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What value do primary care doctors offer to our health care crisis?

What value do primary care doctors offer to our health care crisis? | Healthcare and Technology news | Scoop.it

When I was a resident at the University of Virginia, my wisest mentors gave me one piece of advice that far exceeded all the scientific and statistical jargon that others expected me to swallow. Consider this: When patients walk into your room and sit down, shut up and look into their eyes. When they are done talking, have a conversation. The key word is conversation. The visit should not include a lecture or statistics that diminish the complex needs and wants of the person sitting in front of us. Primary care doctors who care for the elderly and chronically ill confront a plethora of medical problems in virtually every patient who walks through our doors. To solve them all is not possible and may not be what the patient wants. As my mentor told me, unless you address the patients’ concerns, they will hear nothing else that spews from your mouth.

Sometimes it’s difficult to allow a patient to walk out of the room without addressing her high blood pressure, need for a mammogram, decision to stop taking statins, and lack of exercise. It can be painful to watch them leave without fulfilling any of Medicare’s quality indicators, which will be sent to the Centers for Medicare & Medicaid Services (CMS) through our computers and may cause our payments to suffer. Sometimes talking about the patient’s incontinence and back pain seems insufficient in light of all of the other medical issues. But as the patient leaves the room, I tell her that during the next visit, which will be soon, we will talk about those issues. I may encourage her to look over some data in the meantime about statins and mammograms. Many patients choose not to pursue many interventions after they see real data about them. That is their choice, as long as they make it rationally. Much of what we try to “fix” in our patients can harm them as easily as it can benefit. Their choices can lead to fewer tests and drugs and improved outcomes, even though it may mean failing grades for our quality indicators or ramifications for our pocketbooks.

What value do primary care doctors offer to our health care crisis? Conversation. It is our ability to look people in the eyes, allow them to set the agenda, converse with them about medical issues and interventions using reliable data and base decisions on their interpretation of personal risks and benefits. However, when we are forced to stare at computers and enter data, when CMS and the Affordable Care Act (ACA) have set much of the agenda by compelling us to adhere to their often perverse quality indicators, when visit times continue to shrink to pay for the escalating overhead, then none of the value we offer can exist. Being a primary care doctor is one of the most satisfying professions on this planet. We come to know our patients well over many years and live through their peaks and valleys. They rely on us to help them with some of the most difficult decisions they will ever be forced to make. We do our best to keep them healthy, active and happy. I get as much value as my patients do from a conversation that works well. Our health care system gets value, too. The bond between doctor and patient, when it allows for meaningful conversation, leads to fewer tests, fewer medicines, fewer referrals, less hospitalization, lower cost and greater satisfaction.

The ACA and CMS are trying to measure value and quality in all the wrong ways. They are talking about shared savings, incentives and disincentives that rarely work and typically decrease both patient and physician satisfaction. They throw metrics at us that have no correlation with our patients’ wants and needs and only squander our time in the exam room. The value we must insist on as primary care doctors is the ability to have a conversation, which is more difficult to measure but ultimately what will work. It brings greater satisfaction to our patients and to us. And it saves the health care system money while enhancing our patients’ health and well-being. It’s what we do best.


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3 ways to change the way we pay for care

Incentive structures in health care have to change. Right now, we pay for services, or have a so-called, fee-for-service system. The idea is that the more patients doctors see, the more expensive tests doctors order and the more patients doctors hospitalize, the more money clinics and hospitals make. This incentive structure has transformed our health care into sick care.


The reality is, in America, we are adept at caring for complicated medical problems that require multiple tests, specialists, long hospitalizations, and frequent clinic visits. We focus a lot of resources and attention on this part of medicine because it is what we are paid to do. And to further our efficiency in providing this model of care, many medical systems have adopted business practices, like Toyota’s Lean Strategy, to run our hospitals and clinics more like factories. We essentially increase the number of cogs, or patients in this case, on our conveyor belt, to increase profit margins.

Now, it is only fair to acknowledge that “Lean” and other strategies to improve health care efficiency also have real hopes of lowering healthcare costs. In fact, there may be evidence of that. And streamlining health services so that every patient gets a standard quality of care, will likely create equity in the system and reduce costly medical errors, preventing patients from receiving disparate care based on race, gender, or cultural affiliation.

