Cool Things Are Happening In Healthcare

A week ago I attended a conference on information technology and “Population Health Management” (PHM) in healthcare.  Based on my experience as a practitioner and an executive, I am typically somewhat skeptical of “the exciting new thing” in medicine (and I’m also prone to having a “critical spirit”) but a lot of cool things really are happening in healthcare.

As everyone knows, the U.S. healthcare system is not very user friendly.  Although we have the best technology and the most sophisticated care, we are not great at access, quality, customer service, or keeping people healthy.  And let’s not even mention the prices. The good news is, change is at hand and it’s going to produce major improvement in all of these areas.

Multiple macro factors are driving this transformation.  The deployment of smart technology in healthcare, ever escalating prices producing a market reaction, the increased transparency of outcomes and prices, government actions, and a better understanding of the genomic basis of disease are all in the mix.  It’s not my purpose to identify the contribution of each, and healthcare insiders may not agree about the exact definition of PHM.  Let’s not go there.  I’d rather just describe what’s happening.

Healthcare has long been a disconnected, fragmented industry in which the individual patient must navigate on his own.  Everyone I know has a story of poor quality or poor service that affecting them or a family member related to this fragmentation.  You probably do too. This is about to get better. Consolidation of smaller providers into larger systems is part of the story, but more important is the development of software tools that can virtually integrate providers.  Advanced “Clinically Integrated Networks,” such as that of Advocate Health Care in Chicago, can facilitate improvement in quality and service similar to those of more traditional closed systems like Kaiser Permanente.

In these networks, all providers’ medical records are linked through a shared application that facilitates improvements in care.  No more copying and hand carrying, or faxing, records from doctor to doctor.  No repeating lab tests or CT scans because the doctor didn’t know you had it or couldn’t get the results. Basic analytics is used to identify “care gaps” (for example, a mammogram is due) or where care is not working well (for example, the blood pressure is too high despite the treatment). More sophisticated analytics can identify trends and predict problems before they happen, allowing counseling, treatment or behavior change to head off diabetes, hypertension and other potential illnesses.

New care models are evolving to serve patients better and maximize the utility of the new information tools.  Primary care doctors, specialists, nurse practitioners, nurses, care managers, and health coaches are coming together as a team to support patients.  There’s even a movement to stop thinking of the patient as the “patient” in favor of the “customer” or even better as the “person.”  The care team will be interacting with you by email, telephone and text messaging. Smart phone apps will allow you to schedule clinic appointments, get lab results, monitor your health trends and access your medical record. Wearable health measurement devices will be come increasingly common and interact directly with your care team.

Treatments will be more tailored to the unique individual rather than just the diagnosis. Cancers will be routinely genetically sequenced to determine the best chemotherapy. Therapy for many more common illnesses, such as hypertension, will be guided by the individual’s genetic makeup. This will produce a twofold benefit – better management of the illness and less side effects of treatment.

All of this is in progress now, but it’s going to take a while before it all comes together and everyone’s experience of healthcare is transformed. And there will be bumps in the road.  It won’t be a smooth transition for all providers; there are always winners and losers as industries transform. The current environment in healthcare is complex, confusing and constantly changing.  Even as it’s exciting it’s also threatening for many in the industry.

The tremendous innovation in progress will ultimately benefit all of us, but some providers will find themselves too old and slow to successfully adapt to the new world.  The CEO of Geisinger Health System was recently quoted saying, “I have a feeling we’re going to go through an incredible amount of tumult for the next probably five to 10 years.” [emphasis mine] (And Geisinger is one the country’s best healthcare systems and one of farthest along with new care models). This isn’t going to be easy; you might want to give your local hospital administrator a hug.

The other thing to remember is that healthcare itself doesn’t produce good health. The new and better healthcare that’s on the way cannot save us from ourselves. If we eat like pigs, drink like fish, smoke like chimneys, work too much, sleep too little, and stay on the couch watching TV – we’re still going to be sick. So please take care of yourself. The coming healthcare revolution will make it easier to do so, but a healthy lifestyle starts with you.