Future Care - Book Summary - Page 4 of 4 - Dr. Doug Green Dr. Doug Green

Future Care – Book Summary

15. The Value Proposition and Incentivizing Change

The current fee for services model does not incentivize using continuous monitoring that can spot problems and provide action to keep patients healthy. The current system incentivizes greed. The doctor that avoids invasive procedures will be compensated less that one who is constantly performing surgery. Messages and emails that are mostly handled after hours are not billed. Clearly, we need a new business model.

16. Choosing the Right Path

With the right sensors and algorithms patients can manage and treat their own diseases. Insurance companies have already recognized this and are promoting self care and wellness behaviors. In many cases the home bed will become the hospital bed where AI suggestions and continuous sensor reports are checked by clinicians who can visit via tele-medicine calls. Regulations and the lack of EMR integration currently stand in the way. Jag envisions a day where patients take care of themselves for the most part.

17. Future Models of Care

Many patients have multiple doctors who are often in different cities. We are moving to a system where all of your doctors are part of the same system and are aware of what the rest of your doctor network is doing. Doctors will serve e-patients who are educated, enabled, engaged, and empowered. Patients will also become resources for doctors and each other.
Apps are increasingly being used to monitor the pre-op, post-op, post discharge and rehab phases of surgery. We often neglect early signs of ill health so when we do seek help we need chronic disease management. Insurance companies are now incentivizing patients to commit to healthy living behaviors so as to avoid chronic diseases. This will allow the power balance to shift toward to the patient. Some companies are involved in a modular approach to care and drug chains like CVS and Walgreens are seeking to be one stop shops for specific diseases.

18. Hospital of the Future

The future hospital room will be totally connected so that there will be no need for nurses to gather periodic vital signs. Doctors are likely to make daily rounds mostly via screens. The big push will be to move patients to homes or AirBnB style facilities for most of their care. This should decrease the need for hospital beds as we know them.

Robots have already started to join the health care work force and their roles and functions are certain to expand in order to deal with shortages of human health care workers. Look for them to deliver medications and food and to remove waste. They can assist with drawing blood and making surgeon’s hands more exact. They can also comfort patients, help with lifting and transport, and assist with virtual visits.

Epilogue

Many COVID problems can be blamed on an inflexible system that has too many stakeholders vested in the status quo. This system will change, however, because of the innovative mindset of clinicians and researchers and the expectations of patients. Sensor-aided virtual care powered by predictive analytics is here, but it should be used as a complimentary stratagem to the human connection between the clinician and the patient, not a replacement of that bond.

Jag Singh

Jag as a practicing cardiologist at Massachusetts General Hospital in Boston, MA and professor of Medicine at Harvard Medical School. His research work is focused on innovative device therapies, sensors, AI, and virtual care. He has served in many leadership roles within medicine and on scientific advisory boards for device and digital companies. You can check out his website at jagsinghmd.com/. Follow him on Twitter (X) @JagSinghMD.