But as we extol the benefits of these patterns of practice, we must also be critical of their overall impact. Is the way we are paying for medicine coming at the expense of delving deeper into the heart of our field? As care becomes more standardized and protocolized, with each patient treated with machine-like accuracy and precision, we do improve “quality” and efficiency in the system. But where is the healing? Where is the prevention? Where is the practice of medicine caring for the human condition and working to keep us well?

Being well isn’t simply having your diabetes under control, it is preventing you from getting diabetes in the first place. If we continue to commoditize patients, valuing their ailments over their wellness, we miss the opportunity to provide the very care we claim to offer, health.

So how do we re-organize the way we pay for care to build a health care system instead of perpetuating a sick care system?

First, if we recognize that social needs have profound and costly health impacts, then as we transform our payment structures under the Affordable Care Act (ACA), we have to support innovative models that address social inequity. That means, using health care dollars that are typically spent on clinic visits and hospitalizations to also pay for education, food, housing, and job creation in low-income communities of color. That also means that in the spaces where we provide medical care, we should also be equipped to address patients associated needs. There are models for this.

Second, we have to change the narrative about what it means to provide care. We need to think about the overlap between natural life processes, like birth and death and medicine, and learn the limitations or boundaries of the medicines we wield. When there are no quick fixes or magic pills, how will we care for the human condition? In the spaces where listening is better than treating and healing doesn’t come at the end of a needle, we need to foster the relationships in our communities that provide healing and build resilience.

Third, it is time to transform the physician-patient relationship, a dynamic historically limited to a clinics and hospitals, to team-based care. In team-based models, physicians use their trusted relationship with patients to lead a team of community health advocates to address patients’ health needs in the places where they arise. Sometimes those places are hospitals and clinics but more often they are in homes and neighborhoods. The future of care, if we are smart, will deploy complex networks of healers that extend the reach of the system into people’s lives, supporting their wellness as we address their disease. This will require thinking across sectors, partnering with unconventional liaisons in the social service and for-profit sector, to have a coordinated approach for health.

Right now, the Department of Health and Human Services (HHS) is doing historic work to re-design how we will pay for health care. With the guidance of the ACA, HHS is laying out a plan for a population-based payment structure that incentives providers to be efficient with precious medical resources. Doing less for more means we will have to learn how to keep people well. These new changes have the opportunity to shift the focus of our system, towards health. Looking down the pike, let’s be actively engaged in ensuring quality, efficiency, and equity guide how care and healing are provided.


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Apple's New Plan For Healthcare: The Doctor Will Track You Now

Apple's New Plan For Healthcare: The Doctor Will Track You Now | Healthcare and Technology news | Scoop.it

An Apple relay will keep your doctor’s fears allayed.

That’s the plan, at least, behind the company’s growing health care strategy: To use the Apple HealthKit platform to collect real-time data from iPhones, the soon-to-be-released Apple Watch, and other devices — and connect it to hospitals, doctors, and your electronic medical records.

More than a dozen top hospitals already are piloting Apple’s HealthKit software, Christina Farr reported Thursday in an exclusive for Reuters.

This isn’t a surprise. Five months ago, details leaked that Mayo Clinic had teamed up to test several health care applications for the iPhone, such as a service to alert patients when their Apple apps detected abnormal health results, and help schedule them for follow-up visits.


And at the September debut for the iPhone 6, Apple officials said that they’d struck partnerships with a number of other top hospitals, like Stanford University Hospital and Duke University.

The two medical centers last year began helping Apple test whether chronically ill patients could use HealthKit to remotely track and manage their symptoms.

A similar trial is now underway at Ochsner Medical Center in New Orleans, where providers are seeing if HealthKit can help several hundred patients control their blood pressure. The patients use sensors and other devices to remotely measure their blood pressure and other clinical indicators, and send the data to Apple phones and tablets through HealthKit.


Apple plans to use its new Watch as part of its strategy to move into the U.S. health care market.

Ochsner also has launched what it’s calling the “O Bar” — the hospital’s version of Apple’s Genius Bar — to help patients pick between different health and fitness apps for their iPhones, and teach them how to use them.

