages to your doctor? Manage medications, treatment plans and insurance information on your phone? Can you access your health data and medical history within a single, comprehensive view? Nearly every other industry has embraced and benefited from the Internet and subsequent mobile boom, but health care still feels like it’s in the late 1980’s. People are begging for care to become more consumer-friendly and for basic information, like health records, to at least become available online. The health care teams who make this a priority just might find themselves with happier, healthier, more engaged patients -- and doctors who are empowered to make more thorough and confident care decisions.
Connected wellness applications.
Fitness trackers and heart-rate monitors are wonderful, but the data they generate is not useful in a vacuum. These applications need to sit atop platforms that can synthesize their data and turn it into actionable insights for doctors and care teams.
Video visit technology.
I’ve been able to video chat with my friends and family in the United Kingdom for more than a decade. Why, in 2016, can I still not communicate easily and securely with my doctors and care team via online and mobile interfaces? Beyond convenience for the patient, video visit technology opens up opportunities to consult with specialists who may be halfway across the country or on the other side of the globe. Research has shown that telemedicine improves the cost efficiency of health care while reducing hospital stays and health complications in patients.