Scott Mace, for HealthLeaders Media
, October 30, 2012
Nurse practitioner clinicians, bring your doctorate. The U.S. will be short 45,000 primary care physicians by 2020, Ryba says, and the shortage is felt more or less keenly depending on where you live. Ryba says 250 nurse practitioner-led clinics have popped up around the U.S., but in 2015, nurse practitioners will be required to have a doctorate. But since the alternative may be no primary care at all, expect to see more of it.
Technology to monitor medication compliance. Home monitoring of blood pressure and weight is catching on, but Ryba hasn't yet seen effective technology that can monitor medication compliance. "In the hospitals, every single patient goes home with the med in their hands, and we're doing that now, and we're making sure those meds follow them to skilled nursing facilities," she says. "But in the home, I think that we don't have the technology that really does influence behavior" to make sure those medications are taken.
Medical school takes too long. "What if it took half the time?" Rubin asks. "When you cut a year or two down, do you have more people?" He points to the writing of Stanford economist Victor Fuchs on this issue.
Specialists are headed for call centers. "Technology gives us the opportunity to do things that couldn't be thought about," Rubin says. "Maybe you could just do rounds on your iPad or iPhone or whatever the device is." If the physician needs to consult with a specialist, the days of waiting four hours for a call back may be numbered. "Maybe a specialist is sitting in a call center" and the physician brings up the specialist on a screen in the patient's hospital room. "There's a tremendous opportunity to transform how we train, how we work as teams, to leverage the technology, and to change the way we deliver healthcare," he says.