Are Apple’s Rivals Playing Catch-Up?

What is surprising is how far ahead Apple is compared to purported rivals, Google and Samsung.

According to Farr, Google has developers working on applications for its Google Fit service, but hasn’t appeared to make major inroads among the top hospitals yet. Samsung’s own health care platform also has lagged Apple HealthKit on both hype and deal-making.

The market potential for these companies is significant, to say the least: The U.S. spends about $3 trillion each year on health care, and all the incentives are pushing hospitals and doctors to get better at remotely managing patients’ symptoms.

Being able to see real-time data for chronically ill Americans could offer significant financial and clinical benefits. For instance, tracking their health and fitness could encourage positive behaviors that reduce the cost of doctor visits and other treatments. And doctors could use the data to be proactive when a person’s health appears to be taking a turn for the worse.

There are several major hurdles before realizing that vision, however.

For example, Apple appears to have pinned some of its health care-hopes on the Apple Watch, which launches in April. But early indications suggest that the device’s initial applications for health care may be limited; based on current reports, there’s very little chance that the Watch will come with a breakthrough technology, like a built-in glucose monitor.

(However, the Watch may display updates from a separate glucose monitor, per this demonstration last month.)

If Apple Watch can’t add much unique health care value, it may face a practical problem: Regardless of how cool the technology is, most Americans end up abandoning their wristbands and other smart-tech wearables.


And simply introducing new data streams isn’t so simple in health care. Hospitals already are juggling the pressure of protecting patients’ medical information, with hackers constantly trying to penetrate their systems, while trying to identify and organize the data that they do need.

“This is a whole new data source that we don’t understand the integrity of yet,” according to William Hanson, chief medical information officer at the University of Pennsylvania Health System.

So unlike the launch of the iPad — where Apple essentially redefined the tablet computer market overnight — the company will almost certainly need months or years to fully realize its health care strategy.

“There are unrealistic expectations for when and how mobile health is going to come together,” Patty Mechael, former executive director of the mHealth Alliance, told the MIT Technology Review last summer. “We are somewhere between the peak of the hype cycle and the trough of disillusionment,” she added.

Of course, Apple may defy the odds. For one, it’s Apple — the company can create buzz by simply posting a job opening. More than 600 developers are already integrating HealthKit into their health and fitness apps, helping ensure that Apple’s new software is already becoming an industry standard.

That kind of scale and momentum is the key reason why Apple stands apart.

John Halamka, the chief information officer of Beth Israel Deaconess Medical Center and an informal adviser to Apple, told Reuters that many patients at his hospital already use Jawbone trackers and other devices to collect personal health and fitness data.

“Can I interface to every possible device that every patient uses?” Halamka asked ruefully. “No.”

“But Apple can.”

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The rise of the employed physician: What it means to new doctors

The rise of the employed physician: What it means to new doctors | Healthcare and Technology news | Scoop.it

As the youngest member of a family of doctors, it was not uncommon during my childhood to spend summers at my father’s private practice. I fondly remember greeting the familiar office staff as I recklessly ran amok among an endless array of rickety cabinets containing an untold amount of aging, yellowed paper charts. My dad’s patients would tousle my hair like family and his partners would always leave an insurmountable supply of candy for my taking.


Years later, I found myself accompanying my father and his practice partners for lunch as they discussed the ebb and flow of running a medical practice. Beyond sharing complicated medical cases, conversation often revolved around the complex relationships with local medical practices and the independently-owned hospital that my father and his partners had been affiliated with for the past several decades.

By the time I entered medical school, I developed the fixed assumption that, like my father (and grandfather and great-grandfather), I would ultimately be co-running a small office practice, develop a large but manageable patient panel and become highly involved with a local hospital.

Now, I am not so sure.

Around the same time health care reform became a central theme to major media outlets, enormous changes quickly presented themselves to my father’s workplace. The community hospital to which he was politically and financially bound was rebranded into a multi-institution hospital network. That same corporate system soon bought out his practice and ultimately became his employer. This all occurred in the matter of a few years.

I asked my dad why he didn’t resist these marked changes to his career. His response didn’t surprise me.

