Straight TalkA weekly update from management on the issues that matter most. Nov 30, 2017 Transforming healthcare is the focal point of organized medicine today The safest patient is the one who never enters a hospital. The healthiest patient is the one who embraces prevention and self-care. The least expensive hospitalization is the one that never occurs. Successful hospitals will transform from legacy in-patient repair shops to proactive out-patient healthcare systems, providing care mostly in patients’ homes utilizing modern technology, already available. Successful physicians, nurse practitioners, and physician assistants will emphasize prevention. Healthcare is being welcomed into the 4th Industrial Revolution—the Exponential Age, where the merging of technologies are blurring the lines among the physical, digital and biological spheres, causing disruption to most industries, including healthcare. Consider other businesses that were disrupted similarly to Blockbuster and Borders, which went the way of the blacksmith and farrier. Healthcare is the largest industry by far in America, consuming 17.8% of the GDP at $3.2 trillion dollars and growing. The U.S. perennially ranks last of eleven developed nations in healthcare. http://www.commonwealthfund.org/publications/fund-reports/2017/jul/mirror-mirror-international-comparisons-2017 Many changes are already here. Currently, about two-thirds of our nation’s 5,000 hospitals employ some form of tele-medicine. At NCH we have had tele-radiology for over two decades, tele-stroke technology for almost three years, and recently added tele-medicine whereby patients, for a small fee, can use video or Facetime with an NCH Physician Group physician, nurse practitioner, physician assistant, or 24/7 back-up service. https://nchvirtualcare.anytime.org/home Visiting home nurse care combined with other care-givers who are monitoring vital signs remotely by Facetime or Skype has already been shown to decrease ER visits and hospitalizations. Nationally and locally, similar offerings are now more robust, available, and accepted, thus saving everyone time and expense. Artificial intelligence (AI) is becoming more common. As two examples, NCH has had an early sepsis recognition and treatment plan in place for five years, saving an estimated 909 lives. http://www.nchmd.org/news-and-events/newsroom/straight-talk/straight-talk-details/2017/09/21/straight-talk---september-21-2017 And Stanford University used machine learning and AI to diagnose pneumonia on X-rays better than radiologists could. https://qz.com/1130687/stanford-trained-ai-to-diagnose-pneumonia-better-than-a-radiologist-in-just-two-months/ Pre- and post-hospital care accounts for much more of well-being than the few very expensive days a person might spend in a hospital. On the “pre-” side, prevention is monumental. Just stopping young folks from beginning to smoke will prevent misery and cost over a life-time. Tobacco use remains the leading cause of preventable disease and death in America. Cigarettes are responsible for more than 480,000 deaths yearly. When used as intended, cigarettes kill half of all long-term users. And for every person who dies of smoking, at least thirty people live with a serious smoking related illness. The same case can be made for obesity prevention and about 80% of other self-induced diseases. Early diagnosis with treatment of mental illness is an equally important opportunity. Across our nation, hospitals built half a century ago need huge and expensive modernizations. These behemoths have large workforces with monumental inefficiencies. Consider the transformation of manufacturing, retail, or any other industry that can now successfully produce a better product or service using fewer people and resources. Healthcare must continue transforming so that we can help everyone live a longer, happier, and healthier life.