Tech

The Coming Health Tech Disruption

Mark Cuban has been actively commenting in Saurabh Jha’s THCB post about him. We thought this comment was worthy of being a standalone post (and he agreed)–Matthew Holt

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The tech sector will leave people better off at a lower cost. Moore’s law will have its day. But we are 5 years off from minimal impact. 10 years off from Marginal Impact.

In 20 years we will all look back and think 2015 was a barbaric year of discovery.

To give perspective. We pioneered the Streaming Industry TWENTY YEARS AGO. And now we are finally seeing streaming becoming mainstream as a technology but it still cant scale to handle mega live events.

HealthTech will continue to move forward quickly with lots of small wins. It will slow down when there is an inevitable recession in the next 20 years, then jump again afterwards.

In 30 years our kids/grandkids will ask if its true that there were drugstores where we all bought the same medications , no personalization at all, and there were warnings that the buyer may be the one unlucky schmuck that dies from what used to be called over the counter medication.

We will have to admit that while unfortunate it was true. Which is why “one dose fits all ” medications were outlawed in 2040 🙂

By then hopefully we will have a far better grasp on this math equation we call our bodies.

Of course it will be long before then that we make decisions based on optimizing health rather than trying to reduce risk.

The biggest challenge will be training health care professionals.

Medicine today seems to be in that 1980s phase that tech went through where no one got fired for hiring IBM. So IBM got lots of business because it was the safe choice rather than the best choice.

As best i can tell from my involvement in funding a single study on HGH for injury recovery (just getting started), becoming well versed on performance enhancing drugs and from the feedback on the blood capture and testing discussions, doctors are rightfully fearful of messing with people’s lives , so they make the IBM type decisions that “no one got fired for” or they dont get sued for. (Again, just my observations).

This may not be the best process for those who can invest in what they hope are the best minds. But its an understandable process when the funnel of people healthcare professionals have to see stays full continuously .

Which is why I think part of the market and government response will be to increase the number of healthcare professionals.

We need 3x (or some multiple, this is a guess ) as many doctors as we have today so that the amount of time spent per patient can increase to better understand and use the dramatic increase in data we will see.

Anyone have any good ideas on how to train 3x more doctors annually, with better quality at a lower cost ?

IMHO, thats the holy grail.

Mark Cuban is an entrepreneur, investor, owner of the Dallas Mavericks of the National Basketball Association and a participant on Shark Tank.

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Harish_KapoorWhatsen WilliamsEmma Thomas, RNMD as HELL@BobbyGvegas Recent comment authors
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Harish_Kapoor
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Introducing you to – ‘Drug Free Diabetic Care’ I’m happy to introduce you to DDC that I co-founded to reverse high blood sugar progression. Diabetes has become chronicle problem, not only in US but around the world. Scientists don’t know exactly what causes this insulin resistance, as there are several physiological systems and sub-links involved. …. more https://www.linkedin.com/pulse/drug-free-diabetic-care-harish-kapoor?trk=prof-post http://www.healthiosxchange.com/page/dedicated-diabetic-care Our mission is to regulate, high blood sugar by slowly replacing the patient’s medicinal intake with lifestyle and evidence based therapeutic care that prevents long term side effects. Dedicated Diabetic Care (DDC) is a non-pharmaceutical tool and an integrated approach designed… Read more »

Perry
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Perry

Steve, Thanks for your reply. With all due respect: “Put bluntly, that will mean most docs won’t have the autonomy to have high entrepreneurial earnings, at least not from their medical practices. ” Steve, very few of my friends and colleagues have made huge earnings in primary care. What you are suggesting, while maybe somewhat lucrative for the physician, will mean that they are beholden to the protocols and guidelines of the ACO, which means that they are taking care of the chart and the protocol, not the patient. That is why they will be factory workers. Certainly we need… Read more »

Steven Findlay
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Steven Findlay

Answering Perry from April 10….I don’t think most of the docs working today in integrated systems and getting paid a salary (or having a sizable portion of their FFS pay pegged to quality and cost measures) would consider themselves factory workers. And they are paid pretty well, as docs should be after the long hard slog of medical school, etc. It’s very hard in our society and culture to argue that docs make too much money…when investment bankers, football players, and movie stars earn tens of millions. But I do think that we need to reimagine the medical profession even… Read more »

Whatsen Williams
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Whatsen Williams

@emma

R u going to HIMSS? The folks there will be happy to ignore you as they move on to bigger and better things, such as patient engagement, interoperability, meaningful use, and innovation.

