Future-health-care-7

 

It wasn’t what I had planned on a 70 degree day last week when “springtime in the Rockies” was in full bloom. But I was on my way to the hospital, and over the next 24 hours I would learn much about a healthcare industry that is woefully unprepared for the changes that lie ahead.

Just moments early I had woken in a daze on our living room carpet with blood spattered everywhere, and only a vague recollection of what had just taken place. My nose was bleeding, my lungs were having a hard time getting enough air, and I was feeling fatigued. Very fatigued.

Slowly I started regaining my memory of the coughing spell and my inability to catch my breath, and then everything went black. But only for a few seconds.

After a little time spent cleaning blood off the carpet, and briefly toying with the idea of going for a bike ride instead, I decided going to the hospital was a more prudent course of action.

Little did I realize, but the next 24 hours were going to be my journey into understanding next-generation healthcare and the overwhelming challenges ahead for doctors and hospitals.

I entered the Kaiser Permanente facility north of Broomfield, CO thinking I’d be in for a long wait because I didn’t have an appointment. However, once I described my symptoms the attendant dialed a code-red number into the phone and I was quickly phalanxed by a cadre of nurses who put me in a wheelchair, began checking my vitals, and escorted me to an examining room on the fourth floor where a doctor greeted me in less than five minutes of my arrival.

This was far better service than I was anticipating.

Over the course of the next hour the doctor had run a number of tests, including an EKG and blood tests, and quickly came to the conclusion that more tests were needed.

In the hospital every patient is like a giant Suduko puzzle and the tests they run provide the missing numbers as they attempt to win the examination game. In my case they were still missing a ton of numbers.

For this reason the doctor suggested I be moved to the emergency room at Good Samaritan Hospital which was just down the hall from Kaiser.

Unlike Hollywood’s version of the ER being an energized feeding frenzy of attentive doctors and nurses, my experience has been just the opposite. After they connect you to some machines, time slows down and progress is measured in one-hour blocks with brief moments of nurses feigning to pay attention.

Eight hours after my drive to Kaiser, I found myself being admitted to the hospital for overnight observation. My desire for quick answers and quick solutions were nowhere to be found, and this was about to become a very painful experience.

More on this later.

The Future of Healthcare

The speed of information is affecting virtually every industry, and this is especially true when it comes to healthcare. The consumer marketplace is heavily influenced by information, and health-related topics are typically great attention-getters for any media publication.

As soon as the marketplace becomes aware of a new piece of information, there are three ways people will react:

  1. React immediately. If it answers a lingering question or explains something that has previously been unexplainable, a small percentage of people will immediately take action. These immediate actions will include things such as setting up an appointment with a doctor, tell others, buying or not buying a product, or in some way, altering their lifestyle. For investors, it may also affect an investment strategy.
  2. React slowly. Sometimes information will trigger a thought that needs more investigating. This is true for a much larger percentage of people.
  3. Store it away for later. The vast majority of people who consume a new piece of information will do little more than tuck it away into their vast storehouse of memory cells and cogitate on it later.

For people who react immediately or slowly, their actions are traceable in the online world. Activity surrounding keywords and keyword phrases leave definable metrics that industry insiders can track and measure.

Unlike decades past where studies and reports were mostly relegated to collecting dust on the shelves of researchers and analysts, virtually no information today is value neutral. It almost always has some affect, and the cumulative effect of this information is causing seismic shifts in the way healthcare will be measured, monitored, and managed in the future.

Cumulative Awareness

Psychology students who are involved with studying behavioral abnormalities are quick to identify aspects of the traits within themselves. Introspection is a powerful tool.

With every piece of health-related information that an individual consumes, there is an accompanying moment of introspection.

People today are far more adept at connecting cause and effect relationships between everything from food and the body’s energy, to physical activity and mental alertness, to sleep and daily performance.

The more we know about the human body, the more we become aware of its deficiencies. Our health is a common topic of conversation and we now have names for thousands of additional medical conditions and physical performance issues than even 20 years ago.

Over time the number of treatable conditions for us to contend with will increase exponentially. Enterprising people will devise treatments for virtually every slight deviation from the norm, and many will prey on those who are hypersensitive to their own physical maladies

This cumulative awareness is building towards something, and this something I believe will involve more personal control, greater efficiencies, and a focus on the concept of “self.”

