Access to health care, when we need it, is vital to us all – and ever more so as we age. An upside to better food, sanitation and housing is how our generation is living longer than previous ones, and has become less prone to acute life-threatening conditions. A corresponding downside to this benefit, is how our lifestyles, particularly not eating well and lack of exercise, are causing increasing numbers of us to have to deal with one, or more chronic conditions e.g. diabetes, heart failure, hypertension etc. New treatments are also turning the past scourge of many cancers into chronic conditions to live with, and not a death sentence.
Despite how we have changed, and how the manifestations of diseases that typically affect us have also changed, our health care system, which we rely upon to stay healthy, has not altered to the same degree. Often hospitals, with roots in having been a place of sanctuary, and still based on organizational principles from the industrial age, are maladapted to investigate, diagnose, manage and treat the chronic diseases that account for 75 percent of US health care expenditure and causes 70 percent of mortality. I believe ongoing challenges in preventing/reducing hospital readmissions/lengths of stay are symptoms of an underlying issue these legacy systems face in moving from “salvaging” those with disease to more effectively promoting health and wellness.
In this scenario, transformation is inevitable and new information and telecommunication technologies are game-changers; ones that can deliver just-in-time services across the continuum of care – affecting our susceptibility to chronic disease, and influencing decisions on whether, when and how to treat the various manifestations of these conditions. Innovative new technologies enable self-management and shared decision-making, actively engaging us in maintaining our health and in negotiating outcomes that match our preferences. Using such technology-associated strategies in combination with algorithms to risk-stratify remote monitoring data from people with chronic conditions is improving health and reducing hospitalizations.
In the midst of this transformative change, we need a compass to ensure we are headed in the right direction. In this respect health care is, and always has been, about relationships. As various providers, payers and new intermediaries are engaging with us about our health, connected care is not just about bits and bytes of data, or streaming results of physiological variables, it is about communication and connection. As it becomes virtual, as well as physical, the health care system must still touch us.