The daunting tasks of billing for multiple insurance networks and keeping up with proper medical coding for hundreds of diseases were becoming unbearably time-consuming and costly. Transitioning to electronic medical records and staying current on meaningful use and quality measures without managerial support was an increasing daily burden. Dictation companies were eating up his bottom line and documentation was eating up his time spent with his patients. He was tired of having to keep up with the business and politics of medicine, but he wasn’t ready to let go of his practice of medicine.

And so, at 62, my father started his first employed job since finishing his medical training.

Selling one’s practice to work as an employee, as my father has done, or being hired directly out of medical training, as I am likely to do, is not unique to this era of health care.

Physician-owned practices in 2012 accounted for about 50 percent of all working doctors in comparison to about 75 percent in the late 1980s. The number of physician-owned practices continues to precipitously decline, as the percentage of physicians who were practice owners in 2012 dropped almost 10 percent from the previous five years, according to the AMA 2012 Physician Practice Benchmark Survey. This movement away from physician ownership is expected to continue.

Larger political and economic incentives are certainly influencing these trends. The public national agenda for rapid care integration and coordination and the private agenda for reducing competition and increasing leverage through consolidation are likely to accelerate the move away from self-employment, particularly for emerging physicians.

How does the shift away from self-employment affect the new wave of practicing physicians?

I can only speculate that newly-trained doctors must learn to be more comfortable with managerial oversight from both physician and non-physician executives. Skill-sets such as effective team building, employment contract negotiation and the ability to “manage up” are likely more relevant now than in prior generations, where self-employed physicians predominated.

Importantly, in an era where patients see an ever-increasing number of non-physician providers, it is likely that young doctors will require a much more conscious effort to maintain a sense of personal responsibility for the health and well-being of the patients they care for.

I truly believe that this era of health care is providing better care for our patients than ever before, and I couldn’t be more satisfied in having the opportunity to take part in it.

Yet it remains to be seen how the trend from the “physician-employer” to “employed physician” will impact my generation of newly licensed physicians.



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Medicine and Health Care Will be Personalized Thanks to Technology

Medicine and Health Care Will be Personalized Thanks to Technology | Healthcare and Technology news | Scoop.it

From wearable fitness trackers to virtual doctor visits to smartphone apps and attachments that can collect sophisticated medical information, new technology is giving users unprecedented direct access to their own health data. In his new book, “The Patient Will See You Now: The Future of Medicine Is in Your Hands,” Eric Topol, a cardiologist, professor of genomics and director of the Scripps Translational Science Institute, explores how this “great inversion of medicine” will transform the future of health care. He recently spoke with U.S. News about how new capabilities might impact the quality and cost of care, as well as what some of the barriers will be. Excerpts:

What have been some of the drivers of technology changing the world of health care?

I equated the impact of the smartphone in medicine to parallel the Gutenberg printing press in terms of how it affected civilization. That sounds like a reach, but in fact, when you think about it, you will have sensors measuring almost any medical metric known to man; you would be able to check the cost of any procedure, scan, visit, hospitalization; and you could contact a doctor at any moment, 24-7, through your phone. It’s almost kind of limitless how this little device, which changed the rest of our lives so dramatically, is now going to have a similar analogous effect on our health.


How will this impact the cost and quality of care?


That’s a really important unproven concept. Work needs to be done to certainly shore that up. There’s a lot of promise. There’s a big change from having physical office visits to see doctors to these virtual visits, and that has already been shown to reduce in a striking way the costs per visit. Hospital rooms will not be necessary in the future. You could have all monitoring done for very inexpensively in the comfort and safety of one’s home. There’s so much waste in our system. The patient is driving things much more and is alerted to the unnecessary aspects and trivial costs.


Who will resist this change the most?


The medical community, especially in the U.S. This challenges all aspects of reimbursement. There’s also the other issue of the loss of control. This is a very paternalistic profession. This is the greatest challenge it will ever face. Also there are knowledge gaps. This will be the case with sequencing data – for example, matching up drugs and a person’s DNA interactions – and even a lot of the ways that wireless devices can be used to do things like the physical exam. These things are not in the comfort zone of many physicians and health care professionals.

