Is Innovation in Healthcare Benefiting Patients?

I think most of us have seen this graphic before, and quite frankly, it is staggering.

Source

What is happening here? Well, on the aggregate level, life expectancy is going up, and healthcare costs are rising. And on some level, this tracks: spend a little more on health, health should improve. So, what the hell is going on in the US?

Here’s the data visualized another way:

Source

This should not be news to anyone: the US is a dramatic outlier here. Why? Well of course this is complex and the US scores poorly on affordability, access, and equality metrics, but I do not believe that tells the whole story.

I fear that the innovation pouring into the US healthcare system is driving costs and not having a linear impact on outcomes.

Don’t get me wrong: there’s no other health system in the world where I’d rather be acutely sick. But I do not think we do any better with chronic conditions, and we’re not keeping our population healthier. Just the opposite, in fact.

Year-over-year, new drugs, devices, and other technologies make it to market, and often the US market is the first launch for these innovations before they are rolled out to other countries. Do these innovations improve lives? No doubt about it. But at what cost? Are the improvements proportional to the cost? That is where some countries, like the UK, have adopted metrics to evaluate these technologies based on value – both efficacy and cost.

We do not use QALY metrics in the US. But even if we did, there are no QALY metrics for some of the technology that is flooding the system. Specifically, I am thinking about health tech on the software end of things.

It seems like there is a never-ending supply of SaaS platform companies that have developed innovative technology to solve a healthcare-related problem. And yet through their solutions, a whole host of other complexities have now been added to the system. Software for this and software for that. Do these platforms improve outcomes? Do they improve all-cause mortality? Do they solve the problems they are designed to solve? Well, the good ones do, but at what cost? Has the patient experience improved?

In many ways you could argue “no.”

Are physicians screaming for new technology platforms? Are administrators? Most importantly, are patients?

I sat down with my PCP for my annual physical a few weeks ago, and while he gave me a thorough examination, more than half of the visit he was angled away from me, typing notes into my chart. I’m not arguing against the use of EHRs, and dictation software seems to be taking hold to do more automated charting and put the doctor in a better position (literally and figuratively) to engage with patients in their office. But it is a microcosm of a system that is being flooded by technology that seems to be layering in added complexity and cost without a clear patient benefit.

Everything seems to be pushing towards more and more SaaS platforms. Makes sense, this is where investors think they will get the most ROI. But is what the healthcare system needs more SaaS platforms?

Ultimately, I think where we are headed – and where the real winners will be found – will be in two main areas. The first are solutions that enable consolidation. Can they consolidate to solve lots of problems via one platform, without adding complexity or disrupting the doctor/patient/administrator experience. The other winning arena will be solutions that have brought in physicians, administrators, and most importantly, patients, to understand their needs, and reflect that in the innovative solutions being brought to market.

Only then do I think we’ll see patient outcomes and cost tracking more closely.

Max