THE GLOBAL SICKCARE SYSTEM

“We have a sickcare system and not a healthcare system.  You can’t just jam more stuff into a sickcare system.”  Dr. Arlen Meyers’ remarks came quickly and without reservation.  With all the polarizing politics about American healthcare, it is easy for such a statement to be seen as partisan.  In this point, Dr. Meyers has broken through and bounded far beyond those sorts of arguments. 

Dr. Meyers is President and CEO at the Society of Physician Entrepreneurs and Director, University of Colorado CITI Digital Health Consortium.  He is a practicing surgeon and otolaryngologist, professor, and entrepreneur.  He helped create the Society of Physician Entrepreneurs (SOPE) to help others more than just physicians:

- push beyond the concepts of what we think is possible

- pull together what we currently know into ecosystems that are both scalable and meaningful to the patient and those who treat patients.    

Dr. Meyers and I met through social media.  A member asked about the best practices in using electronic medical records in the patient environment.  Dr. Meyers responded, “1.  Show up for the patient appointment on time.  2.  Sit down and talk to the patient.   3. Avoid using the EMR as much as possible.”  By his other posts in various forums, I could see that there was more to this statement that just the bad and worthless EMR rhetoric one so easily finds. 

Dr. Meyers purports, “The experience people value the most is experience in the exam room.”  Everything else is secondary and must support that experience.   It isn’t so much as not liking EMR, it’s a much larger issue of how an EMR interfaces with physicians.   He asserts that the physician interface should be providing “decision support and actionable information.  Within the time constraints of the few moments I have with a patient and with limited resources available, how does the EMR optimize and maximize the quality of that experience.”  Revenue, expense, and meaningful data should be captured while enriching the patient to physician experience not detracting from that experience.  It’s not a matter of if it can be done; rather, someone needs to get it done.

Spend time with the patient. Less Focus on finding a way to charge the patient for every little thing...via the physician....  The complaints sounded familiar.  So I asked, “Listening to what you are saying, seems that many of the same issues surfaced at the rise of the HMO.”

            He replied, “There have been various experiments to try and do that.  HMOs were one of them.  That was more about rationing healthcare.  I don’t think what’s working out now will work either.  And in reference to the social media post, in order for things to change we don’t just need new technologies - hardware, software, and digital health technologies, we need new business models.  We need new ecosystems.  We need a regulatory apparatus which allows those things to grow.”

Dr. Meyers has similar perspectives on wearable devices as well.  Great inventions but…  “How is this helping the patient or the doctor?  By integrating it into the patient record?  This is different from a health diary in which a patient may take blood pressure readings or records when certain symptoms occur.  These are devices capable of transmitting data on a continuous basis.  Some people have the expectation that the data will be beamed into the respective patient’s medical record in real-time.  Who gets it and what do you expect them to do with it?  It’s not scalable as currently presented.”      

The conversation transitioned a bit.  Dr. Meyers elaborated on the role of technology in healthcare.  There were two ideas.  The first idea, not a problem.  The second was something that gave me pause. I wasn’t comfortable with it at all.  At least, not until I had time to think about the context of what Dr. Meyer’s view of how healthcare should look.

The first, Dr. Meyers stated, “Healthcare education is mostly hospital based.  The business cases and regulatory apparatus are geared toward a hospital based care.  This is a sickcare system.  Admission into the hospital should be seen as a failure in healthcare.

“If I attach a monitor to my car, I could get substantial discounts if I behave on the road. If we go to wearable medical devices, hook them up and give money or credits to adhere to care plans and avoid hospital stays based on that data.  Make it easy to be healthy with minimal effort on the consumer’s part, and save money.  The policy apparatus should support that.”

Then he started into the second idea, the one that gave me pause.  That is, a machine diagnosis.

Dr. Meyers continued. “As technology helps us get smarter in making more predictive diagnoses, the computer can connect the dots better than I can.  So, what is there left for me to do when it comes to diagnoses?”

Read part 2