Exponential Growth in Awareness Tools

In 1714 Gabriel Fahrenheit invented the first mercury thermometer. But it wasn’t until the mid-1900s when thermometers became common household tools that enabled average people to make one small diagnostic measurement on themselves.

Similarly in 1896, Italian physician Scipione Riva-Rocci invented the first mercury sphygmomanometer, which used an inflatable cuff on the upper arm to nullify the arterial pulse and measure blood pressure. This device was very much like the blood pressure monitors in use today. With inexpensive home units, monitoring blood pressure today is almost as common as taking someone’s temperature.

The massive surge in smartphone technology is setting the stage for a wide variety of health-related peripheral devices to spring to life, revolutionizing how healthcare is monitored and managed.

The combination of smartphones, functioning as small anytime, anyplace computers; wirelessly connected peripheral devices such a ultrasound wands, blood pressure cuffs, EKG monitors, skin-monitoring patches, and ingestible cameras; along with a rapidly growing app-builder community capable of finding uses for equipment that manufacturers never dreamed possible, and the stage is being set for an entirely new health system to emerge.

It is this convergence of smartphones, peripherals, and apps that is on the verge of granting us, the consumers, a whole new level of awareness, and the ability to live with far fewer gatekeepers in our quest for optimal health and physical performance.

Future Medical Peripheral Devices

Here are just a few of the possibilities for future medical peripheral devices. Some are already on the market, others just months from being introduced.

  • Heart rate monitor/analyzer
  • Digital stethoscope
  • Galvanic skin response monitor
  • Skin dryness measuring device
  • Blood pressure cuff
  • Skin microscope
  • Sweat analyzer
  • Body fat measuring devices
  • Hair quality analyzer
  • Personal EKG
  • Stress level tester
  • Foot pressure analyzer
  • Portable ultrasound wand
  • Intra oral cameras to inspect teeth
  • Ingestible camera
  • Blood analyzer
  • Oxygen level tester
  • Digital thermometer
  • Caloric intake monitors
  • PH level testing device
  • Vitamin deficiency monitor
  • And many more

Over the coming years we will see thousands of these kind of devices hit the market, and each, in turn, will spawn thousands of apps to run them and analyze the results.

A few will go the route of getting FDA approval, but the vast majority will not, opting instead to position themselves as personal alternative healthcare devices.

The great age of experimentation is about to begin.

The Explosion of “Self”

The future of healthcare will be far more oriented around the concept of “self” – self-diagnostics, self-monitoring, and self-medication.

People today tend to resent medical doctors as the gatekeepers of their own health. They resent having to orient their life around the doctor’s time and location, and the finely metered access they grant whenever a need arises.

A recent study published in USA Today showed that about half of all 18-50 year old men don’t even have a doctor to go to if the need arises, and one out of five do not take prescription drugs because of cost.

As we move away from our heavy reliance on doctors for answers, we will begin to see a number of shifts occur.

The “Good Enough” Trend

Most people who are searching for information do not require 99.999% accuracy. They are looking for 10 second nuggets of information, and once they find the piece they are looking for, they move on. They are only concerned with information that is “good enough.”

In medicine, doctors are trained to view the world through a very analytical mind with high degrees of precision. Because of malpractice lawsuits, doctors are held to a very high standard and medical procedures are constructed to be exhaustively precise so as to protect both the doctor and the hospital they work in.

This, of course, comes at a price…. a very high price.

For this reason, most hospitals are in the business of selling tests. In all the thousands of tests done at hospitals, only a small percentage actually reveal something actionable. Most are little more than a way of defining the white space around the given subject matter.

Given the option, people are generally fine with less testing and less accuracy. They are far less interested in protecting the assets of the doctors and the hospitals and far more interested in simply finding an answer that is “good enough.”

Their objective is to get their life back to normal by expending as little time, money, and effort as possible.

Will We Still Need as many Doctors in the Future?

With all of these advances in personal inspection devices, the natural question to ask is, “Will we still need as many doctors and nurses?” And the answer is a qualified “yes.” But their jobs will be different.

