If we want to change anything we need to change people’s minds. Here in the US we are fighting an existing system steeped in the in-person visit with reimbursement and policy all centered around hands on body as the “gold standard.” And let’s be honest, these systems are like biology and want to survive and spread. This creates a huge headwind. We need some creative destruction in healthcare.
If we were to build a new healthcare system from scratch today, it would look totally different from the current system. We need new digital first care models that guide a patient to the appropriate level of care which match cost to acuity and better manage resources and the patient experience. We need better tools in the home from remote patient monitoring standpoint (think hospital at home) and a redefinition of a health system from bricks and mortar to an integrated care delivery platform where place is just one aspect of the broader continuum. I also think about the potential to create precision care teams that assemble expertise from across the world to treat a specific patient’s co-morbidities or genetic makeup.
The real breakthroughs will be not so much in the tech (we have all the tech we need to create tomorrows healthcare system today), but in the policy and regulations that drive the behavior (or how the tech is used) of the clinical teams. These can affect huge paradigm shifts in how patient’s can access their data (wouldn’t it be cool if patients “owned” their data and just granted access to the treating physician?), and what we incentivize clinical teams to do (maintain health vs treat acute illness), etc…New models of care are truly where the big advancements lie. Turning being healthy into a true part of a new “lifestyle” supported by policy and economic incentives would be a game changer. Imagine a tax break for leading a healthy life (eating well, exercising certain # of times per week, progress on weight loss or blood sugar management). The economic rent on society of avoidable illness is huge.
COVID lead to the rapid adoption of digital health tools, but there was no new whizbang tech that drove it. We used tried and true technologies to implement new care models catalyzed by a global pandemic. But as the pandemic waned, despite people discovering that it is easier, more convenient and of similar quality to do a telemedicine visit, we all slid back to in-person care, waiting in waiting rooms, taking time off work, paying for parking…because doctors couldn’t figure out how to get reimbursed for telemedicine…We need to treat the illness, not the symptom, and the illness is the existing system and model of care which arguably is the toughest thing to change. It will take courage, conviction, political mettle, new methods of training in medical school and more.