Description: The article below is focusing on the details about how the forward healthcare system started up and some other information about how it is going and developing.
A year ago, I got my medical degree and I officially became a doctor, the future of healthcare wasn’t going to look very much like the past and so I’m here today hoping to convince you that the future of healthcare won’t just be about what your doctor or your nurse can do for you, but it will be about three new things.
First, it will be about what can I do as a patient to manage my own health to be the quarterback of my own care, second, the Internet and mobile will be the enablers that make this paradigm shift possible and number three and most importantly that this digital health revolution, as we call it, it won’t necessarily come from people inside the healthcare system, but it will come from innovators technologists from around the world who live outside the healthcare system.
We need to talk about the past, understand how our healthcare system has developed and where it’s going, so over the last century our healthcare system has become good at treating people, once they’re sick, if you have an infection, we have the antibiotic for you, if you need your knee replaced, your surgeon can fix it for you and so a lot of the healthcare that we’ve given has come in a hospital where we treat really sick people and because we became very good at fixing people when they were sick, that’s how our governments and how our health insurance companies started paying for health care, so we would pay doctors and nurses and hospitals for how long a patient stayed in hospital or how many tests were done or how many patients were seen and so on.
We would incentivize healthcare providers to do more based on by paying them for how much they did which made sense at the time, the more sick people you treated, the more you got paid, but as our health care system got better, people started to live longer and be healthier and we saw this rise of chronic disease.
As this graph from the public health agency of Canada shows by the mid 20th century chronic disease such as diabetes and heart disease and so on became leading causes of death and because people started living longer, we also started doing surgery on people when they were older and that makes them higher at higher risk of complications,so our healthcare system should have evolved to focus on preventing people from getting sick and keeping you healthy in the community.
In many ways, by the 21st century, we were still mostly paying health care providers to treat people when they were sick and not really paying them to keep you healthy and this is a big problem, because health care is expensive when someone gets sick, because our funding models and health care didn’t evolve our health care system didn’t evolve with it and so even though the needs of patients have changed over the last 50 years.
We haven’t changed health care to fit those needs and so we finally come to this scary reality that health care isn’t sustainable anymore and how do we know that, so last year ten in the u.s. spent three trillion dollars on health care three trillion dollars.
I can’t even imagine what that might look like in bills, it must be a lot of briefcases, it’s really big and in 2012 Canada spent eleven or ten point nine percent of our GDP on healthcare the u.s. spent sixteen point nine percent, that’s the highest among developed countries,so we have higher than average spend on percent GDP on health care among developed countries.
We don’t come anywhere close the top of key healthcare outcomes, we must do better for our patients,there’s the shift in healthcare going on where we want healthcare providers to care more about preventing you from getting sick and so we’re starting to realize that maybe we start changing these incentive models how we pay hospitals and doctors and that might do something.
So in 2010 here in Ontario, the government released the excellent care for all act and that made health care providers and hospital executives more accountable for how well you did at patients.
For example, they started tying Hospital executive payment to how well patients would do in the state’s through the Affordable Care Act or, Obamacare that came to effect also in 2010 and that brought even more dramatic changes in the way we pay for health care, so over the past few years, many hospitals of the states have been penalized millions of dollars for having too many patients unexpectedly come back to hospital within a month of leaving.
So we’re seeing these major shifts in how health care is paid for from paying for quantity to paying for the quality of care that you’re getting, for the first time in history health care providers and hospitals have to work together to keep patients healthy.
I want to shift gears a bit and talk a bit about something else happening over the last few years, in the technology world, a new technology comes into the existence that changes the way we live our lives in the 70s, we had the home computers in the 90s, we had the internet and most recently, we’ve had this explosion of mobile technology, so things like smartphones and tablets have changed the way we live our lives.
Today more than a billion people in this world have access to a mobile device certainly by 2020, almost every single person on this planet will have access to the Internet be connected to each other through a mobile device.
for my point of view, one of the most amazing things about this is that it creates this unprecedented opportunity to bring healthcare to people everywhere, no matter where you live, there’s suddenly this new game-changing opportunity to be able to deliver something to billions of people around the world.
