Health System Crisis

For the last six months I have attended seminars, watched and listened to webinars and podcasts on the digital transformation of the health system and the changes needed to manage an aging population. Most panels consisted of high level consultants and industry CEO’s. I must admit that I have been utterly underwhelmed by what I have heard! They continually patted themselves on the back for removing application silos and multiple logins. This is hardly an earth shattering breakthrough. To me this is just rectifying bad original design and implementation.

Not once did I hear about changes to the health care model to cope with the aging Tsunami and the chronic shortage of nurses. The focus on the patient experience in filling in forms and websites is tinkering at the edges.?

Covid-19 brought telehealth to the fore and now we are moving to normality and living with Covid-19 we seem to be reverting to the old model of 3 monthly face to face appointments. Prior to Covid-19 the system was struggling and during Covid-19? most elective surgery was suspended. There is now a backlog that needs to be caught up. Nurses have left the industry to pursue higher paid careers leaving a chronic shortage of nurses. So either nurse to patient ratios are changed or less patients are treated.?

Meanwhile demand increases daily with 11,000 turning 65 every day in the US. Last year the US hospital system incurred a cost of close to $100B for preventable falls and pressure injuries (bed sores). The solution “they are not really preventable and should be reclassified so someone else should pay for them”. The fact is they are preventable with low cost technology that is available. Protocols that have not changed since Florence Nightingale need to be changed.

Nurses manually taking vital signs and writing them on patient charts and recording them in an IT system is archaic and time consuming. Handing out meal forms daily and collecting them for the kitchen to prepare meals is just as wasteful of resources.?

The present model does not work and will not cope with the ever increasing demand. It must be changed.?

Changed to what?

The only way forward is to implement a hospital-in-the-home model and support the 90% of families currently caring for aged loved ones at home. Technology exists to passively monitor patients remotely. Patients cannot be relied on to carry out blood pressure tests regularly. It must be passive and happening 24/7. The results must use AI to analyze and raise alerts when anomalies occur. This is much more efficient as only the exceptions are attended to. Modern ballistocardiographs can alert you to a heart attack or stroke up to 50 minutes before the event. This time slot allows for medical intervention and a better outcome for the patient. Current ICU’s cannot do that even with the patient wired up for ECG.

It is a fact that patients treated at home have a better health outcome.?

The health sector is not an industry known to quickly embrace new methods and at best lip service is paid to change. The standard response of “that's not how it is done here” is no? longer acceptable.?