VC Marc Andreessen wrote back in 2011 that software is eating the world. At this moment, it feels like healthcare is the main course. Our August 2014 Startup Index is all the proof you need of that. Here are the numbers for HIT startups, device startups and pharma/biotech startups: 22, 2, 2.
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I have always said that the real solution to fixing healthcare is a high-tech and high-touch combination. My husband’s recent trip to the emergency room illustrated how one part of this solution enables the other. It also reminded me that personal conversations with doctors and nurses and physician assistants will always be more helpful than technology — at least when you are in the hospital facing surgery.
These are the three people who helped us the most when we were trying to figure out why my husband was doubled over in pain. Technology made some of these conversations possible, but not every one.
The nurse with the data in the ER
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
The last time I was in this hospital was several years ago when I was pregnant with my son. I don’t remember the laptop stations on wheels. The woman who registered my husband had one to gather all the pertinent information. The nurse on duty in the ER had one, too. She perched near us to chart in the “results pending” waiting area. I hovered at her elbow to ask a question. We didn’t know at that point that my husband’s appendix was the problem, but we did have results from his blood and urine tests. The nurse pulled them up on her laptop.
“All his values are textbook perfect except for his white blood cell count,” she said. “But his pain isn’t the classic presentation for appendix problems.”
The nurse was friendly and direct and she had all the info we had at that point. It was very reassuring to have her in the right spot at the right time with the data I could get my hands on.
The friendly doctor who put information in context
Luckily, we got a surgeon with an excellent bedside manner. She took all of our questions seriously and provided all the context we needed — reassuring us before and after surgery. My husband even wanted a picture of his appendix from the camera used during the laparoscopic surgery, and she said she would email it to him. What can I say — he’s an engineer and still has the X-rays from when he broke a finger playing basketball 18 years ago.
I was particularly impressed when the doctor put some context around the results of an MRI done earlier in the day.
“Before I read the results, I always see who analyzed the scan initially,” she said.
The radiologist who had read the scan always took a very conservative approach in his analysis (meaning any anomaly required attention). The surgeon added that background info so that we would understand his recommendation to get a follow-up on another issue that the MRI had revealed. The surgeon didn’t think that was necessary and she wanted us to understand why recommendations from two doctors conflicted.
The well-informed and thorough care coordinator
As my husband checked in to the ER and filled out the paperwork on Wednesday, he left the “primary care doctor” space blank. Both my husband and I are relatively healthy and we don’t have a PCP we see regularly.
As I sat with my husband waiting for surgery on Thursday, I wondered if an algorithm would pick up that missing data point and recommend a follow-up action. I was not disappointed.
On Friday, when he was released, the care coordination person came by, and after going over several topics, said, “I hear you don’t have a primary care doctor. Here is a list of all the doctors in our network. Maybe we can help you find one.” We both scanned through the well-designed handout that had names and pictures of the doctors in the health system organized by specialty. This up-sell worked, as we will both find a doc based on this interaction.
His discharge orders were not electronic – I was hoping someone would offer to email them to us, but no luck there. Something to look forward to the next time, I suppose, another technological advance as software continues to devour healthcare.
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[Image from Intel Free Press on flickr]
