HealthManagement, Volume 18 - Issue 1, 2018
Thefutureisnotsofaroffasanewbookonfuture healthcareshows
A newbookreleasedbyJacobsInstitutehas its finger on the pulse ofthelightning-speedchangeshappeninginhealthcareand howstakeholderswillneedtoadapttostayahead.
Peering intothefutureofhealthcareislessabout predictionsand more aboutimplementing systemicchange tounlockourpotential.A commitmentfromthehealthcarecommunitywould leadtodramaticallyimproved patient careandcost savings foreveryoneinthehealthcarepipeline. Butwe havetoremovebarriersandthinkoutsidethebox.
TheFutureofMedicine bookreleasedby medical deviceinnovationcentre,JacobsInstitute(JI),basedin Buffalo,NY,tacklesamyriadoftrendsofwhichhealthcareexecutivesshould beaware.
“We’vebuilttheJIonthepremisethatfosteringinnovationisthemostimportantthingwecando
toensure improvedqualityofcareforcurrentandfuturegenerations,”saidL.NelsonHopkins,MD,andAdnanH.Siddiqui,MD,PhD,ClinicalleadersattheJI.
Virtualmedicine
Disruptionoftraditionalhealthcaredelivery,asweknow it,isalreadyunderway.LeaderssuchasJohnsHopkins Hospital,MontefioreHealthSystem,Kaiser,andeventhe CentresforDiseaseControl(CDC)havevirtualpatient monitoringorphysician consultation.Montefioreopened a12-storyambulatorysurgicalcentre—withnohospitalbeds.Patientsdonotwanttowaitfortests,diagnoses,andfollow-up appointments. They wantaccurateanswersnow.Onlinechats andtelemedicineare thesolution.Thisrepresentsacostsavingstohospitals thataren’tpayingfortraditionaloverhead.Oneofthe keybenefitstobeingvirtualisthescalability.Ifadigital system worksforyourcurrentpatientvolume, youcan increasethatexponentiallywithease.Hospitalsthatare notmovingtowardvirtualmedicinewilllagbehindearly adoptersandwillnotreapthebenefitsofcostsavings.
Universalhealthrecords
ElectronicHealthRecord(EHR) systems cancostmore thananewhospitalbuilding.Addtothatthecostof cybersecurity,andyouhaveasignificantportionofa hospitalbudgetdevotedtoabigproblem.Open electronicmedicalrecords(EMR)wouldhelp,butno current openstandard
forEMR exists,Despite
the$30billion theU.S.governmenthaspaidinincentivesforsucha transfer.Therearepresently245differentEHRsystems inuse.Theyareoftenover-customisedforeachspecialityorhospital,leavingtheinformationin
useless siloswithHIPAAlawsandanti-kickbackstatutesexacerbatingtheinformation-sharingconundrum.Withall thisinfoindisparatelocations,physicianscannotutilise artificialintelligence(AI)tominepatientdataforinformationandtrendsthatcould lead toresearch
breakthroughsoracceleratedrugdevelopment.thesolution tothedilemmalies,inthiscase,notwithhospitalsbut with theEHRcompanies. Whicheveronecandelivera platform—thatcanbeutilisedwithAIthatcanaccess andtranslatethedataintousefulinformationwhilealso integratingwithvarioussmartphone applicationmonitoringsystems-andcreatingitwith globalscalability inmind—will bethevictorinthese
datawars.
Roboticsurgery
Inreality,robotsarealreadyin
theoperatingroom— for autonomouslysuturingsofttissue, guidingvisualisationandassistingorthopaedic surgeons, helping neurosurgeonsplaceelectrodesin thebrain, andmore. Thecurrentcostof roboticsurgicaltechnologyishigh andrequiresaminimumpatientvolumeinordertosee returnoninvestment.
However,economicswillprevail,whenavalue-based approachisembraced byhospitals.efficacyandefficiencyof surgeryimprovewith robots.Newfinancial modelstomakerobotsmoreaffordable—suchaspay- per-procedure—will meanevensmall-town hospitals could offerthelatest andgreatest technology. When alignedwithartificialintelligence,robotswillbethepreferredsurgicalmethod,withphysicianoversight.Eventually,nanotechnologycouldmeantheendofinvasive surgeriesaltogether.
Ambulatorysurgicalcentres
Bigboxhospitalswillbegintofeeltheeffectsofambulatorysurgicalcentres(ASCs),wherelowacuitysurgeries andprocedurescanbeperformed,suchasendoscopy, jointreplacement,andcataractsurgery.Therewillbe tremendouscost savings inhavingaprocedure at anASCversusatahospital.Hospitalswillnotbeleft behind,however.enterprisinghealthsystemswillopen ASCs independentlyorpartnerwithphysicians todoso.
Here—aswithsomanyothercatalysts ofchange inhealthcare—patientsatisfactiondrivesthismigrationtoASCs.First,theyrepresentagreatercostsavings topatients. Forinstance,in2014, acataractsurgery cost$5,672atahospital,compared to$2,932atan ASC.Additionally,patientsappreciatethefactthatASCsaresmallerandeasiertonavigatethananoverwhelminghospital,andtheteamisspecialisedbyprocedure-type.The efficiency andqualityofthecareissuperior, with equalorbetteroutcomes.Thissmaller,specialised approachtosurgerywillcomplement theadvances in roboticsurgery,machinelearning, imaging,andelectronicmedical records,creatingamorestreamlined healthcareexperience.
Impactoftech
As healthcareleaders,weareon thecuspofsignificant changesthatwillimpactthewaywedelivercare.Technologywillempowerpatientsinaway previouslyunseen, goadingustoinnovateandinvestineveryone’sfuture.
Tolearnmoreabouttheopportunitiesandroadblocks onthepathto thefutureofmedicineinsurgery,staffing, innovationanddataamongstotherhotfuturehealth- caretopics,goto:www.futureof.org/medicine-1-0
Key Points
- Disruption of traditional healthcare delivery, as we know it, is already underway
- Ambulatory surgical centres are already being used and will lead to cost savings
- A key benefit to being virtual is the scalability
- EHRs and related cybersecurity can take up significant parts of healthcare budgets
- Hospitals lagging behind early adopters will lose out on savings
- EHR companies that can deliver smart platforms will be victors in data wars
- Budget-friendly robotics will lead to wide implementation of the technology
- Patient satisfaction will be one of the biggest catalysts in healthcare change