As the health reform debate intensifies, the rightful role of medical technologies is stuck squarely in the
middle, caught in a simplistic tug-of-war over whether these innovations raise or lower health care costs. Instead of this argument, we should be focused on how to best identify the truly valuable technologies – those with potential to save both lives and money – and get them into the health care marketplace.
So how can we ensure that the U.S. is making smart investments in innovative technologies that pay dividends for patients and the system, something Europe, Canada and many other countries are already doing?
Answering this question would give us a shot at fixing some of the most broken parts of health care. Technologies can play a key role in the redesign of the ailing primary care system by providing quality patient data, assisting in preventive practices, and taking the burden off the backs of primary care physicians. Similarly, technologies can help combat and manage the massive burden of chronic disease, and they can help reduce the costly clinical waste and inefficiency plaguing the system.
The paradox here is that plenty of valuable technologies already exist. For instance, no fewer than 11 promising telemedicine technologies with the potential to vastly improve chronic care delivery have recently been identified by a partnership of the New England Healthcare Institute and the Massachusetts Technology Collaborative. Called the Fast Adoption of Significant Technologies (FAST) initiative, the partnership seeks to identify, assess and aid in the adoption of transformational health care innovations.
The 11 technologies identified in the latest FAST research, ranging from next-generation medication adherence systems to advanced tele-stroke technologies, could transform chronic care by providing better coordination, ensuring timely access to treatments and reducing costs. Yet these valuable existing technologies, like countless others out there both known and as yet unknown, are languishing as chronic disease consumes 75 percent of the nation’s $2 trillion in health care costs
Why? Because our health care system, while in desperate need of innovation, is not designed to deliver it. There is no standard mechanism to routinely identify the technologies that work, no widely accepted model to evaluate them. Physician practice guidelines, which ostensibly could filter valuable technologies to providers and thus to patients, enjoy only loose adherence at best. Payers have little incentive to promote new technologies without empirical, universally accepted evidence proving their value. And consumers, who have multiple means of evaluating cars, televisions and other everyday goods, have virtually no way to evaluate the health care they receive or the technologies through which they receive it – and thus do not create the demand for them.
To find technologies that work and speed their adoption, we must start with a sound vehicle to identify them. Initiatives such as FAST stand as a good model for both the federal government and private groups to create programs that evaluate the true potential of technologies. The technologies would have to meet a rigorous set of standards proving their value: they should benefit a substantial patient population, improve patient outcomes, reduce overall costs of care, have low-market penetration, and have barriers to adoption that can be cleared.
Once these valuable technologies are identified, they need a clearer and quicker route from patent to patient. We need to remove barriers such as payment systems that fail to create incentives for promoting technologies – even those that prove themselves cost-saving over time. We need sound policies, both public and private, that support the broad-based adoption of technologies that have proven their value. And we need better educational efforts to teach providers best practices to ensure the technologies’ proper adoption.
This issue is a timely one, as the billions of dollars in federal funding for health IT and comparative effectiveness initiatives are disbursed and President Obama looks to enact broader-based health reform. A process for bringing valuable technologies out of hiding and into the system should be a key component of these plans. The issue is not whether technologies are a driver or a drag on costs; they can be either, or both. The issue is how to harness the ones that can save lives and save money. That’s what true health reform is all about.
The author is the president of the New England Healthcare Institute. (NEHI) For more information about NEHI, please visit www.nehi.net