People who have the ability to monitor and test themselves on a regular basis will find more things wrong and will require more advice, not less. Many will email photos, charts, and videos to their doctors for feedback before making an appointment.

Very likely, this will give rise to a new breed of non-doctor medical advisers who are trained as intermediaries. To the extent this new class of healthcare adviser is permitted under law will determine the rise or fall of doctor demand.

Finishing My Story…

The primary reason I was admitted to the hospital was for one final test which they hoped to run in the morning, an echocardiogram.

When I offered to come back in the morning, they were quick to say that I would have to schedule a separate appointment and it would likely be days before I could get the test done.

I found myself in the unusual position of having to argue against the seemingly insane hospital-centric rules that were clearly not in my best interest.

So reluctantly, very reluctantly, I agreed to spend the night. This is a decision I would very much regret in the morning.

Several times I was given papers to sign with very little explanation as to what was actually in the documents.

Hospitals are not a place where you get very much sleep. Throughout the night I had devices monitoring me and nurses periodically coming in to draw blood and check my blood pressure.

The nurses were ruthless with the stick-on patches and the connecting wires they used to monitor my heart and lungs. Throughout the night they attached no fewer than 100 of these dreadful patches, and each one was a painful exercise in removing them from my hairy chest.

I don’t know this for certain, but I’m fairly confident that if I had demanded an itemized list of every cost before it was incurred, the whole series of events would have ground to an immediate halt. The process of calculating a final bill (hospital, doctor, and related costs) is so muddled and opaque that few people have the ability to make heads or tails of it.

I was surprised when a nurse showed up to give me my meds, which she explained were pills that some doctor had prescribed. The nurse was equally surprised when I asked her to give me a detailed explanation of each pill, turning down about half of the mystery batch.

Somewhere around 7:00 am a lady showed up to perform the echocardiogram, a test that took around 10 minutes to perform. She said the doctor would be in to give me the results in about 2 hours.

Five hours later, never having seen the doctor, I decided I had had enough of this fun time in the hospital, got dressed and was getting ready to leave. At this point the nurses were scrambling, paging the doctor with hopes that he would show up before I was ready to bolt.

At one point a cardiac nurse showed ups with preliminary results of the echocardiogram, saying basically that all of the testing indicated virtually nothing wrong with me.

Just as I was ready to walk out the door, the doctor finally arrived. To his credit, he was very understanding, letting me know that his patient load at the hospital had more than doubled in the past couple days, apologizing for all the delays.

After a quick check of my vitals and scanning through the charts he said that none of the tests revealed anything seriously wrong. The reason I passed out was because of a sensitive vagus nerve problem that is fairly common, and my coughing and shortness of breath may be because of the onset of bronchitis even though they weren’t able to detect anything in the lungs.

In the end he prescribed some antibiotics, more on a whim than for any concrete reason, and sent me on my way. The antibiotics worked like a charm.

I wish I could say that my stay in the hospital was a good experience, but it wasn’t. I also wish I could say the people I encountered were quick and efficient, always with my best interest at heart. But that also wasn’t true.

What was clear was the fact that the entire healthcare industry is poised for a massive transformation, and virtually none of the transformation will have anything to do with the new healthcare legislation passed in Washington.

We are in for some huge changes, and it will be up to us to decide how they affect us personally.

By Futurist Thomas Frey

Author of “Communicating with the Future” – the book that changes everything

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12 Responses to “Rethinking the Future of Health Care”

Comments List

  1. Lisa

    Hello Thomas, I had a very similar experience at Medical Center of the Rockies in Loveland where I was taken for a broken leg. Transformation is needed, but not of the legislative form, of the attitude and service-provider form. I am glad you are well and hope we can find a way to remove some of the layers of the labrynth of health care. Lisa
    Reply
  2. Karen Porte

    Hey Tom, Glad it was nothing dreadful in the long run. Being a nurse in an emergency room, I can tell you this story repeats itself over and over again. Our system is so badly broken, it defies description! Give yourself another jolt of reality and request an itemized statement of your stay. (You have a right to that) You will be beyond stunned! I can't wait to see your blog post then. Stay well. Karen Porte
    Reply
  3. nemesis

