An economist's perspective on how to improve healthcare
The biggest challenge in our healthcare system is the patient, says economist and HealthMaker Jane Sarasohn-Kahn. In this video, she explains that patient engagement is key to improving healthcare and outcomes for patients and providers.
Transcript
[RAMBLING PIANO MUSIC PLAYING] The most prevalent problem is that people-- the patient-- is the most underutilized resource
in the US health system. People don't take care of themselves. They don't engage with themselves, with their doctors, with their families, with their communities on health care.
We have all the technology in the world per capita-- more than we really need-- in terms of ORs and MRI,
CT scanners, gamma rays, et cetera. What we don't have is patient, person participation in their own health.
[ELECTRONIC MUSIC PLAYING]
[RAMBLING PIANO MUSIC PLAYING] You can slap sensors on anything now. Sensors have gotten very cheap. And so sensors themselves-- the sensor technology--
will not be the problem. What will be the problem is making sense out of sensors-- sense-making. So you'll have all these data points, potentially,
about somebody, but unless we have a way to corral that data, and make it picturable, graphic, and understandable to people--
let alone doctors-- who don't want to be flooded with a million data points on a single patient, we have to create ways to funnel it so that we
get the most important sensor data, the most meaningful data, and then be able to analyze it very quickly, very nimbly,
so that we get to the core of what's really important. And my fear is that we're all going to be such quantified selves that we're not
going to be able to make sense out of all these data points. The potential for mobile health in general is huge because health, as our Surgeon General says,
is where we live, work, play, and pray. It's largely outside of the doctor's office. So if we can have an app that helps
us do the right thing through the day-- choose the right foods to eat, take the extra steps through the day, take our medications--
that does move the needle on personal behavior, bolsters good health behavior, and then outcomes,
and drives costs out of the system. The workflow of how a physician shuffles papers and moves from a paper-based environment to the digital environment, how
an insurance company moves from that check-paying environment to direct deposit kind of environment--
so all of these players in the ecosystem have to move away from paper and will save some waste
money that way as well. That's not a panacea, but it's part of the needle-moving challenge.
Apps aren't as well-designed as they need to be. I think people would like them to be because they download
them, but they're just not fun. So a lot of this involves-- and I use the word "design"
several times in our conversation-- we need to make health a lot more fun and engaging than it's
been. There's a theory called "consumer-directed health care," which means putting consumers with more skin
in the game, paying more out of pocket, paying more in premiums. That's supposed to, in theory, get people to pay
better attention to health. In this early, pioneering stage of consumer-directed health care, it hasn't worked.
We have to design health plans much more artfully than we've done in the past, thinking about how people actually think about health care
as a consumer, not as a patient. So I believe in paying a primary care physician, an internist, a family practitioner, a pediatrician,
an OB/GYN more than we pay brain surgeons, relative to what we pay brain surgeons today.
Primary care is tremendously underfunded, and that's why a primary care doctor has to speed up the visit from between 3 and 7 minutes,
versus what should be a 30-minute visit at least once a year. [WHOOSH]
health care
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