In Health Care, it’s Time for a Paradigm Shift
“Health systems in all world regions are under pressure and cannot cope if they continue to focus on diseases rather than patients,” according to the International Alliance of Patient's Organizations (IAPO). In order to achieve the benefits of effective health care, IAPO argues, policy makers, health professionals, service providers, and health-related industries have to change their focus from disease-centric to a patient health focus.
I would go one step further: To achieve this shift, innovation must be unfettered from the limitations of current mindset. Only by demonstrating what is possible outside the context of traditional methods will we be able to abandon the limitations of "treat the disease" thinking.
The benefits of patient-centered health care are especially clear in a disease like diabetes, which causes myriad symptoms, is usually accompanied by other medical conditions, and is significantly impacted by the social realities of everyday life. Managing diabetes requires a holistic, patient-centered approach to address all of these factors.
Traditionally, patients are handled as a collection of individual medical concerns and their social and familial situations are ignored. A person with diabetes is much more complex than the phrase “diabetic” can begin to encompass.
Patient-centered health care is a lofty aspiration; it will take a lot of work to make it a reality. I think the main reason is that this just does not fit into the left-right political divide; its natural advocates are the patients themselves, who not united, or even aware that there are other ways forward.
Other challenges arise from opposing pressures on the industry: How do you balance patient confidentiality with the need to aggregate trends by collecting broad data? How do you decide between reimbursement policies based on interventions and those based on outcomes?
How do you value established drugs and surgeries against new, promising treatments (and their accompanying promise of great profit for the industry)? And finally, there’s the challenge of urgency when a person is not well and becomes a patient: they usually don't have the education (or time) to make sense of the decisions that have to be made.
To overcome all of these challenges, we have to start by returning to the patient as an individual: How do we do this?
This is where the Making More Health competition gets its power. Some of the problems facing us can be solved technologically. Others depend on novel approaches to the intersection of health policy and real community needs.
A lot of what is wrong with health care here in the United States can be traced to a logjam of special interests, each defending its own piece of an unsustainable flow of money. Internationally there are other challenges, from education to community involvement to the delivery of simple preventative medicine.
So how do we change the system? By changing and expanding expectations and mind-sets and opening up the opportunity for new ideas. Then we may find that there is a road forward to health care and wellness as a part of normal life, and not just a set of disjointed interventions aimed at treating isolated diseases.
As a technologist, it can be hard to look at the system and see how to make changes. We are trained to see the disease, after all. Health care professionals need novel ideas and innovative concepts.
After spending most of our careers worrying about a few trees, we need your help to see the forest. I look forward to seeing your innovations.
Scott Hampton, an expert commentator for the Making More Health competition, has directed medical product engineering and commercialization for over a decade. He has a number of patents and has started companies in both medical devices and pharmaceuticals. For the last seven years, Scott’s work has focused on early-phase innovation: structuring companies, negotiating technology licensing agreements, raising capital, and building great management teams. You can also check out Scott’s blog.
Photo courtesy of DIAC Images (cc)