These are interesting and disturbing times for boomer-turning senior consumers of health care. The oldest baby boomers have turned 70. Some might even call them seniors. They are more likely than their parents to have chronic diseases [1], and 39% of baby boomers are obese. They are presented with rising health care costs [2], although real wages are barely growing [3]. So what is the health tech sector inventing [4] to help boomers span this disconnect between health, healthcare costs, and incomes? Investors are becoming disillusioned [5] with the array of tools have emerged that have only a tangential effect, including health apps they won’t download [6] – and if they did, wearables that are not necessarily accurate [7] or may not be secure. And so far, workplace health incentives that are not yet necessarily effective [8].
Cost of care and some readmission rates appear to be unaffected. On the one hand, a report by ACA International [9], noting that consumers don’t understand cost-sharing deductibles, “estimated that hospitals provided $46B of uncompensated care in 2012, with average debt recovery rates of 15 percent.” Rising health insurance premiums are unaffected by technology use, and price increases appear to disproportionately impact workers [10], including the self-employed older adults not yet on Medicare [11]. And using smartphones and apps to monitor disease does not seem to reduce the cost of treating those diseases. And remote patient monitoring has also been shown to be ineffective at reducing re-admissions related to heart failure [12].
Innovation? Technology to help with bill repayment. On the other hand, Consumer Reports notes that even with insurance, you are still not protected from ‘out of network’ charges incurred while you are unconscious on the operating table – like a $70,000 bill from a surgeon who doesn’t take YOUR insurance. The tech solution – help with bill repayment.
Efficacy of care appears to be unaffected. It is chilling to read the list of the biggest safety risks for hospitalized patients [13]. The key problems are basic and unsolved: Reading health records thoroughly – or even having access to thorough records; communicating properly, especially in patient hand-offs; calculating a unit of measure correctly. These are the basics of procedural improvements and have almost nothing to do with electronic records -- which seems to serve as a glorified copier and email system.
Innovation? Wireless monitoring of disease may avert doctor visits – but not costs. Dr. Eric Topol once asserted have found that the future of medicine may be in your smartphone [14]. Maybe not a lower cost future -- according to reports this past week, your smartphone (and associated self-monitoring of chronic diseases) may not lower the treatment costs [15] associated with those diseases.
Security of health care information is deteriorating. The most popular mobile health apps have documented security risks [16]. Insurance companies have not adequately reassured consumers that their databases are securely protected from hackers today, let alone the millions of hacked consumer records in 2015 [17] – and it is only beginning to be known how many of those have been sold on the black market [18].
Innovation? Big data? Interoperability? On demand healthcare? Not so much. Forget about ‘big data’ being too useful in the short term according to security experts. Organizations lack a clear strategy, data governance models [19] (No kidding) and apparently data scientists who can figure out what to do with the data. Information does not flow seamlessly across boundaries [20] (or perhaps at all) and the investment world is way ahead of the reality [21].