Autonomous vehicles. Augmented reality. Artificial Intelligence.
The world is undergoing radical transformation via technological innovation. Healthcare is not immune to this trend and has lately unleashed its own wonders from CRISPR to 3D-printed prosthesis to sensor-enabled pills. We can truly transform lives in ways unimaginable even just 10 years ago.
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In other ways, however, healthcare lags.
In transportation, Google’s first “driverless” Street View cars were on the road a scant few years after the DARPA Grand Challenges of the mid-2000s that paved the way for them, and Uber become a verb in the same amount of time it takes to implement a current EHR system. Furthermore, Amazon’s chatty Alexa now interacts with you in your home, having arrived just a short time after Siri became the personal assistant in your pocket.
Healthcare innovation has been incapable of gaining similar traction even with profound technological advances.
There is an unmentionable dark side of healthcare innovation.
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Advances in productivity via utilization of new tools and technologies has been anemic. Healthcare is struggling to keep pace with other industries. In fact, in a recent McKinsey study, healthcare is one of only two industries (construction is the other) that has shown a productivity decline. Read that again: Despite IT spending growth increasing by over 5 percent per year over the last 10 years, we’ve actually seen the healthcare labor pool and service environment become less efficient!
You’re going to need a bigger boat
Stating the problem can grimly ignore the great entrepreneurs and companies trying to address the issue. Countless leaders in health, technology, and academia have launched innumerable well-intentioned efforts to bring meaningful solutions to our healthcare system. Unfortunately, many of these efforts have been limited in scale, scope, and impact.
This is compounded by the fact that we’ve been trying to create solutions for a healthcare system that is not designed for, and no longer addresses, the present task at hand. In effect, we have been using all our creative energy on a static view of an old world.
For generations, the U.S. healthcare system has centered on supporting acute, episodic care. We are really good at fixing broken patients (e.g., broken bones, heart attacks, traumas). The new surgical techniques and tools (TAVR) and unimaginable advances in imaging (3D rendering, pill diagnosis) are examples of a breathtakingly long list of innovation and research that should be celebrated. However, these innovations, coupled with demographic trends, have resulted in our most urgent care needs becoming different.
With one in three Americans now pre-diabetic and chronic diseases topping the list of leading causes of death, we have a new epidemic on our hands. A semiannual trip to the emergency room is not a treatment protocol for chronic illness. You don’t normalize high blood glucose levels with an occasional outpatient procedure.
The design of our health system has made adapting to the shift in America’s healthcare needs incredibly difficult. The abundance of new digital health tools and solutions have all been made to function within the “old” structure. From an episodic ‘fix what’s broken’ mentality where behavior change and engagement matter little to a management of the sick where continuous and constant engagement make all the difference. Given that our current chronic disease epidemic is projected to become only more pervasive, we have a responsibility — and an opportunity — to reimagine the practice of healthcare and the tools needed to effectively deliver it.
I’m not quite dead yet
We must flip the model of care. Delivery of episodic data-entry interactions must transform to continuous cognitive interaction between the doctor and each person. The fact is, we’ve made such progress that we are now dying of slower and more annoying causes. Americans have gained over 30 years in life expectancy over the last century. Further, when we contrast this with comparisons to even more modern times (the fundamental shift from 1999–2009), we’ve seen deaths resulting from heart diseases and stroke continue to decline to 21% and 24%. A model for episodic, acute care worked well for the last century. But for the next century, we must retool our systems with a model for patients with chronic, long-lasting issues.
To support that redirection, we have to look at payment. Recent legislation has been moving the entire healthcare system toward a reimbursement methodology that puts more emphasis on outputs instead of inputs — overall results rather than individual procedures. This creates a unique challenge for legacy systems. But it simultaneously creates an entire greenfield for innovation around how revenues will flow in this new system and puts an emphasis on outcomes for these chronic diseases and the productivity of the system as a whole to do better.
What we’ve got here is failure to communicate
We also have an opportunity and an obligation to support connected care as the method for enhancing physician-patient engagement. Why is it that I can take and edit a picture and send it to my friends around the globe in a snap, but as a patient of our “advanced healthcare system,” I must fax, scan, and print my way through a maze of paperbound bureaucracy relying on technological relics that were nostalgic even in the ’90s?
We have decades of technological capabilities we’ve yet to implement in healthcare. That said, our problems won’t be fixed by cobbling novel new solutions together here and there. We actually need to think at a systems level about how we develop and integrate the right tools, with the right parameters, to facilitate a more intuitive experience. Establishing a connected framework for individuals to personalize medicine through their very own data in partnership with new care delivery models for physicians and healthcare support systems must be a critical industry focus.
I’m a doctor, not a data-entry clerk!
Finally, we have an opportunity to develop workforce enabling tools that allow physicians to spend more time with their patients and less time entering data points. Half of U.S. physicians are experiencing some form of burnout, and EHR implementation has been cited as the largest contributing factor. By asking our most highly-trained individuals in healthcare to handle this task, we’re basically making physicians our highest-paid data entry clerks.
Prioritizing real-world usability and implementing frictionless methodologies improve physician satisfaction and makes more economic sense. It also improves care delivery and outcomes, especially when it comes to the kind of attention that chronic care management requires. Currently, the management of chronic conditions recommended care quality is only provided 56% of the time. That’s unacceptable.
We should set our sights on the achievable technological improvements that we actually need to cultivate: a system that prioritizes and enables care for patients with chronic diseases, connected solutions that deliver a more personalized level of engagement, and functional tools and platforms to offload support and clerical tasks.
In order to achieve the kind of technological leaps and bounds in healthcare that we’ve seen in practically every other industry, we must be clear in our diagnosis and think critically about how we can enable continuous, connected care in a way that makes the best use of our resources — economically, technologically, and intellectually.
Photo: HASLOO, Getty Images
Jack is focused on driving innovations that improve the way people live and physicians practice. He is managing director at Health2047, an integrated innovation company with a mission to improve healthcare by bridging the gap between the medical and tech communities and leveraging the strengths of its founding partner, the AMA. As a physician who possesses strong analytic skills refined at McKinsey and a broad understanding of system-level issues gained at the WHO, Jack offers unique insights into the transformation needed in the healthcare industry.
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