Thoughts & considerations after a decade of working in healthtech by Max Denker
It is impressively scary to think how far healthcare has come in the United States; how primitive care used to be compared to the precision, speed, and efficacy of care now. In the 1600-1800s, medicine was a family affair utilizing home remedies. And now, we are to the point where my father, a cardiologist, can read EKGs texted to him from a smartwatch. Diagnostics like labs and images can be shared across hospitals and integrated directly into a patient’s electronic medical record (EMR) to reduce costs and provide a more robust patient story.
The 1960s and 70s brought about tech innovation that led to standardized documentation approaches and sharing of medical records. During the early 2000 presidencies, the HITECH and Meaningful Use programs pushed the industry further towards wide-spread adoption of electronic health records (EHRs).The future of technological ability in healthcare is exciting, but where is it leading to?
Patient care has been and will move further away from inside the hospital walls to outpatient and at home care via telehealth and advancing technology for remote monitoring and patient self-care engagement. Below I outline some underlying reasons that are building up the shift towards home care and people taking charge of their health.
A take on current landscape challenges:
Hospitals are struggling to keep their staff employed and happy, COVID-19 has only exacerbated this. In 2021, 47% of surveyed physicians reported feeling burned out. This is a slight increase from pre-covid reporting of 42%. COVID-19 has certainly and understandably increased the feeling of burnout, but it existed beforehand. 60% of respondents attributed their burnout to administrative tasks. Hospitals are also experiencing severe staffing shortages, so much that it has taken over as healthcare system CEOs’ top concern. COVID-19 amplified the shortage, but it has been a problem before COVID and will continue to be one as COVID-19 challenges subside.
Hospital costs and healthcare spending are on the rise. “Health spending in the U.S. increased by 9.7% in 2020 to $4.1 trillion or $12,530 per capita”. Before we get stuck on the “COVID-factor”, looking years before COVID in 2015, the US had the highest average cost per day to stay in a hospital in the world. There are a plethora of reasons behind these high costs, political debates, potential solutions, etc. that you can debate another time. For now, the point is, hospital care is expensive. In addition to cost, people are less likely to seek care because of hospital capacity, peoples’ hesitation to walk into an environment where COVID may be prevalent, and on the positive front – new technology that affords them the opportunity to receive alternative care (i.e virtual care).
Trends in US population health:
Let’s look at a few health trends in the US in 2018 and 2019.
- Obesity and the related are serious health risks that lead to heart disease, stroke, diabetes, and more. In 2019, the estimated annual medical cost of obesity was $173 billion. 2 in 5 adults have obesity.
- Only 24% of US adults engaged in enough aerobic and muscle-strengthening activity.
- More than that, 26.6% of people aged over 21 engaged in binge drinking.
- There were 6.5 new cases of diabetes per 1,000 adults.
- 13.5% of calories people consumed was from added sugars.
Now let’s pause… I have thrown a lot of stats at you, and will have a few more below. The main take away from the data is we are ripe for broader, earlier, and personalized healthcare. Healthcare and population health are big topics, there is a lot going right, and there are many other discussions and potential solutions than what I propose below, but preventative and proactive self/at-home care will play a major role in the future or our health and well-being.
Some options for moving forward:
People want to take charge of their health, they want to feel good, they want to manage and own not only their data but their destiny. Just look around – how many people have a sleek wristband on their arm that tells them how to optimize their sleep, their calorie intake, their exercise levels, and reminds them to go for a walk? The global wearable technology market size and share is predicted to surpass $380.5 billion by 2028, exhibiting a CAGR of 18.5%. We are beginning to see advancements in the ability to connect with hospitals and providers on real-time health data for things like pre-surgery coaching, patient-reported outcomes, and overall improved insights into a person’s health through remote patient monitoring tools.
If COVID-19 did one positive thing, it unlocked the potential of virtual care from the convenience of one’s own home/office. Telehealth is expected to rise from $79.79 billion in 2020 to $296.78 billion in 2027. People expect in other aspects of their lives a seamless digital experience. We are/will expect this in our health care. To be able to schedule appointments, get medications, communicate with our providers, review and update our health information, or quickly check our immunizations or upload them for verification. Virtual care opens the door for more flexible and higher (virtual) touch care, as well as even greater collection of data, while easing the burden on providers.
Artificial Intelligence and interoperability will also have a major role in our future. To be able to create that omni-channel of data exchange will require advanced data sharing. AI will assist in workflows by aggregating the massive amount of data from technology to utilize it to its fullest value, model digital twins, expedite clinical trials, reduce human action on routine tasks, and more.
For the patient, AI has a potential to learn their health needs and assist in care – one cool example I read: “you’re driving to work and your ambient AI assistant notifies you that you took the last of your remaining blood pressure and statin pills this morning. The AI assistant also says that there’s a pharmacy in three exits and it took the liberty of calling your scripts in there. You exit the highway, stop at the pharmacy drive-through, and pick up your pills”. In 2020, the global AI in the healthcare market was valued at $ 6.7 billion, and it is expected to grow at a CAGR of 41.8 percent between 2021 and 2028.
A lot of change outside of the actual tech will also need to take place. Investments in IoT, 5G, cloud, and other infrastructure will need to continue. People and practitioners will need to learn and become more and more comfortable with remote care and data tracking. Operational, regulatory, and financial models will need to shift.
Now having digested the stats, trends, and my opinions above, think about where this can take us, and what technology, innovation, incumbents, and startups can do to facilitate the future. The areas I find most interesting are interoperability, preventative and proactive care, health and wellness advancements, and combating physician burnout. I have greatly enjoyed meeting many founders in these spaces doing truly novel and downright cool things. So far in my founder meetings a few concepts have stood out (and info is publicly available).
- Connecting your health info via wearables, goals, and health data with eating habits and nutrition, delivery services, restaurants, and grocery shopping. The end product is a customized food score to help you meet your health and wellness goals.
- Revolutionizing at home screening methods by providing immediate results for things like blood pressure, BMI, cholesterol, HDL cholesterol, and more that upload to your phone.
- For physicians, creating the ability to take your note templates from hospital to hospital and EHR to EHR.
If you are building in or curious about companies who are innovating in this space, reach out to me on LinkedIn and send me a note or contact us via the form below.
Sources: TheTruthSource; HHS.gov; AMA; BayTechIT; Beckers; Forbes; AHA; KKF; MedicalEconomics; AMA; Statista; CDC; Health.gov; Globenewswire; Philips; Medium; Cognihab; Deloitte;