Twelve Major Health Care Trends; Skate to Where Healthcare Is Going

I have always been a sucker for published lists of major trends in healthcare. Such lists usually strip away unnecessary verbiage and give an unvarnished view of where the authors thinks healthcare is headed. A recent blog note about "skating to where healthcare is going" fell into this category (see: Skate to Where Health Care is Going; Not to Where It Has Been). Here is Kent Bottles top ten list:

• The Affordable Care Act and the need to decrease per-capita cost and increase quality
• The transition from fee for service to global, value-based payment programs
• The emergence of wireless physiological sensors
• The growth of social media
• The decreasing cost of storing data in the cloud
• Big Data analytic platforms that mine new actionable correlations
• The patient-centered medical care movement
• Genomics and personalized medicine
• The ubiquity of smartphones
• The concept of reverse innovation where the U.S. learns from developing countries
• The shared decision making movement
• The emergence of population health

Lists such as this one tend to be subjective but I am in agreement with Bottles' choices and I have blogged about most of them. Here's one that I found from his list to be very interesting: reverse innovation where the U.S. learns from developing countries (see: Harvard's Clayton Christensen: Can Medical Innovation in Developing Countries Disrupt the U.S. Healthcare System?). This is interesting on two counts. In the last decade, such reverse innovation has mainly involved the development of devices such as portable ultrasound or inexpensive CT scanners. They have often been designed with developing countries in mind because of their lower cost and less complex support requirements. However, they are now being deployed in the U.S. for exactly the same reasons. Here's one example of an innovation from abroad cited by Christensen that we could use:

An example of such innovators is a non-profit in Ghana called mPedigree, which has developed a low-cost, mobile application to verify if prescription pills are counterfeit -- a potentially life-threatening problem that costs the pharmaceutical industry US$200 million every day. Africa is a particularly receptive market to mobile solutions, as all sorts of transactions are done with them. For instance, according to the World Bank, half of all banking in Kenya is now done through mobile phones.

I think that this idea of reverse innovation is about to change because of our new emphasis here on lowering the cost of healthcare. Combining the idea of population health and reverse innovation, we in the U.S. will now be scrutinizing healthcare delivery in other countries for clues about how to lower the cost of healthcare here. This is not rocket science but our system has never been cost-constrained. We need to figure out how to improve the health of our population without waste and the personalized services that increase the cost of care here (see: For Medical Tourists, Simple Math).

At the end of his note, Bottles makes the following wise observation: 

If my environmental assessment is correct, and it may not be, those traditionally prestigious positions in medicine may not be where the real action occurs. Instead of focusing on positions and titles, the wise physician executive might concentrate on the twelve bulleted factors that will probably make hospitals and medical schools less central to the delivery of care in a transformed health care delivery system.