Chronic diseases are eating the health care system from the inside out, yet most of the technology progress we see in health care is about creating new connections within and among health care providers.
Driving this frantic retooling of health care delivery, outside the ACA’s mandates, is the absolute certainty that the current system cannot possibly handle the growing number of sick people. The health care system as a whole is girding itself for the influx of more chronic patients, anticipating increased workloads and associated logistical and financial costs.
The CDC estimates that half of Americans—117 million people—have at least 1 chronic condition. 25% of Americans have two or more chronic conditions. Their grim prognosis: it’s only going to get worse. Further, the majority of healthcare spending—86%—is taken by the 25% of Americans with one or more chronic conditions.
The demanding and daunting task of infrastructure work is absolutely critical to the advancement of better patient care, to be sure. But it’s not going to improve population health.
The CDC emphatically states: “Chronic diseases and conditions—such as heart disease, stroke, cancer, diabetes, obesity, and arthritis—are among the most common, costly, and preventable of all health problems.” Common. Costly. Preventable.
The rush to connect infrastructures and optimize patient care is directed at helping manage those who are already sick, leaving the biggest asset on the table for actually solving the problem: Consumers themselves. All efforts to stem the rising costs of chronic diseases arise only after a consumer has passed on several opportunities to self-divert from the system.
Think about it from this scenario that could have easily have taken place 6 years ago:
- Patient: Doc, I have no energy, my joints hurt, and I can't fit into my clothes anymore.
- Doctor: I don't see any diseases here, so that's good. What you really need is to follow a sensible diet and get some regular exercise. Losing weight will reduce stress on your joints and a sensible diet and exercise regimen will help improve your energy levels and even help prevent heart disease in the future. Here's a handout of some suggestions for helping you lose weight and get more exercise.
- Patient, a few years later: Doc, I still don't have any energy, my knees are killing me, and I get out of breath trying to keep up with my kids.
- Doctor: Well, I see that your cholesterol level is too high and your BMI puts you in the obese range. You're a candidate for heart disease if you don't get your cholesterol under control and lose some weight. I can help you with the cholesterol with this prescription. And here's a handout of suggestions for losing weight and getting some exercise.
- Patient: Suffers heart attack.
What has caused consumers not to care—enough—about their health in the past had to do with the relative casualness of their doctor's orders in comparison to the real, painful, expensive long-term consequences of those bad lifestyle choices. This complacency is rooted in a reimbursement system that treated both good and bad health conditions with the same formula. Financial penalties for unhealthy behavior were only slightly, if at all, more expensive than for healthy behavior.
Now that the reimbursement model is changing, and doctors are on the hook for getting and keeping us healthy, it's time to rethink how we manage health, not just chronic diseases. Many of the current healthcare IT initiatives are all about improving chronic disease management. Few, if any, are about chronic disease reversal, or even about improving a person’s general health.
We've seen the power of consumerization in the computer age. Personal Computing was a revolutionary concept. Companies like Dell and Hewlett-Packard took down giants like Digital Equipment Corporation (DEC) and IBM (in minicomputers and PCs) by bypassing traditional wisdom that computers had limited usefulness in homes.
We've seen the power of consumerization completely transform non-digital industries like movie, book and music distribution into completely digital experiences.
We can accomplish consumerization in health care when we start looking at the issue from the eyes of the consumer. We can solve some health care access issues with the intelligent application of home diagnostics. We can bypass busy doctor's offices when we apply telehealth via video feed, as American Well, Teledoc and Vidyo are striving to do.
What consumers need is for the likes of General Electric, Dell, Hewlett-Packard and IBM to focus as much energy and attention on helping keep people healthy by looking at ways that technology can solve the problems of poor food choices and sedentary lifestyles that are driving the prevalence of chronic diseases in the first place. These are brilliant companies. And they’re missing the mark by focusing their time, research and effort only on those who are already sick.
My husband, business partner, and Moor Insights & Strategy health consumerization co-practice lead, Yuri, likens the healthcare IT improvement frenzy to this analogy:
Doctors are jumping into the river to save drowning patients. More people with chronic conditions are coming down the river than ever before. So health system “innovators” are developing technologies to help doctors rescue more patients, faster, more efficiently and for less money.
But why aren't we stopping people from falling into the river in the first place? At what point did the health care system just flat out lose focus on actually helping people get better?
The biggest lesson I’ve learned from observing high-powered innovators in technology over the past 20 years is actually pretty simple: If you focus on optimization rather than innovation, you’ll end up broken and bleeding on the tech roadside faster than you can say
Disclosure: My firm, Moor Insights & Strategy , like all research and analyst firms, provides or had provided research, analysis, advising, and/or consulting to many high-tech companies in the industry, including Dell, Hewlett-Packard, IBM Intel cited this article. No employees at the firm hold any equity positions with any companies cited in this column.
