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Transforming Healthcare

Connecting information, applications, data, and people—a report from the Stanford 2013 Healthcare Innovation Summit.

Can healthcare information technology (IT) fix a dysfunctional healthcare system fraught with physician shortages, rising rates of chronic disease, and, in the United States, $750 billion in annual waste? Stanford’s 2013 Healthcare Innovation Summit explored whether healthcare IT may hold some of the answers—making new business models possible and producing tools with the potential to expand access to care, improve outcomes, and reduce costs. Along the way, technology innovations will disrupt the industry and rearrange the playing field for payers, patients, providers, and innovators alike. Here are some top-line predictions for how these players may be affected:.

Payers: Prepare to manage health, not risk.
According to keynote speaker Mark Bertolini, CEO of Aetna, traditional insurer business models are being reinvented as health care slowly shifts from a fee-for-service model to one that values preventative care and wellness. In response, Aetna has expanded its focus from optimizing actuarial risk to helping its customers manage their health, with the goal of realizing mutually beneficial results. Specifically, the company has positioned itself for growth by assembling an integrated suite of user-friendly health management applications, including tools to encourage exercise and healthy eating, databases for symptom evaluation and cost transparency, and productivity applications to simplify the process of finding physicians and making appointments.

Patients: the new CEOs of MyHealthcare, Inc.?
Could the right IT not only empower consumers to research conditions and find doctors, but also actively confirm their diagnoses, devise treatment plans, and choose between medications? Probably not anytime soon. As Ann Lamont of Oak Investment Partners put it, “We are only at the very beginning of thinking as healthcare consumers.” While IT can make us more educated patients, the model of the consumer as the consummate healthcare CEO breaks down when the medical condition is acute and decision makers are under stress. “When patients are suffering, they need and want to be told what to do,” said health psychologist Dr. Kelly McGonigal. For now, McGonigal sees the highest value in technologies that help people adopt healthier lifestyles. “Diet- and exercise-focused programs that combine games, incentives, and social networks nudge us to make better decisions by providing instant feedback and accountability,” she said.

Providers: Use technology to do more for less.
“For providers, innovation is about identifying technologies that will accelerate the achievement of core business strategies,” said Dr. Molly Coye, chief innovation officer of the UCLA Health System. Like her fellow panelist from Kaiser Permanente, she carefully selects technologies with a high likelihood of generating measurable results, and invests considerable time in defining and disseminating new standards of care that support their use. As examples, Coye described two innovations that are helping UCLA realize strategic results. The implementation of an electronic intensive care unit (eICU) has extended the reach of UCLA’s scarce intensivists (physicians specializing in intensive care) while decreasing mortality, patient length of stay, and costs. A second technology, eConsult, has generated a 40 percent reduction in the need for specialist care by allowing primary care providers to securely share health information and remotely confer with experts.

Innovators and entrepreneurs: Make healthcare easier.
Whether the inspiration comes from “persistent and frustrating issues” or “things people don’t think about,” Summit panelists representing the entrepreneur’s perspective agreed that leading opportunities at the intersection of healthcare and IT include harnessing big data to inform and improve decision-making, and developing consumer-centric uses of the mobile platform. They also advised innovators to view competition as a positive force that can validate an emerging market and be willing to pivot in the face of new information. “The plan you start with is very rarely the one you end up with,” said Chini Krishnan, founder of GetInsured.com. The surest path to adoption? Be certain your innovation makes something that is difficult, daunting, or expensive, simpler, more intuitive, or affordable.

The future of medicine: healing hands or robotic arms?
Looking forward, venture capitalist Vinod Khosla theorized that the most effective way to improve patient outcomes is to replace much of what physicians do with intelligent information systems. Presenting alarming statistics about physician bias and diagnostic errors, Khosla asserted that computers are better equipped than people to synthesize and apply research findings and patient information, and that “data will improve care more than anything else.” Counterpoint speaker Dr. Abraham Verghese championed the value of compassion and the human touch in medical interactions. “The physician-patient relationship is far more than establishing a diagnosis; it’s about caring for the patient,” he said. Rather than replacing human-centered diagnosis and treatment paradigms, Verghese advocated the use of technology as a “bionic assist” to improve patient care and outcomes. That idea—the combination of human compassion with powerful data and analytics—offered the day’s most compelling vision for the future of healthcare.

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