What role will the Affordable Care Act play?


It’s kind of in a different orbit. The only thing where there’s some overlap is it is trying to promote the concept that the patient has access to their medical information. But it needs to go much further. Patients have a hard time getting their data, and it isn’t right. The Affordable Care Act doesn’t get to the core issues here of the democratization of medicine. I’m hoping, of course, that in the future we’ll get governmental support. That’s essential. No one’s suggesting that we don’t need doctors and the infrastructure that exists today, but in a very different way, in a more equitable partnership model going forward.


What should policymakers do?


The hope is that we recognize the fact that this is an inevitable progression of medicine, and while it represents quite a radical change, it’s time to grant [patients] rights ownership and acknowledge that the flow of information is going to be completely different than in the past. These data are going directly to one’s own devices, that they own, about their own body, for services that they pay for; it’s about time that we adopt this new philosophy. This is something that is not in our culture, not in the medical culture. But I do think that it can be fostered, it can be embraced, and eventually consumers will demand it.

What risks should patients be worried about with new technology?

I think privacy and security is one of the greatest factors that will potentially prevent this from moving forward in a catalytic way. We’ve seen all these various hacks and breaches. People’s health data is quite precious. It isn’t even just the privacy. This whole concept that one’s medical data is being sold – for example, one’s prescription use is being sold to pharma companies. This can’t go on. We’ve got a lot of work to do.


What can consumers expect ahead?


You can have your child’s ears examined through your own smartphone attachment and get a diagnosis of whether they have an ear infection, or get a skin lesion diagnosed immediately through a picture and an algorithm. Can you imagine getting data while you’re sleeping or while you’re in traffic? We have the exciting potential to get involved with pre-empting disease for the first time. By having all that data on populations of people, then that affords new ways to foster better treatments and preventions. That takes the information era to new heights.


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Cameron's curator insight, March 26, 2015 10:25 PM

The author carefully explains how healthcare apps can change our lives. Even with a paragraph dedicated to the risks of healthcare apps, the 'beneficial paragraph' is directly after it, giving the readers a choice to weigh out the bad with the good. 

Ben Simpson's curator insight, March 27, 2015 5:19 AM

This source provides great in depth detail and explanation on how technology will impact the future of medicine.

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Should doctors offer a money-back guarantee?

Should doctors offer a money-back guarantee? | Healthcare and Technology news | Scoop.it

How many times each week do we hear the phrase, “If you’re not completely satisfied, we’ll refund the purchase price — no questions asked.”

This is more often a marketing ploy than a true money-back guarantee.  I have a sense that trying to obtain a promised refund on an item that dissatisfied us is about as easy and carefree as changing an airline ticket reservation or reaching a live human when our home internet service is down.   So, when the weight loss pills don’t really melt the pounds off, don’t be shocked if the check isn’t in the mail when you mail back the placebo pills to a post office box several states away.  And, of course, you won’t recover the shipping and handling costs.


(This is my opportunity to ask for help from my erudite readership.  What exactly is shipping and handling?  Doesn’t postage already cover the shipping?  $8.95 seems pricey for a handling charge for anti-wrinkle cream or a set of steak knives endorsed by make-believe chefs.  I don’t really want strangers handling my stuff anyway.  Are they wearing gloves, I hope?)

I often hear a commercial for a zinc product that promises a full refund if the product does not shorten the course of the common cold.  I do have some medical training, as readers know.  Readers who are smart enough to understand’shipping and handling’ are asked now to explain how an individual can assert that the zinc product was not effective.

The complaint

“Please give me a full refund.  My cold lasted six days. Usually, I feel better by the 5th day.  Your zinc stinks.”

The response

“Thank you so much for your input.  All of us at Zinc Jinx, Inc.welcome customer feedback.  Please send urine samples for days 4, 5 and 6 packed in dry ice at your own expense so we can verify that you were taking the product as directed.  Include all packaging including the shrink wrap around the bottle that you should have retained had you consulted our customer service web site prior to opening.  Expect a response in 6 weeks.  Even if your urine drug content is deemed to be sufficient, our on site cold and flu experts may conclude after impartial study that your cold would have lasted nine days without our product.”