Humanity finds a way to make it easy to do so, it is easier and cheaper than ever to build software to write an app, they had a million users by 2012, they had a billion users, Instagram was started 6 years after Facebook, they reached their millionth user in less than two and a half months.
so the rate at which you could reach people around the world now through mobile is just exponential, so let’s recap for a bit, we’ve learned that the health care system has completely started changing the way, it’s paying for health care and now they’re in urgent need of new solutions to keep people engaged in healthy in the community.
But in health care, we have limited resources and limited people and so the question is how you bring health care to people around the world in a way that’s cost-effective and scalable number two we’re in the midst of this digital health revolution with better access to mobile and the internet than ever before and number three, anyone who can write software can reach people all over the world, we can do amazing things.
so let’s put that together, you have this healthcare system that needs new solutions,so not just health care providers not just really big companies anyone who can write code and build a product can make a dramatic impact on the health of millions of people around the world.
I was in medical school, but I wasn’t even a real doctor, there were a million reasons why that hospital could have at least a million and I’m so glad, because if they had, I wouldn’t be standing here talking to you today.
We live in the 21st century and despite how complicated this whole journey is, through surgery, we still rely on paper and verbal instructions to get a patient through this journey, but David’s story ends up being a bit different, as it turns out, David surgeon is an early adopter and pioneer in technology.
A half weeks ago, David had his actual surgery and he continued to use felis as he went through his recovery, so every day David’s been going on our application and he’s been tracking how he’s feeling any symptoms, he’s feeling and every day gives him personalized feedback about what to do if something’s wrong.
So patients like David actually knows how to safely manage their recovery and when to get help from a doctor and how if they need to and so by empowering patients like David to be more engaged in their recovery, we also help hospitals catch complications like infections earlier and prevent costly visits back to the hospital and this is really important especially for patients like David who often liveS hours away from the actual hospital.
We aren’t the only ones working on problems like this, there are hundreds of startups, try to solve some of the most pressing problems in healthcare today, in 2013, they’re already over 40,000 health care apps in existence, many of which were meant to help patients manage their own health, but what’s amazing isn’t just the pure volume of innovation happening right now.
In the space, what’s even better is that we are starting to break down barriers to making digital health meaningful and connected in our actual healthcare system, so earlier this year, if you’ve been following Apple, they release their health kit platform and health kit will come on every new Apple device and it integrates with fitness trackers, monitoring devices, other applications and it brings all your healthcare information into one place, whether it’s your blood pressure your sugar levels through medical history, it’s now all in one place and Apple is now starting to integrate this platform with apps from the Mayo Clinic.
It’s integrating with some of the leading electronic medical record systems in North America and what the importance of that is over time, we’re going to see more and more integrations between third-party systems and the healthcare system itself makes easier than ever for doctors and patients to connect.
I think what’s most important is that these are signs that this digital health ecosystem is really expanding and that’s going to become even easier for people to build solutions that can impact the lives of patients and doctors.
It’s going to be to start building solutions in healthcare, that doesn’t mean it’s easy to have a real important impact,it’s not about circumventing the healthcare system, it’s not about going rogue and trying to solve these hard problems on your own without talking to patients, doctors or hospitals, that’s not what seeing this MD is did and that’s not what you should do.
Either the reason we’ve been successful is that we realized early on that we all need to work together, we realize that technology alone is not an effective solution and whether you’re a doctor or a nurse or a patient or coder or designer, we have to come together and make sure whatever we build has real positive impact.
We’ll always need doctors and nurses to care for patients to prevent us from getting sick and to cure us when we do, but these health care providers also need our expertise to help engage and empower patients to be managers of their own health and this is a once-in-a-lifetime opportunity to build something that can change how healthcare is done today, so if you’ve ever in your life wanted to make the road healthier, join the digital health revolution and build the solutions that will keep our patients and your family safe and connected and able to manage their own care from the comfort of your own home, the future of healthcare depends on it and depends on you, thank you.