It’s no secret that we often don’t get what we pay for when it comes to health care. While we spend upwards of $3.5 trillion a year for health care in the US1, our longevity, infant and child mortality, and maternal mortality fall behind other countries.2 Eric Topol, author of the book Deep Medicine, calls this state of play “shallow medicine” where our life expectancy is declining, and health care utilization is increasing. He points out we are “bending the curve in the wrong direction.” Embedded in this narrative is the state of play for physicians (high burnout rates, suicide rates that are the highest for any profession,3 and 12 million serious diagnostic errors each year4). Large consumer-centric platform companies such as Google, Amazon.com, Inc., and Apple Inc.5 are trying to reshape the existing health care model and change the trajectory that we are on.
I recently moderated a panel at the Milken Institute Global Conference, where we took a quick spin through the current state of health care in the US and peered ahead into the future of health. Alex Moazed, author of Modern Monopolies (a book about the evolution of platform business models) explained that “platforms create the means of connection versus production.” Today’s health and life sciences sectors appear to be headed toward a transformation that is likely be built on a platform business model.
Can the frictionless consumer experience we now have in banking, retail, and entertainment be achieved in health care? Can the data generated by our digital devices—combined with greater penetration of electronic health records (EHRs)—lead to better patient outcomes and improved efficiencies? Here are some of the highlights from our discussion:
- Aligning incentives could improve clinical trials: One of our panelists, who heads a data-driven technology company, explained that as the health care dam continues to spring more holes, change driven by platform companies becomes inevitable. For example, he noted that a patient typically needs to have multiple points of engagement before finally being enrolled in a clinical trial. By aligning incentives, he suggested that cycle times could be shorter, and progress might be faster…rather than impeded.
- Consumers could become more closely connected to their health data: FasterCures (my previous employer and a center of the Milken Institute) has done some work showing how consumers don’t necessarily interact with their health data. Their project, healthdatabasics.org, found that only 41 percent of patients interact with their own health data. During our discussion, one panelist explained that some companies are starting to address the way health data are shared in research and development, in post-market, and in the delivery of care. Since patients are the source of health data, health stakeholders might need to change the way they interact with patients. He predicted that the way medicine is practiced today will be disintermediated by new models. Tanisha Carino, executive director of FasterCures, noted that we all want to continue to receive care from the local clinicians and health systems that we know and trust. But she explained that our existing health system needs to help consumers make stronger connections to their doctors and to their own health data.
- Web searches could lead to patient-specific insight: When people want to learn more about a health condition, they often start with a Google search. David Feinberg, vice president at Google Health, talked about how searches could be made more meaningful by helping people have more informed discussions with their physicians. This dynamic would also make it easier for patients and physicians to focus on a targeted discussion about diagnosis and treatment options.
These are early days as we chart the future of health, but I left this panel energized and optimistic about some things on the near and long-term horizon.
1 US Centers for Medicare and Medicaid Services, National Health Expenditures 2017 Highlights
2 Kaiser Family Foundation analysis of data from OEC, 2017
3 American Psychiatric Association (APA) 2018 annual meeting.
4 National Academy of Sciences, Improving Diagnosis in Health Care, 2015
5 A disclaimer of sponsorship, affiliation, or endorsement by Apple, similar to the following, is included on the publication and on all related printed materials “The Deloitte Center for Health Solutions is an independent blog and has not been authorized, sponsored, or otherwise approved by Apple Inc.”