I’m not offering an opinion on zinc’s effectiveness in fighting the common cold.  I’m suggesting that it is not possible for a zinc swallower to really know if zinc expedited his recovery.  Belief is not evidence.  If we recover on day 6, perhaps, zinc was an innocent bystander receiving credit for a favorable outcome that it did not contribute to.

Sometimes, we physicians are lucky in the same way.  Our patients get better, as they usually do, and we get the credit. As we know, the converse is sometimes true.  We get blamed when we don’t deserve it.

Should doctors offer a money-back guarantee if our patients are not fully satisfied?  The zinc scenario illustrates how difficult it can be in medicine to assign credit or the blame for the outcome.  The only secure guarantee in medicine is that there are no guarantees.

If any reader is not fully satisfied with this post, the full purchase price will be promptly refunded:  no questions asked.


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1 In 4 New Doctors Would Change Careers If They Could Start Over

1 In 4 New Doctors Would Change Careers If They Could Start Over | Healthcare and Technology news | Scoop.it

Even as doctors enter a medical field with more paying patients under the Affordable Care Act and unprecedented numbers of job opportunities, 25 percent of “newly trained physicians” would still choose another field if they could, according to a new analysis.

More than 60 percent of doctors-in-training who were in the final year of their medical residency last year received at least 50 job solicitations during their training, according to a survey by physician staffing firm MerrittHawkins. Another 46 percent received at least 100 job solicitations.

“There are simply not enough physicians coming out of training to fill all the available openings,” MerrittHawkins president Mark Smith said.

This comes amid a physician shortage, changing payment structures and new regulations and paying customers under the health law that are creating more opportunities yet anxiety among doctors as they enter this new order.

“The paramount thing on new doctors’ minds is: will I have a life,” said Phil Miller, vice president at MerrittHawkins, a division of AMN Healthcare (AHS). “They are running into a maelstrom and there are all sorts of changes taking place.”

Merritt executives say it shouldn’t be surprising that 25 percent would select another field of study if they had to start over with their education given the turbulent environment they face.

The 2015 survey of residents in their final year of medical residency, which tallied more than 1,200 responses last year from a sampling of 24,000, indicates young doctors are ready to enter a world of “9 to 5” employment rather than launching their own private practice. More than 90 percent said they preferred employment with a salary rather than an “independent practice income guarantee.”

The more predictable hours young doctors want comes after four years of medical school and three to five years of residency, often with long hours and an exhaustive schedule.

Here are some other survey highlights from residents in their final year:

  • 78 percent expect to make at least $176,000 in their first year of practice
  • 39 percent are unprepared to handle the business side of medicine
  • 2 percent preferred a solo setting as their first practice
  • 93 percent preferred to practice in communities of 50,000 or more people


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Three Ways Doctors Can Use Patient Data to Get Better Results | The Health Care Blog

Three Ways Doctors Can Use Patient Data to Get Better Results | The Health Care Blog | Healthcare and Technology news | Scoop.it

Physicians have always been in the information business. We have kept records of patient data regarding the vital signs, allergies, illnesses, injuries, medications, and treatments for the patients we serve. We seek knowledge from other physicians, whether that knowledge comes from the conclusions of experts from research published in a medical journal or the specialist down the hall. However, a physician will always benefit from additional good information such as the analysis of pooled data from our peers treating similar patients or from the patients themselves.

Over the next few years, vast new pools of data regarding the physiologic status, behaviors, environment, and genomes of patients will create amazing new possibilities for both patients and care providers. Data will change our understanding of health and disease and provide a rich new resource to improve clinical care and maximize patient health and well-being.

Patient Data Used by the Patient

Instead of a periodic handful of test results and a smattering of annual measurements in a paper chart, healthdata will increasingly be something that is generated passively, day by day, as a byproduct of living our lives and providing care. Much of the data will be generated, shared, and used outside of the health system. It will belong to patients who will use it to manage their lives and help them select physicians and other healthcare professionals to guide them in their quest for a long and healthy life.

Based on a patient’s preferences and needs, the data will flow to those who can best assist them in maintaining their health. It will reveal important and illuminating patterns that were not previously apparent, and with the right system in place, it will trigger awareness and alerts for patients and other providers that will guide behaviors and decisions.


