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AUSTIN — Should we offset with the good news or the bad news starting time? The expert news is technology is going to radically transform healthcare in the next two decades. Information technology'southward been said before and we should continue to say it — if ever there is an industry that is in need of disruption, it's health. Wellness expenditures in the U.S. are approximately 18 percent of GDP, upwardly from around 5 percent in the 1960s. There are many reasons for it, including a population that'due south aging and living longer. But information technology besides reflects a system with ever-rising costs that accept gone mostly unchecked, and a arrangement congenital effectually the providers of services and not client satisfaction.

A System Non congenital Around Outcomes

In a wide ranging discussion on healthcare, Michael Dell and Clay Johnston (Dean of the new Dell Medical School in Austin) talked about some of the structural issues of the organisation, from how we train doctors, to how services are paid for, to how technology has failed to bring downward costs with productivity as has happened in other industries. Johnston commented on how physicians are notwithstanding trained to memorize enormous volumes of information. Most of it is impossible to remember unless, maybe, it's in your specialty. Dell Medical School is looking to teach doctors to improve their skills at finding information rather than memorizing it. The fourth dimension hereafter physicians gain from not memorizing can exist put to teaching how to spend time with patients while understanding all their history, and how to better work in teams across specialties and with intendance providers.

Johnston noted that electronic wellness records (EHR) have not been put to apply to deliver better outcome and experiences for patients. In too many instances, they are used equally a style to ensure everything gets coded correctly and billed for insurance reimbursement, rather than as a tool for agreement patient history and treatment over fourth dimension. The lack of interoperability beyond EHRs has not helped. His joke was that the "client feel" in medicine might be worse than the DMV (Department of Motor Vehicles). In medicine, you may go to a md, have a long wait, have some tests with a vague thought of toll, and emerge with a nib after for time and services, but your issue may not take been resolved. And you may be bounced effectually to other specialists, depending on the issue.

In other words, the payment system is transactional and not congenital around an outcome – solving your health problem. The health insurers practise not sympathise how to pay for outcomes versus services, nor have they been particularly good at informing consumers of the costs of services – despite the fact that they take that data.

Pricing Transparency — More like Opacity

The lack of pricing transparency was the subject of another panel that convened doctors, academics, and an entrepreneur in a frank discussion of the topic. The panelists showed a video and discussed a typical patient feel for an MRI, where ane was ordered and maybe wasn't required, at least at that point in fourth dimension. The patient is stuck with a $ii,000 nib, and perhaps the medico could have been firmer in outlining other options and setting expectations accordingly. Often doctors are disconnected from the toll of their ain services, or other lab services they may order. Neel Shah, a practicing OB/GYN and professor at Harvard Medical School, recounted a family story of just how disruptive pricing and figuring out-of-pocket costs tin can exist, fifty-fifty for people in the medical field. He thinks people need some agents to help navigate the pricing and real costs of the organisation.

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Along that line, Amino is a startup focused on providing pricing transparency for services directly to consumers, although the service is marketed to employers. The company has ingested 9 billion health care claims and developed algorithms to determine what a particular service should cost. They besides help consumers shop for high-quality providers (measuring experience with specific services based on their data) and evangelize services at prices that fit the norms. Amino has wrapped an HSA (Health Saving Account) card around their service to aid consumers control healthcare spending and understand out-of-pocket costs with their specific insurance coverage.

Simply in that location are no easy answers to the pricing issue. Some things will ever be expensive. In some cases, a new way of treating a disease is easier, but the toll is likewise high. Dr. Shah noted how there is a cure for Hepatitis C, but the pair of drugs tin can cost up to $100,000 for the treatment. Compared with a liver transplant, that may be much less expensive, and Hepatitis C can cause permanent liver damage. Merely the cost of decision-making it with drugs may be cheaper than curing it — at least for now. Doctors are besides trained to be err on the side of thoroughness rather than ceremoniousness of the test or procedure ordered, significant that they make sure they employ all the tools available, versus looking at what is most toll-effective.

Engineering science Will Help Change the Organization — But not Overnight

Is it time for some practiced news? Advances in technology volition aid the game. Mayhap the almost promising things coming are technology-based solutions that will empower people to understand their own wellness improve. In a rapid fire presentation, Dr. Daniel Kraft, a Harvard and Stanford trained G.D. and kinesthesia Chair of Medicine at Singularity University, discussed what he terms Exponential Medicine — using new technologies to non just nip at the edges of the organisation, simply disrupt the current model to offer improve outcomes and cheaper solutions.

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Echoing some of the concepts touched on by Johnston of Dell Medical School, Kraft describes the current medical system as reactive. The feedback loop is irksome and expensive: have a symptom, run into a doctor, get a prescription, go back over again, go a examination, maybe encounter a specialist, and start over once more. With new devices, sensors, and software, these feedback loops can exist continuous — monitoring things like blood force per unit area, glucose, heart rate, physical activity, and more than. A holistic view of wellness tin can be painted that both the md and patient can monitor. The upshot of unhealthy behavior — as in bad diet and low activity levels — contribute more to health care costs than bad genetics. Fitness monitors and apps similar Fitbit and Apple Watch tin collect data and integrate it with other medical records.

The bug around this are more structural and regulatory than technical. Currently there are no standards for this kind of data interchange or for the medical profession's ability to finer utilize this information. Change volition likely come from entrepreneurial ventures that combine these technologies to deliver services in a unlike way. Services like Apple tree HealthKit and Google Fit may not end up being a panacea or the ultimate integration points for health data, merely they certainly signal to the time to come.

Kraft also talked about predictive analytics. If we tin collect all the information from billions of sensors, we tin start predicting how certain beliefs will atomic number 82 to medical bug. If weight creeps up, and other vitals alter, it can pb to greater cardiovascular affliction take chances, for instance. What if these analytics were coupled with augmented or virtual reality to show how yous'll wait if you keep on the same weight gain trajectory? The visual might jolt you into taking advisable action. Both collectively and individually, continuous monitoring and data analysis tin change behaviors so that symptoms that trigger that doc visit happen less, or not at all.

The Genome

There are other advances that promise potential cures for cancer and other diseases. Our agreement of DNA and decoding the man genome have advanced faster than Moore'southward police. The costs of decoding take come down from $1 million to under $1,000 in the last dozen years, with companies similar Illumina and its desktop sequencer leading the style. While the problems with data generation (of gene information) take been largely solved, interpreting that data is nevertheless a work in progress. Neuroscientist Ashley Van Zeeland thinks eventually in that location may exist an ecosystem of applications to analyze and translate your Deoxyribonucleic acid data — perchance downloadable on your device. Other companies like Ubiome are sequencing specific things like gut bacteria to detect a variety of issues, including cardiovascular affliction, kidney disease, metabolic disorders, and gut diseases like Crohn's.

There are many more advances that are across my ability to cover hither. Just the future for exponential advances in healthcare (to use Dr. Kraft's term) looks bright. The alter in the systemic bug is non likely to come from within, or will be solved past legislation. In the same manner that the smartphone revolution created opportunities for companies like Uber and Lyft to revolutionize transportation, wellness trackers and other devices and sensors, coupled with AI and other analytic software, will provide a new platform of data to ability new forms of providing consumer friendly, cost effective care. Information technology will take another x to 20 years, but we may look back at today and recall a very different health care landscape, wondering how we ever survived the former way — in the same way we can't retrieve how nosotros lived without smartphones.