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We Need Technology to Scale Healthcare

Posted on June 2, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was recently talking with one of my healthcare IT friends about the future of technology in healthcare. As we were talking, they made this really interesting observation:

“We Need Technology to Scale Healthcare”

I don’t think I need to go into too much detail with readers of this blog about the possible shortage of doctors that could happen. In fact, Kyle Samani covered some of this shortage in his post, “The Nurse Will See You Now.” In that post he talks about the limited number of residency slots that are available. Not to mention the lengthy path to becoming a doctor. I read an astute observation recently that the only reason we don’t have a real crisis in general medicine is because there’s a limited number of residency slots for the other specialties. When a med student can’t get into their desired specialty, then they fall back into general medicine. The idea of general medicine being a “fall back” profession doesn’t bode well for us, but that’s a topic for another day.

Consider the supply and demand constraints that Kyle talks about, we’re going to have a growing problem where the demand for healthcare outstrips the supply of doctors. Kyle covered the move towards nurse care, but I think there’s also an important case to be made for how technology can help to scale healthcare as well. As one example, Telemedicine has the potential to make our healthcare visits much more efficient. Properly implemented technology can do that across a wide variety of healthcare. Plus, technology has the potential to reduce unneeded office visits as well.

What I find even more intriguing is that right now we look at a visit to the doctor as a last resort for our healthcare. How many of us go to the doctor in order to remain healthy? Almost no one. If we really want to scale health care to the point that we’re providing health care and not just sick care, then that will require a scale that healthcare has never seen. I personally call this movement “Treating Healthy Patients” and I think this movement will be data driven with technology at its core.

Lest those reading at home get confused. I don’t think most of the healthcare technologies out there today work on scaling healthcare. Most of the healthcare IT solutions out there today are about optimizing the status quo. That’s very different than what will be required to scale health care. I’m excited to see these later technologies come to fruition.

The Nurse Will See You Now

Posted on May 13, 2014 I Written By

Kyle is CoFounder and CEO of Pristine, a VC backed company based in Austin, TX that builds software for Google Glass for healthcare, life sciences, and industrial environments. Pristine has over 30 healthcare customers. Kyle blogs regularly about business, entrepreneurship, technology, and healthcare at kylesamani.com.

The Atlantic just wrote a piece highlighting the growing trend of non-physicians (commonly referred to as midlevels) providing healthcare. The reason is simple: supply and demand–more precisely, a fixed supply.

For any location where a patient demands healthcare services, there is only a binary result: either there is a qualified healthcare professional available to deliver care, or not. This slide (from Pristine’s investor presentation) illustrates this:

Screenshot 2014-05-04 21.01.17

The supply and demand problem is further compounded by an archaic regulatory system. The path toward becoming a physician, at least in the US, is so arduous that the decision to pursue becoming an MD must be made by age 18 or 19. Even if a huge cohort of 18 year olds suddenly decided they wanted to be physicians, the artificially capped supply of available residency slots each year stimies traditional supply and demand economics.

Nursing, on the other hand, has a more varied cohort in terms of age of entry. Many nurses don’t enter the profession until well into their late 20s or 30s. The same is true of physician assistants. This has resulted in a more liquid supply of non-physician practitioners, and these non-physician practitioners are available to respond to the influx of new patients resulting from the ACA, and to the growing number of retiring baby boomer population.

Given the fixed supply of physicians, there are two fundamental ways to solve the supply and demand problem: make physicians more efficient, or substitute physicians with others who can do an equally good job for a given patient’s needs.

The realities of practitioner supply suggest that nurses and other non-physician practitioners will deliver an increasingly large percentage of healthcare services. Physicians will be relegated to the “high end” per Clayton Christensen’s disruption theory. That could manifest itself in a future in which midlevels deliver primary care and triage more acute conditions to “higher end” specialist physicians.

The greatest challenge in the triage-centric model led by midlevels is the (historically quite poor) communication among healthcare providers. We will need a robust technological infrastructure to support the seamless transfer of patient data among providers. Additionally, we’ll need more capable communication tools to empower providers to connect with one another and with patients regardless of location.

Telemedicine seems to be taking hold to power a future in which location is irrelevant. Interoperability is improving within health enterprises, though there are some signs that community health information exchanges (HIEs) are not doing as well as many had hoped.

At some point down the line, we’ll likely look back and wonder why location mattered so much. It shouldn’t, and because of telemedicine, and liquid data connectivity, it won’t.