In 2016, Americans spent roughly 18% of gross domestic product on healthcare. Abetted by an aging population and continuously rising costs of care, the Center for Medicare and Medicaid Services projects that this number will only grow over the next decade, increasing at an average of 5.6% annually. A crisis seems unavoidable: yet a huge fraction of this sum is lost to inefficient spending, which when compared to other factors like an aging population, socio-economic challenges or expensive new treatments, seems completely within the industry’s control to control and eliminate. A new OECD report calculates that approximately 20 cents out of every dollar spent on healthcare is considered unnecessary.
Could a simple reallocation of time and resources be enough to check the seemingly inevitable? The potential cost savings of such a reallocation has policymakers and health professionals poised to revolutionize healthcare, as an industry that has long been resistant to innovation rejects antiquated models of care for more efficient methods that prioritize patient and provider alike.
A simple resolution that is already allowing more patients to receive necessary and important primary care is the extension of care teams through mid-level providers that cost a fraction of the salary of a full time physician. Physician’s assistants and nurse practitioners are being granted more autonomy, as state governments remove restrictions while enacting legislation that grants physician assistants and other personnel full prescriptive authority. Allowing these lower cost health professionals to perform routine, primary care instead of more expensive, specialized physicians immediately eliminates inefficiencies in the system and increases access to care to patients in the midst of a physician shortage.
These changes in personnel are necessary, but not enough to respond to the changing face of care. The answer to more affordable care is in leveraging existing technologies.
The rapid adoption of synchronous, video visits between patients and providers across the country is an exciting example of how technology can eliminate waste and help the system reallocate its resources. Recognizing its potential to decrease the administrative demands on providers and facilitate access to patients in remote areas, the industry has placed great emphasis on this aspect of telemedicine—even to the extent of providing incentives to providers for facilitating care through video.
But far from being the solution, video visits just scratch the surface of technology’s potential contributions to affordable healthcare, and in fact are the least beneficial of the efficiencies that technology is poised to provide. Some studies have indicated that when video visits are included in a medical plan, patients tend to treat them as an add-on, rather than a replacement for traditional in-person care. Furthermore, without integrated systems, video visits function much as if a patient were receiving all medical care at the emergency room producing a fractured and incomplete medical record.
The dialogue must be centered on those innovations that revolutionize the way we approach healthcare, not simply attempt to translate an outdated system into a world that has evolved past it.
The conversation needs to focus on the most relevant, effective and impactful technology tools to affect the ultimate cost of care. Already, forward thinking providers like Greenville Health are creating end to end “virtual strategies” that rely heavily on remote monitoring apps and asynchronous visits that have the capacity to identify the problems before they begin. Beyond the immediate benefit of proper allocation of time and resources, the ultimate goal of technological innovation in healthcare has always been the opportunity to identify potential problems and create the necessary infrastructure to allow our healthcare system to focus on preventative health.
Of the healthcare apps currently in the digital marketplace, some have been shown not only to decrease costs but to be as successful as medication in preventing complications, anticipating a future of decreased prescription costs. Remote monitoring programs that use Internet of Things devices like blood pressure cuffs and weight scales have reduced the cost of prenatal care by 40% while detecting problems like preeclampsia and other high-risk illnesses. Yet there is no coding or direct payer incentive for deploying preventative technologies like these like that provided for video visits.
And why not? Video visits are a move in the right direction, but the decrease to cost of care does not have to come at the expense of the client/physician relationship or integrated care. Instead, effective technology should cut costs while assuring patient and provider of the continuity and efficacy of care.
The conversation among policymakers needs to expand to include these more revolutionary aspects of digital health, rewarding those who are effectively reducing costs without compromising care. Digital health will not be confined to a narrow vision, but it is up to government and the industry to expedite the future of healthcare.
Juan Pablo Segura is co-founder and president of Babyscripts, a technology company that builds mobile and digital tools to empower women to have better pregnancies.
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