Extracting medical care from the health care system is all too often an expensive exercise in frustration. Dr. Eric Topol says your smartphone could make it cheaper, faster, better and safer. That's the gist of his new book, The Patient Will See You Now. Lots of people are bullish on the future of mobile health to transform health care, but Topol gets extra cred because of his major medical chops: Former head of cardiology at the Cleveland Clinic and present director of the Scripps Translations Science Institute in La Jolla, Calif. We caught up with Topol during his book tour to ask him just what mobile, digital health care would be like. Here's an edited version of our conversation.
The humble infusion pump: It stands sentinel in the hospital room, injecting patients with measured doses of drugs and writing information to their electronic medical records. But what if hackers and identity thieves could hijack a pump on a hospital's information network and use it to eavesdrop on sensitive data such as patient identity and billing data for the entire hospital? It is not a far-fetched scenario. Although the hacking of wireless infusion pumps hasn't happened, it is considered a critical cybersecurity vulnerability in hospitals — so much so that federal authorities are focusing on the pumps as part of a wide-ranging effort to develop guidelines to prevent cyberattacks against medical devices.
After decades of false starts and frustration, free market champions should be cheering— competitive marketplaces work in health care. And no matter what your opinion of Obamacare, you have got to admit, that's a good thing. It's now been about a decade since President George W. Bush enacted Medicare Part D — a competitive market for drug benefit plans with government set ground rules. Competing plans have to comply with benchmark regulations—for instance, they have to cover two or more drugs in each drug category—but otherwise, they are free to set their formularies, premiums, tiering arrangements and co-pays.
As a doctor, every day I'm reminded that the way we think about health care is rapidly evolving. We're finally beginning to appreciate that our patients are in fact consumers of healthcare and as such, should be treated in a way that engenders loyalty, engagement and even delight. Our patients are growing increasingly accustomed to a mobile, on-demand, and thoughtfully designed experience in their daily lives from companies like Apple, Amazon, and Airbnb, all striving to serve and retain their customers. We as health care providers are challenged not only by increasing costs, governmental mandates and complexity of care but a customer that has higher expectations of how health care should be.
The Obama administration has adopted sweeping new rules to discourage nonprofit hospitals from using aggressive tactics to collect payments from low-income patients. Under the rules, nonprofit hospitals must now offer discounts, free care or other financial assistance to certain needy patients. Additionally, hospitals must try to determine whether a patient is eligible for assistance before they refer a case to a debt collector, send negative information to a credit agency, place a lien on a patient's home, file a lawsuit or seek a court order to seize a patient's earnings.
Ask venture capitalists in Silicon Valley about which industry they're most excited to revolutionize, and odds are high that they'll say health care. So it's no surprise that money is surging into start-ups that focus on the intersection of health care and technology. In 2014, venture funding for these start-ups hit a record $4.1 billion. That was a 125 percent year-over-year jump, according to Rock Health, which provides seed funding for start-ups and conducts research in this area. Those working in this sector say health care is undergoing a technology transformation with a range of start-ups aiming to make the industry more efficient, convenient and cost effective.