In October I attended the Fortune Global Forum, held this year in Toronto, Canada. It?s an invitation event for, primarily, the CEOs of businesses all over the world. The makeup of the event evolves as it moves from country to country ? and in Toronto, Canada and the USA were well-represented.
One of the more troubling panels in the whole conference was on the subject of healthcare.? It wasn't troubling because of the topic, per se, but because of the fatalism and defeatism clearly present among a panel of experts who don't believe that we can make the changes we need to make healthcare more effective (and cost-effective).
First, there's a huge problem with sharing data.? There's no common tech infrastructure, which makes it even harder.? There are also significant problems in terms of how data is analyzed - example given was just looking at all Diabetes patients the same, rather than looking at co-morbidity factors for specific patient populations. But there's still a lot of opportunity for AI in clinical decision support. I think the panel correctly thinks of AI as a tool to be leveraged, not the answer to all healthcare challenges.
Second, we have a healthcare system that doesn't reflect present world views.??? We are trying to create value out of our episodic health care system, but we need holistic views of healthcare to create that value.? We can reduce cost and improve outcomes, for example, with lifestyle choices and early intervention.? We can focus more on prevention in a holistic system.? Lots of vested interests apparently slowing this down.
Third, an acknowledgment that much of the cost in our system is coming in the last six months of life, when it is too late to effectively or subjectively improve the patient's life or lifespan.
Fourth, there's an idea floated that the only way to save money is through headcount reduction.? Someone proposes faster access to the right screening (e.g. MRI) when needed, rather than just always doing it. Fewer MRI's should save money right?? Researcher comments that MRI hours and staff are there whether it is used or not.? I found that attitude incredibly self-defeating.? And if that is how we think about the cost of an MRI - that it doesn't save money to do fewer of them - then why do we charge so much for an MRI per occurrence? Sounds like they should be free or baked into the costs of a hospital then...
The attitude of "the only cost savings is headcount reduction" is just wrong.? Velocity and throughput are ways to improve cost savings when there is excess demand. More effective outcomes improve cost savings. Hours of operation can be reduced if demand can be satisfied faster. It also reflects a baked in attitude in healthcare that nothing can be improved - that it just is the way it is.
What I am looking for from healthcare leaders, and what I see in our clients who are in healthcare is:
- Emphasis on getting it right the first time.? No matter what anyone tells you otherwise, getting treatment right the first time saves money and improves outcomes for patients.
- Increased throughput.? If we can more efficiently serve patients from existing facilities and staff, then we will have a more cost-effective system.
- Reduce secondary infections and complications. These have major cost and patient outcome implications.
- Reduce administrative overhead to support the provision of care.? Many doctors' offices have as many administrative / insurance related staff as they do care-giving staff.? Implementation of intelligent automation can address much of this workload and bring the administrative staff back into balance with caregiving staff.
- Better use of data to pick the right treatments - likely leveraging machine learning.
I was disappointed that some of the most experienced members of this panel had such a defeatist view on these elements of a better health system.? The more innovative members of the panel and audience were flabbergasted.
We can do better in healthcare.? Better outcomes, better cost structure, better incentives.