Spiraling costs, poor quality outcomes, and inequities in access to care are driving significant and long overdue changes to the way health care is administered and managed in the United States.
And while the U.S. spends more on health care per person than other wealthy countries, its health outcomes are no better than those in other developed countries. In fact, it performs worse in several health metrics, including life expectancy, infant mortality, and unmanaged diabetes.
These types of poor clinical outcomes are often driven by inequitable access to good health care in low-income neighborhoods. And a growing body of evidence suggests that an individual’s U.S. ZIP code—where people live—is a more accurate predictor of future health outcomes than genetics or medical care.
Concerns about cost, quality, and access to care are re-energizing a national debate on health care that will continue throughout the 2020 presidential election campaign. As American voters seek answers from candidates, the election will bring health policy to the forefront. Given tremendous uncertainty about how the election’s outcome will affect health care, it’s important to focus on areas where we can make a difference by introducing structural innovation and promising technologies. We anticipate that the following five disruptive health care trends will intensify in the coming year and ultimately improve health care in America:
1. Value-driven health care. If our country continues along the current path, it is projected that Americans will spend $45 trillion on health care in the next decade. As costs escalate and wage growth remains low-to-flat at 3%, the stage is set for disruption in the way health care is practiced by most organizations. Expect to see a continued shift from the dominant fee-for-service model, in which incentives aren’t necessarily aligned with the best interests of patients, to a more value-based approach focused on patient care and getting value from quality services.
2. Personalized care and convenience: Increasingly, patients expect the same level of personalized care from health care providers that they already receive for a range of services from other industries. Health care organizations can meet these expectations by leveraging technology to deliver more convenient, personalized virtual care. For example, they could offer telehealth options that include video visits where physicians have access to the patient’s complete health history through an electronic health record (EHR), and prescription management. Seventy percent of dermatology visits in our Northern California health care organization are now conducted via smartphone technology, which has been shown to increase both the accessibility and the quality of care. This trend toward increased convenience and personalization will also include a renewed focus on patient education to encourage behavior changes that promote wellness, as the industry’s focus shifts from “health care” to “health.”
3. Platforms, data, and technology: Health data captured in the EHR—the foundational platform for meeting the evolving needs of patients and the broader health ecosystem—will be combined with data captured via smartphones, sensors, and wearables to deliver personalized insights into a patient’s health. This will enable physicians, aided by artificial intelligence, to intervene earlier to prevent sickness and disease, help patients understand disease progression, and encourage behavioral changes. Such shifts could help reduce many of the expenses now associated with chronic and catastrophic illness.
4. Maximizing technology and data to expand care delivery and education. Soon, many more health care apps will deliver health care, health care education, and possibly even health care encouragement to patients when, where, and how they want to receive these services. In the future, sensors embedded in everything from bathroom mirrors to toothbrushes could be used to monitor a range of health issues, from potential strokes to dementia.
5. Shifting care delivery from hospitals to homes. Technology will continue to make care more continuous and less episodic. Patients with heart conditions, for example, can use portable, high-tech devices to track and relay to their doctors several clinical measurements, including heart rate, blood pressure, and blood oxygen levels. Patients can be monitored 24/7, enabling physicians to catch and treat health challenges early, and lowering the risk that a patient will be admitted to a hospital or wind up in an emergency room.
The U.S. health care system stands at an inflection point in its technologically supported journey to value-based care. During this time of uncertainty, we believe these disruptors will be a catalyst for positive change.
Richard S. Isaacs is CEO and executive director, The Permanente Medical Group. Chris Grant is executive vice-president and COO, The Permanente Federation, and co-founder, Kaiser Permanente Ventures.
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