Thursday, July 23, 2015

What Experts Predict about Health Care Future

Experts, it is said, are someone from out of town who knows more and more about less and less until they know everything about nothing. Experts cannot predict the future because it involves the future. Keep these truisms in mind as you read these predictions about the future of health care from 10 well-known and respected health care futurists as presented in the July 21 Wall Street Journal, "The Future of Health Care: The Experts."

As I read their predictions, I thought of Edward De Bono, an English physician who runs a think tank for experts on the Island of Malta. De Bono has said the healthcare landscape is composed of a series of vertical holes, which hospitals, academic centers, and specialists inhabit. At the bottom of each vertical hole resides a collection of world class experts. The only problem, observed De Bono, is that the holes are not interconnected.

The present crop of experts are not in holes. They are hovering over the health care landscape. They have new tools - the Internet, social media, and mobile devices – that they believe will allow them to connect the holes, for better or worse.

Here are 10 of their predictions, as set forth in the July 21 edition of the Wall Street Journal “The Future of Health Care: The Experts.

1. John Sotos cardiologist, flight surgeon, and CEO of Expertscape. com. “How Future Hackers Will Target Your DNA.” Expert hackers will design DNA sequences that will spread DNA viruses from person to person that will allow hackers to redesign the human race into species they favor – redheads, whites, blacks, members of the British Royal family. DNA, notes Sotos, is nothing more or less than a programming language for living tissue. The human genome therefor is vulnerable to hackers. Our only defense against social engineering hackers is to build a cadre of experts to defend against them..

2. David Blumenthal, MD, president of the Commonwealth Fund, “What Health Care Will Look Like in 2013. Maybe.” Mobile devices will make health care better, more convenient, and cheaper. Maybe, if certain problems are resolved – preserving the privacy of personal data, making sure various devices and websites can be made to talk to one another, and bridging philosophical gaps between government elites and marketing experts.

3.Marc Agronine, MD, a geriatric psychiatrist in Miami, “The Nursing Care of the Future Will Be in Our Homes.” Home care services of every kind will be possible with wireless wearables and mobile devices that provide data on vital signs, metabolic indices, home safety, and daily needs. Many of these devices will be voice-activated. Most will be under the patient’s control and will monitor, track, and engage patients in innumerable ways even if the patient is computer illiterate and no matter what their mindset or capabilities.

4.Robert Wachter, MD, professor at the department of medicine at the University of California in San Francisco, “How Technology Will Change the Doctor/Patient Relationship,” Telemedicine and technology will transform these relationships at the level of patient stays and visits to hospitals, doctor visits, and emergency rooms, transforming many of these relationships into virtual visits over the net. The problem will be making sense of it all. Treatment will be customized to the fit patient needs based on gene analysis, risk factors, and the real-time monitoring of hundreds of thousands of similar. patients will similar problems.
5.Gur Dhal, MD, professor of medicine at the University of California, “How Technology Won’t Change the Doctor/Patient Relationship.” Twenty years from now, medical practice will focus on 3 tasks: 1) discovery of the unique manifestations of a single patient; 2) searches on the Internet for diagnosis and treatment of these individual characteristics; 3) improvements of a plan for care in spite of the unwieldy nature of our health system. Interactions of doctors and patients will remain pretty much the same but will change the nature of the conversation by narrowing the knowledge gap between doctors and patients.

6. Molly Mettler, Senior of Missions at “ A Personalized Owner’s Manual for Your Health Care,” We will have a totally personal, totally interpretive owner’s manual to access health care patient records and a patient’s personal health care record. It will focus on your health goals, will be lifelong, and individualized to give you access to unlimited information, and to understand your complete health care .

7. Drew Harris, MD, Director of Health Policy at Thomas Jefferson University School of Population Health, “How Big Data Will Customize Your Health Care,” Fear not for the future of your health. Big Data in wearable devices will track where you go, what you eat, what you do, and how we sleep in real time. But we must use this data and control it so as not to impinge on individual liberties and make sure the data system is unhackable. So far the government has proven impotent in warding off hackers. Hackers has stolen data in 21 million government workers.

8. Madly Dychtwald, author and co-founder of Age Wave, “A Vision of the Future Free of Alzheimers,” By 2015 we will be well on the track of preventing and ending Alzheimers, that dread that results in senility of 5 million Americans. We will do this through advances in technology, that reduce or dissolve amyloid plaques that short circuit normal synapses. When Alzheimers no longer exists 1) half of nursing home beds will be emptied 2) tens of millions of caregivers will be unshackled; 3) money now going into Alzheimers research will be freed up to pursue cures for other diseases; 4) Alzheimers patients will be able to lead independent lives; 5) fears of a longer life without dementia will be realized.

9. Leah Binder, President and CEO of the Leapfrog Group. “What Hospital Websites Will Look Like,” High Deductible Health Plans (HDHPs) will transform the health care landscape and radically change health consumer behavior. Patients will shop for care, compare costs, seek out what hospitals have to offer, rate the quality of hospitals, have unlimited access to hospital pricing structures, consider hospital special offers, and rate the food and amenities offered by various hospitals.
10. Susan Devoe, President and CEO of Premier Inc, a health care organization representing 3000 community hospitals, “What Future Hospitals Will Look Like,” Hospitals will consists of an interconnected network of hospitals, doctors, and other providers provided coordinated care across the continuum of care. The network will bring together primary care physicians, specialists, post-acute care facilities, and pharmacy, nutrition, and wellness coaches – all available for managing outcomes and total costs will be lowered by bundling care, each provider or group of providers being paid on a sliding scale based on the effectiveness of the organization in achieving its outcome goals.

So much for utopian predictions, based too much, in my opinion, on the dependence of data, social media, and wearable and implanted devices to be the be-all and end-all and measure-all of future health care. There is no such thing as total transparency, total prevention, or total cures. But one can always hope and have big dreams and big goals. If even half are achieved, it will be worth the effort.

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