A friend recently asked me what it will take to fix healthcare. My response was that I have little background in public policy but that I can point to a couple of things that I think will make a difference in our children and grandchildren’s lives.
- Value-based care – This is the notion of incentivizing providers to share financial risk with the insurance companies. As it turns out (roughly) 5% of the population drives 2/3rds of the cost of healthcare. Finding the proverbial needle in the haystack high-risk patients before they get sick, designing interventions, and managing their health is the key to controlling costs. When done well everyone wins – patients get less sick, costs are minimized, the drain on the scarce resources of the system are focused on the neediest, and profits are created. Much like putting a legacy application into the cloud though, costs are maximized and results are minimized if you do not re-architect. The same is true for healthcare, the system has to be re-imagined which is not easily done. Chen Med (Florida), Iora (Boston), Mercy (St. Louis) are some organizations that have seemingly figured this out.
- Big data with AI/ML – Some time ago I heard a statistic about how much new data is getting generated. Of course, there is the traditional clinical data but there is so so much more. For example there is imagery, genomics, doctor’s notes, IOT, Alexa voice recordings, and many more new types of data. When joined with non-healthcare/quasi-healthcare data sets such as claims data, prescriptions, credit history, socio economic, and geographic information a rich profile of the patient emerges. We are just scratching the surface of what can be done with that information. In 2021 a Petabyte of data is the new Gigabyte and technologies like Spark will be as common as an HTML form was 10 years ago. All of this information will accelerate drug discovery, inclusion of patients into clinical trials, and provide the ability to target interventions before people get sick.
- IoT – Fueling the engine of big data will be sensor data from everything from your Apple Watch to Alexa-like devices in your home where you can communicate with your care team (e.g., look at Vivify Health). In the next 10 years every device on the planet from your dishwasher to your car is going to generate exhaust about what it is doing and its interaction with humans. In healthcare that information is going to get married to your clinical condition to form a rich picture of you and will help your care givers map out a personalized care plan.
- Privacy – A headwind that society will need to work through is the whole conversation about protecting personal information. Though this may be changing, the United States actually has one of the most permissive cultures about data sharing. In Europe and the rest of the world privacy is a much bigger deal. New solutions will be required for researchers (and marketers) to find a way to do their work in an ethically compliant kind of way.
- Blockchain – So far, Blockchain the underlying technology in Bitcoin, has been a cool idea in search of a business model. Other than cryptocurrency no one has figured out how to make money off of it. In the coming years someone will figure this out possibly as a solution to the problem of privacy in healthcare.
- Automation – While probably not as meaningful as any of the other ideas here, one of the few good things to come out of the Pandemic of 2021 is consumer acceptance of computers doing things that were previously only done by humans. Just as self-checkout is widely accepted in retail stores patients are now increasingly comfortable with checking into a visit, having their vitals collected, and scheduling a follow-up at a kiosk rather than with a human. In addition to reducing cost this type of automation will eliminate human error, create (much) more data, and incubate new previously unanticipated applications. The challenge for healthcare as a business is to achieve these benefits without leaving patients feeling like they are dealing with a cold impersonal computer.
Healthcare is a complex ecosystem but, in many ways still a green field for innovation. That being said there really is no silver bullet.
Blog of Scott Blodgett 