Andrew Pecora, M.D., speaks about the future of healthcare and how cultural forces will come together to create a tipping point.
We are in the digital age now. We all know that bits-based businesses like Facebook, Google, have transformed the way we think about business. Atom-based businesses — things that you have matter, not bits of data — they are way less efficient, way harder to scale. Making a car or making an airplane is way more complicated and way more expensive than what Facebook does, right? And so, if you are able to link bits-based business, like Facebook, like Amazon, like Google, that technology with true, relevant medical content that is specific to an individual, it’s going to transform everything. So if you think about Uber and you want to get a car, the simple thing is: you’re standing somewhere, there’s a driver somewhere else, you’ve never met before, but through technology — GPS technology and other technology — the two of you who have the same intention — you want to go someplace, he wants to take you or she wants to take you someplace, that technology links you in a very high reliable and affordable way.
Now let’s talk about healthcare. What’s the difference between standing on the street corner in New York City instead of hailing a cab, doing that to get to wherever you want to go, versus, you find out you have high blood pressure for the first time and you want to get it treated and it to go away? Wouldn’t it be pretty amazing if you could get all of the elements you need to know that refines why you have high blood pressure, the type of high blood pressure you have that gets you to the right doctor, that gets you to the right medications, that gets you to right technology to monitor it? Because what you want is your high blood pressure to go away. What the doctor wants is your high blood pressure to go away. What the payer wants — it doesn’t want you to have high blood pressure because it knows if you have uncontrolled high blood pressure, you’re going to have a stroke, a heart attack or develop kidney failure, and that’s going to cost a heck of a lot more money than just treating your high blood pressure. And your loved ones don’t want you to have high blood pressure.
I’m using that as an example. It could be anything — diabetes, cancer, anything. So now, you have the pieces. You have wearables where you can take your pulse, your body mass index, the number of steps you take. Pretty soon we’ll be able to look at your blood sugar levels. We clearly can monitor your blood pressure, hookup to whatever technology, and send it anywhere you want. Well, somebody or some things are going to put all these pieces together — so just like the example I did of getting a cab by clicking your phone — this is going to happen in healthcare.
So, what is going to drive the change to overcome the current model? It’s going to be a tipping point event. It’s going to be a culmination of several different things that may not seem to be all coming together, but there will be a convergence. Now when is that going to happen? I don’t know that anyone can tell you when it’s going to happen, but I can tell you when it’s going to happen by. There is no doubt in my mind five years from today, healthcare is going to be fundamentally different in its delivery than it is today — there is no doubt in my mind. Is it next year, two years, three years? I don’t know.
The only thing that I think is holding it back is the pace at which the Centers for Medicare & Medicaid Services (CMS) changes reimbursement. CMS can’t do things fast because of the way it’s constructed. The single greatest motivator for changing behavior is reimbursement, more than anything else. So, I think reimbursement will be dragged along by innovation. Bits-based businesses can scale very inexpensively. You don’t need lots of people to write code. You don’t need lots of people to push electrons through wires.
So, I think that what we’re going to see is people, consumers of healthcare, taking it upon themselves, linking in to their doctor — you’re not going to not want your doctor — and to information technology, but also the circuit of care. The pharmacy — will Amazon become your pharmacy? You go to Whole Foods to buy your foods and your pills are waiting there. You think about how this could all come together. It’s pretty obvious it’s going to, it’s just a question of when.
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