Emma Thomas, RN
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Emma Thomas, RN

Addendum: To compare treaming to medical care is consistent with misunderstanding of what doctors and nurses do. The systems so described are not fit for purpose. The adverse events, errors, and near misses go unreported. This week, the doctor had CPOEed and order for BID potassium with a perameter to hold it if the serum k+ was > 4.6 mg%. the order on my palate was obfuscated by innumerable lines of instructions such that I missed the perameter and gave the potassium supplement when the serum potassium was 4.7, and the next day, 4.9. The doctor missed it because the… Read more »

Emma Thomas, RN
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Emma Thomas, RN

Wonderful plan for treating patients with hangnails, or the worried well.

You fail to consider mandatory reporting of EHR failures, unavailability, and crashes and the deaths and injuries that occur from such.

When streaming does not work, so what, someone can not watch the Mavericks play!

Get real and get consent for this experiment.

Jeremy Lansman
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Jeremy Lansman
Jeremy Lansman
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Jeremy Lansman

I suppose I should go on record, I believe Mark’s opinion is based upon inadequate knowledge and study. A lot of discussion on this topic can be found on the “Paying ’till it Hurts” Facebook page, or in the various writings of Dr Atul Gawande. Or read Malcom Gladwell – The Picture Problem. http://www.newyorker.com/magazine/2004/12/13/the-picture-problem Some medical treatment kills. More medicine that can kill is not a good thing. I speak as someone who has an almost 20 year graph-spreadsheet of blood readings. But no. I do not leave it up to doctors to tell me what to do with that… Read more »

MD as HELL
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MD as HELL

There is no scaling up the bedside interaction to make it cheaper unless it is shorter and the doc/PA/NP does not have to touch the computer.

If all I have to do was provide care and the scribe/documentor/recorder did all the data entry, we could crank out a lot of quality care.

The admin types relish the doc at the keyboard doing their bidding for MU and CPOE.

Someone get it right…I’ll wait.

@BobbyGvegas
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Robert Cato
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Robert Cato

“We need 3x (or some multiple, this is a guess ) as many doctors as we have today so that the amount of time spent per patient can increase to better understand and use the dramatic increase in data we will see.” I understand the argument that is taking place but I couldn’t let this statement slide without disucussing the implications for cost. Mark, have you ever heard of the cost disease? So, in an era where we need increased productivity in healthcare, you’re suggesting we employ three times as many physicians and ENCOURAGE lower productivity? No discussion in healthcare… Read more »

Jeremy Lansman
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Jeremy Lansman

Mark. The first step in creating individual medications or therapies is to gather information. One interesting project along that line is this: https://www.openhumans.org/. There is an international project under development that should provide much better privacy.

As for training doctors, maybe you should visit Cuba. For decades that nation has earned money by exporting doctors. How do they do that?

Perry
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Perry
Steven Findlay
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Steven Findlay

I’d take 2x more docs/nurses/caregivers of some sort to care for elderly and coordinate care for chronically ill…but ONLY at 1/2 the usual cost, on salary, and in context of integrated health systems. While we’re at that, let’s transform the home care industry — by training home care workers better and paying them a decent living wage. They’ll be needed to take care of influx of aging baby boomers, and future generations who will be living to average age of 90 or more. That’s the kind of “personalized medicine” I’m looking for.

Perry
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Perry

“I’d take 2x more docs/nurses/caregivers of some sort to care for elderly and coordinate care for chronically ill…but ONLY at 1/2 the usual cost, on salary, and in context of integrated health systems. ‘ Steve, please refer to Leonard Kish’s reply above. Part of the lure of being a physician has in the past been autonomy, the use of intellect and patient interaction. While we can complain about what doctors make, some think too much, some too little, but the bottom line is, medical education is extremely expensive. If you read comments from primary care docs on Medscape and in… Read more »

Peter1
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Peter1

“We need 3x (or some multiple, this is a guess ) as many doctors as we have today so that the amount of time spent per patient can increase to better understand and use the dramatic increase in data we will see.” Wondering how 3x the docs spending more time, will cut costs? It’s been shown that more docs don’t create competition to lower prices, they just find ways to creative bill. There are income and lifestyle expectations. Also fail to see how Moore’s Law applies to doctors and patient health with understanding that innovation can find better cures, but… Read more »

Gregg Masters
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Well said on the uptake trajectory and the likely looking back at ‘barbaric’ practices… A guarantee, IMJ. Think ‘pre-anesthesia’ surgical theatre located in at the top of the hospital so you couldn’t hear the patient scream. On the 3x doctors thing, the last time the Council of Graduate Medical Education prognosticated, they grossly understated supply without looking at load balancing (primary v specialty) mix and further, the aggressive political activism to exclude an army of ‘mid level’ practitioners (NPs, Advance Practice Nurses, PAs, etc.), all need to factor into the supply/demand equation. Also, the ‘Moore’s Law comment by Nick is… Read more »