The future will mandate that healthcare systems have sophisticated analytical infrastructures in place to collect, analyze, and display these vast streams of data in ways that assist physicians and other care providers in delivering optimal care. Healthcare has always been dependent on managing information and knowledge to achieve the best possible outcomes, but this will become increasingly truer over the next decade.

Three Aspects of the Data-Driven Healthcare Transformation

This data-driven transformation will likely play out in at least three important ways.

1. Efficient and Effective Operations: Reduce Wasteful Spending

First, health systems will have to use data to run their operations more efficiently and effectively. Data can help healthcare providers better understand their operations. It can spotlight where they are wasting time, energy, and money. If an organization effectively uses information, it can optimize the use of resources, run more efficiently, and maximize reimbursement—all prerequisites for survival in the years ahead. While it sounds simple, this process alone promises to yield major efficiency gains and cost savings for organizations and for the nation. Experts have estimated that between 30 and 50 percent of healthcare expenditures in the United States are waste. Thus, this step alone represents a potential trillion-dollar opportunity to free precious resources for more productive use.

2. Manage Population Health
Second, data can help healthcare providers optimally manage population health. Data can be used to design more effective clinical processes that improve the diagnosis and treatment of the ill and injured. It can help physicians and other care providers understand how to standardize on evidence-based care processes. Standardization on a best practice represents significant additional opportunities to save costs and improve the quality and safety of care. Coupled with a physician’s knowledge and experience, data can augment a clinician’s ability to provide the best possible care.

3. New Technology-enabled Care and Personalized Medicine

Finally, new technology-enabled care delivery models will help healthcare providers deliver care that is more continuous, proactive, and geographically dispersed. Facilitated by the revolution in sensors, these care models will provide vast streams of data and turn society into an enormous learning laboratory. These sensors will provide information about what we do, how we eat, and when we exercise. They will provide information concerning our behaviors and our environments. In short, these new technologies will provide information regarding how we live in the real world and how our activities and environment impact health, disease, and treatments.

With the support of modern digital sensors, former trickles of information will turn into torrents creating vast pools of information that can provide new knowledge. In combination with genomic medicine, this new information will allow care providers to determine the right diet, medications, and therapies for each individual based on their specific situation, thereby delivering care that is far more personalized. And this type of personalized care will be empowering for patients and families, enabling them to participate in their healthmanagement in far more meaningful ways. The opportunities to improve population health are massive. Yes, there are significant issues regarding data security and privacy that must be addressed, but in time, they will be solved.

The Impact of New Data on Healthcare Costs

The impact of these trends on healthcare will be immense, to the point that it becomes hard to predict the ultimate impact on national healthcare expenditures. For years, healthcare policymakers and economists have been projecting massive increases in healthcare spending with each passing year. They correctly point out that this inexorable rise in healthcare costs poses an unacceptable risk to our economy.

While this is certainly of concern, the ultimate impact of aggressive waste elimination, process standardization, and new, more efficient, outpatient-centric care models is hard to quantify, yet it will likely be substantial. These powerful forces promise to drive healthcare expenditures down. As healthcare experiences the exponential impact of technological change, it is likely we will face a far different healthcare world a few years from now. Recall that not long ago we all relied on the thick Yellow Pages left on our doorsteps. Little did we know what impact a small company called Google would have on our lives.

Sooner or later, the same forces that have transformed other industries will fundamentally change healthcare. This will result in entirely new care environments and dynamics. This new world will most definitely revolve around data.Physicians have always been in the information business. We have kept records of patient data regarding the vital signs, allergies, illnesses, injuries, medications, and treatments for the patients we serve. We seek knowledge from other physicians, whether that knowledge comes from the conclusions of experts from research published in a medical journal or the specialist down the hall. However, a physician will always benefit from additional good information such as the analysis of pooled data from our peers treating similar patients or from the patients themselves.

Over the next few years, vast new pools of data regarding the physiologic status, behaviors, environment, and genomes of patients will create amazing new possibilities for both patients and care providers. Data will change our understanding of health and disease and provide a rich new resource to improve clinical care and maximize patient health and well-being.