    Be careful of hospitals. You could come out with more than you went in with. I'm scared stiff of Western doctors. My Dad checks his own blood sugar levels. The doctors changed his dose. Then he pricked his finger and there wasn't any blood! They got him mixed up with another patient of the same surname. Apparently this happens all the time, often with lethal consequences. Its the institutionalization of medical practice that is such a concern. You're just a number. In Nepal I contracted amoebic dysentry. I went to the practice of a local Tibetan/Western doctor on a friday night. We had to phone him, but he arrived. He wasn't in a rush, and completely on top of the situation. He examined me and gave me a few pills, charging only for cost of the medicine. I was almost taken aback how disinterested he was in me personally. Intimate but professional - which is so difficult to get right when you take authority and subject it to narrow legal bureaucracy. Ivan Illich wrote an important work in 1976, Medical Nemesis. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1237194/
    Reply
  4. Syl Houston

    Tom, It is not always the system; most times its the personnel in the system who are relectant to do what "needs" to be done at the time it needs to be done. We have lots of tools. They should use them.
    Reply
  5. Antonio Bramante

    Tom: Two words from down here in Brasil: 1. I`m glad that you`re well. I did my doctoral work in leisure studies and considering what you have produced so far, I should say that you work too much! 2. Consider yourself a happy man! Should you live in developing countries, then you would be experiencing the real adventure of being in need for serious health care...
    Reply
  6. <a href='http://highlycontagiousmarketing.com' rel='external nofollow' class='url'>Judy Murdoch</a>

    Glad to know your story had a happy ending Tom. The biggest issue I see is that people don't do simple, easy things to prevent the big, expensive problems that come up later in life. Our healthcare system is basically like the fire department: we only see them when there's an emergency. (Not aimed at you, Tom, I don't know how you could have prevented what happened). It's not healthcare, it's emergency response. I don't think it would have helped your situation Tom, but I personally like the idea of cash incentives for demonstrated prevention of health issues that cause problems: that people are getting enough exercise, eating well, getting tests that catch problems early. Nothing is going to work if most people have the attitude that "I'll be a couch potato and live on Doritos. If my ticker gives out, no biggie, I'll just go to the emergency room and they'll give me a new one." Reform needs to cover everyone including the people who have the most to gain: the patients: It's our bodies after all!
    Reply
  7. Neville Berkowitz

    Hi Tom, There are not many people as clear sighted, articulate and humble as you are and I'm sure I speak for all your subscribers, family and friends when I say "please stay healthy!"
    Reply
  8. Ron

    Your article is fair and just needs a couple more paragraphs to be complete. The purpose of medicine is not to provide you with an experience similar to a 5 star hotel or restaurant. Rather to help find the problem and provide a solution. No where does the manual suggest patient delight, if we / you do not like the experience - participation is optional. We should be grateful we have a system that goes to extended lengths to try and find the problem and the seemingless endless number of staff who smile and go out of their way to help. Which tests would you have prefered they not administered?
    Reply
    • admin

      I would have preferred they eliminate the expensive tests that were marginally useful at best. I don't know which ones they were. This is a clear example of asymmetrical economics, where one party has a significant advantage over the other because of they know far more about a given situation. As a medical patient who's less than healthy, having to make decisions about tests that I'm unfamiliar with, puts me at a significant disadvantage. Because of the potential for medical malpractice lawsuits, doctors and hospitals are very interested in covering all the bases. They have different motivations than me, the patient. I'm not saying there is any overt effort to do something underhanded. But their obligations to the hospital and their obligation to the patient are often in direct competition with each other. There are currently no good checks and balances for this. Tom
      Reply
  9. Tammie

    I see this was published in April, I am just now seeing this,, I see no comments regarding a huge portion of your article, smartphone applications for healthcare. Brilliant by the way! I am so excited to be able to get to the point where "minor" self diagnosis is possible and cuts medical costs for uninsured and elderly medicare patients. Mostly men who refuse to go to the doctor unless bleeding to death or dying is imminent (joke). I am thankful for the era we live in medically but it is not without it's sacrifices of many to get there. Thank You for a great article
    Reply
  10. Dixie Netley

    Joel, good point. I think any blurp out of the FDA in regards to OPTR in the briefing documents that can be seen as negative may reduce share price before the panel. I may short right before the B.D>'s are released and hedge with calls.
    Reply

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