Physician Patient

Archive for November, 2015

The Job of All Doctors is to Improve the Health of Their Patients: What Can IT Do to Help?

Wednesday, November 4th, 2015

As we shape the MPPA’s mission this year, we’ll pay close attention to the fine work that Douglas Wood, MD and the Mayo Clinic Center for Policy Innovation are doing.
See https://transformconference.mayo.edu/ Their research and recommendations are in synchrony with the energy, mission, and goals of MPPA.

I heard an excellent presentation by Dr. Wood yesterday at the Minnesota Academy of Medicine http://www.mnacademyofmedicine.com/ on how IT will transform the future of medicine. Here are my takeaways from his talk:

The practice of medicine will be transformed and IT will be a big help in personalizing medicine:
Very Importantly, not by using Big data to drive allowable (reimbursable) treatments — which is now the strategy of managed care, insurance companies, and the government (DHS, CMS, Obamacare) but rather by providing accurate, timely, confidential, and relevant information to patients and doctors in the course of their clinical work.
Given that the true goal of medical care is to improve a patient’s health, it follows logically that both patients and doctors need to first understand why he or she is doing whatever interferes or prevents achieving and maintaining the patient’s (and his family’s) health. And then the patient and doctor can implement strategies to improve health. So the new emphasis is on enhancing a patient’s health rather than controlling doctors and others who provide healthcare to patients.
Instead of viewing patients primarily as fitting diagnostic categories or disease groups and evaluating doctors by adherence to (population-based) disease treatment algorithms, change the role of most physicians to work for a patient as his or her consultant, advisor, and only when indicated a provider of expert medical techniques.
There will not be a US doctor shortage in the future. Today many too many doctors today spend an excessive amount of time and energy documenting what they are doing for the electronic health record (EHR) rather than focusing on improving the patient’s health. Dr. Wood estimates that most primary care physicians today spend only 6% of their professional time doing things that only a well-trained physician can do, an appalling fact if true!
The annual physician medical check is obsolete. We knew that.
Supercomputers like IBM Watson http://www.ibm.com/smarterplanet/us/en/ibmwatson/what-is-watson.html are not needed or useful to crunch numbers (data is cheap and often unreliable) but rather to afford doctors and patients ongoing access to personalized information which is relevant to the needs of a specific patient’s circumstances (including family support and financial status).
To provide this new person-centered care, there is no particular need for physicians and other health care professions to be required to work in large groups or be employees of large organizations. Innovative IT permits virtual conversations PRN. Professionalism is important. Solo and small group practices will be in the healthcare marketplace.
There is no intrinsic value (and there are high costs) for expansions of hospitals and other health care ventures using expensive real estate. Home healthcare will dramatically expand.
This transformation will require radical changes in private sector and government payment policies.