Robert Schooling and Clare Krusing
It seems like everywhere you look technology players are looking to disrupt the status quo in health care. Microsoft, Google, Apple, and even Uber have all made big investments in health care. Major health care players, like UnitedHealth Group and their Optum unit are making massive investments in better data and artificial intelligence to help improve health care delivery. On top of that, Google’s recent $375-million-dollar investment in Oscar, the health insurer, points to a technology trajectory that will change the way consumers interact with the health system.
But is it enough?
The health care system is on the ropes. Costs continue to sky-rocket and consumers are being asked to take on ever-increasing portions of their health care costs, often at levels that are unaffordable and discourage care. Layer on top of that a massive wave of chronic disease, and we’re facing the perfect storm for a health care meltdown. In fact, one report found that the next generation of seniors will be markedly less healthy with substantially higher rates of diabetes than current seniors. This inevitably puts a greater strain on an already burdened Medicare program.
On the bright side, our health care choices have improved dramatically – there are more and better medicines, medical devices, and diagnostics than ever before. It was just fifty years ago when about all your doctor could do for you is to say, “Take two aspirin and call me in the morning.” Today patients have a range of options.
So how do we ensure access to these new medical technologies?
Some argue that we should consolidate control of the health care system under the government to save money. Putting aside the fiscal and economic problems with that for a moment, it does nothing to address the real issue: how are we treating people in the health care system?
So, is big data and artificial intelligence just the latest fad in health care or can it make a fundamental difference in bending the cost curve?
From our perspective, the answer is not if it will make a big difference, but when. The good news is that it would be hard to have a less efficient system than we have today – so we can only go up! The virtually real-time market responses that exist in most areas of commerce are almost entirely absent from health care.
In part this is due to third party payment models, but it is also due to the siloes in health care and to the fact that the system was conceived largely to deal with acute episodes of hospitalization, rather than to manage the tidal wave of chronic diseases that now flood the system. It was never envisioned that health care would require such routine coordination with such a large number of people. This is a perfect problem for technology to solve. Coordinating millions of inputs and outputs and making sense of it.
Of course, the “how” of making that come to pass is incredibly complicated, but there are three simple “whats” that we need to focus on:
1. We need to educate and activate patients before they enter the health care system, rather than after. Once a patient is in the ER, it is too late. Instead, when patients understand their options and when they are self-motivated to do something about their health, therein lies the sweet spot for designing effective interventions and care delivery. It allows us to interact with consumers at the moment they need assistance and help them find the right resource for their immediate needs.
2. We need to anticipate illness and prevent it. Predictive modeling can help us anticipate when a patient is likely to trigger an episode of care that could be averted, but the trend of artificial intelligence in health care should not come at the expense of human judgment and interaction. We need to utilize technology to support, not replace, the type of patient-provider interaction and discussion that is needed to effectively help them navigate the system and their care.
3. We need to genuinely commit the entire health care system to paying for value, but also designing health care so that patients want value too. That requires us to be able to better measure value and, importantly, to give feedback to doctors, hospitals, and others in real-time about their performance, so they can adjust.
The potential cost savings from greater efficiency in health care are massive. Those cost savings can then be deployed to help us afford the advancements in health care that are so exciting.
The Cancer Moonshot is a great idea – but if we really want to transform our system we need a Data Moonshot as well. Let’s identify the barriers in the way of speeding adoption of better data collection, better value assessment and reporting, and greater use of telemedicine, just to name a few. These challenges are solvable and solving them would improve the lives of all Americans.