In the currently raging debates about healthcare, there’s little attention to population aging and the cost of care — two critical trends that I call the $4.6 trillion question.
By 2020, there will be 55 million Americans over age 65, reflecting a global population aging trend that could be as important to our future as global climate change. Also by 2020, according to federal government projections, the nation’s healthcare costs will be $4.6 trillion, close to doubling in a decade.
One of the ways we must respond to these trends is to use technologies that enable a model I call “care anywhere.” Thanks to a range of personal health technologies available now—mobile health (mHealth) capabilities for smart phones and tablets, telehealth technologies for remote patient monitoring and virtual visits, intelligent software assistants for prompting and coaching, and social technologies for connecting patients, families, and providers in powerful new ways—we have the opportunity to move away from costly, institution-centric care delivery for the majority of needs.
The core necessity is this: care must occur at home as the default model, not in a hospital or a clinic. We need this to curb escalating costs, increase access and improve patient experience and outcomes.
Policy makers are paying attention. Last month, committees in both the House and Senate passed Medicare reform through Sustained Growth Rate (SGR) bills with bipartisan support, encouraging greater interoperability and data exchange for electronic health records (EHRs). And a discussion of telehealth measures led to an agreement between the Congressional Budget Office director and Senate to work together on how to estimate savings, an issue that has plagued telehealth and mHealth for years.
But even with all of the excitement, reforms and investment activity around mHealth, the promise of care anywhere – made possible by mobile technologies, data analytics and real-time connectivity – is far from being realized.
I think about the importance of care anywhere from three perspectives:
As a patient who tried to force in-home, mobile and virtual care models for myself while undergoing cancer and chronic kidney disease treatment for 24 years, my fight was not just against cancer but against a flawed healthcare system.
As a social scientist who has studied the cultures of healthcare innovation, I have seen the many challenges we must overcome to redefine the roles of patient, caregiver and provider.
And as a business executive responsible for health innovation opportunities globally, I have learned a lot from other parts of the world that are deploying social, political and technical infrastructure for care anywhere.
A new Intel study found that more and more people are feeling empowered through new technology tools to become fuller participants in their own care. More than half of the respondents globally believe the traditional hospital will become obsolete in the future.
Today, technology is reducing unnecessary emergency room trips using real-time video collaboration between patients, EMTs and doctors and reducing doctor office visits with innovations such as in-home blood pressure, ultrasound and eye tests that instantly send information from your smartphone to your doctor.
In Indianapolis, where cardiac patients were treated using remote care technology, St. Vincent’s Hospital saw a 75 percent decrease in hospital readmissions, proving that care anywhere can take costs out of the system and better support patient recovery.
In the future, doctors will be able to track patients’ health instantaneously through ingestible tracking devices in their bodies. More than 70 percent of respondents in our research are even receptive to using tools like toilet sensors, prescription bottle sensors and swallowed monitors.
But no amount of technology innovation investment alone can help us mainstream mHealth. We need a shared roadmap and strategy to create a movement around these care models. Remote care will never gain momentum without laws that allow doctors to be reimbursed for effective patient care no matter how it is delivered.
Medicare reform through the SGR includes telehealth as a method for physicians to transition to alternate payment models. Reform should provide incentives to use advanced technology innovation, when appropriate. As Congress makes needed changes in payment, let’s take this opportunity to make bold changes in the way people access care. By expanding telehealth reimbursement for all chronically ill patients in their homes, not only will patients benefit, but the United States will see a reduction in Medicare costs.
The Wyden-Isakson-Paulsen-Welch Better Care, Lower Cost Act of 2014, introduced last week, offers a targeted approach for providers to focus on chronic care management by offering preventive services through new technologies such as telehealth. This bipartisan, bicameral legislation would encourage providers to coordinate care and reward them for achieving healthy outcomes rather than for the number of services they provide. It’s about time we change the formula for smart care and payment in the United States.
Our nation is aging and traditional healthcare costs are unsustainable. Technology advancement has outpaced our laws. Patients have told us that they are ready to embrace care anywhere. It is time for policy makers to help patients, their families and a broader range of health workers innovate answers to the $4.6 trillion dollar question.