Patient Data Used by the Patient

Instead of a periodic handful of test results and a smattering of annual measurements in a paper chart, healthdata will increasingly be something that is generated passively, day by day, as a byproduct of living our lives and providing care. Much of the data will be generated, shared, and used outside of the health system. It will belong to patients who will use it to manage their lives and help them select physicians and other healthcare professionals to guide them in their quest for a long and healthy life.

Based on a patient’s preferences and needs, the data will flow to those who can best assist them in maintaining their health. It will reveal important and illuminating patterns that were not previously apparent, and with the right system in place, it will trigger awareness and alerts for patients and other providers that will guide behaviors and decisions.


The future will mandate that healthcare systems have sophisticated analytical infrastructures in place to collect, analyze, and display these vast streams of data in ways that assist physicians and other care providers in delivering optimal care. Healthcare has always been dependent on managing information and knowledge to achieve the best possible outcomes, but this will become increasingly truer over the next decade.

Three Aspects of the Data-Driven Healthcare Transformation

This data-driven transformation will likely play out in at least three important ways.

1. Efficient and Effective Operations: Reduce Wasteful Spending

First, health systems will have to use data to run their operations more efficiently and effectively. Data can help healthcare providers better understand their operations. It can spotlight where they are wasting time, energy, and money. If an organization effectively uses information, it can optimize the use of resources, run more efficiently, and maximize reimbursement—all prerequisites for survival in the years ahead. While it sounds simple, this process alone promises to yield major efficiency gains and cost savings for organizations and for the nation. Experts have estimated that between 30 and 50 percent of healthcare expenditures in the United States are waste. Thus, this step alone represents a potential trillion-dollar opportunity to free precious resources for more productive use.

2. Manage Population Health
Second, data can help healthcare providers optimally manage population health. Data can be used to design more effective clinical processes that improve the diagnosis and treatment of the ill and injured. It can help physicians and other care providers understand how to standardize on evidence-based care processes. Standardization on a best practice represents significant additional opportunities to save costs and improve the quality and safety of care. Coupled with a physician’s knowledge and experience, data can augment a clinician’s ability to provide the best possible care.

3. New Technology-enabled Care and Personalized Medicine

Finally, new technology-enabled care delivery models will help healthcare providers deliver care that is more continuous, proactive, and geographically dispersed. Facilitated by the revolution in sensors, these care models will provide vast streams of data and turn society into an enormous learning laboratory. These sensors will provide information about what we do, how we eat, and when we exercise. They will provide information concerning our behaviors and our environments. In short, these new technologies will provide information regarding how we live in the real world and how our activities and environment impact health, disease, and treatments.

With the support of modern digital sensors, former trickles of information will turn into torrents creating vast pools of information that can provide new knowledge. In combination with genomic medicine, this new information will allow care providers to determine the right diet, medications, and therapies for each individual based on their specific situation, thereby delivering care that is far more personalized. And this type of personalized care will be empowering for patients and families, enabling them to participate in their healthmanagement in far more meaningful ways. The opportunities to improve population health are massive. Yes, there are significant issues regarding data security and privacy that must be addressed, but in time, they will be solved.

The Impact of New Data on Healthcare Costs

The impact of these trends on healthcare will be immense, to the point that it becomes hard to predict the ultimate impact on national healthcare expenditures. For years, healthcare policymakers and economists have been projecting massive increases in healthcare spending with each passing year. They correctly point out that this inexorable rise in healthcare costs poses an unacceptable risk to our economy.

While this is certainly of concern, the ultimate impact of aggressive waste elimination, process standardization, and new, more efficient, outpatient-centric care models is hard to quantify, yet it will likely be substantial. These powerful forces promise to drive healthcare expenditures down. As healthcare experiences the exponential impact of technological change, it is likely we will face a far different healthcare world a few years from now. Recall that not long ago we all relied on the thick Yellow Pages left on our doorsteps. Little did we know what impact a small company called Google would have on our lives.

Sooner or later, the same forces that have transformed other industries will fundamentally change healthcare. This will result in entirely new care environments and dynamics. This new world will most definitely revolve around data.



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