The U.S. continues to lead the way in development and use of healthcare technology, despite the latest report from the United Nations World Health Organization (WHO). Ranking the U.S. slightly ahead of Cuba, the WHO report apparently emphasizes fairness and equality regarding access to healthcare, in contrast to quality and availability of medical services.
The U.S. healthcare system has an interesting dilemma — we only have very average health statistics as a country when measured by factors such as infant mortality, life expectancy, cancer incidence, cardiac disease rates, etc. We also have the ultimate access to pre-eminent diagnostic and therapeutic tools to treat detected diseases.
If we expect the U.S. healthcare system to remain market-based, then the drivers for change will continue to be technology, economics and the individual.
Technology Updates
The pace of healthcare reform is exceeded only by the mach-speed of global technology developments, which daily opens new avenues of diagnostics and treatments. A worldwide explosion of scientific advances includes the following areas:
Genetics-driven knowledge — We finished mapping the human genome and have funded more than 100 biotech companies in the last few years. If this effort is compared to the New World explorers of 500 years ago, the benefits may not be fully known today, but everyone seems certain that we’ll find real knowledge and rewards. The biggest benefit could be from patient-specific treatment strategies, matching the right drug and dose to the individual, ensuring an appropriate therapy. In imaging, cellular analysis should migrate from a central laboratory to become a widely dispersed and more heavily utilized tool. Radiologists may consider extending their image analysis skills (and tools, such as MR spectroscopy) into this new domain and not be limited by the gross physical anatomy. Biopsies should be analyzed onsite for immediate results.
Computer technology — Storage and bandwidth are the present focus of computing developments that healthcare providers are seeking technical advances from in the next few years. The ability to move into a filmless environment has substantial implications for networks and storage media, which can be bogged down rapidly by the need to review and share medical images. The Internet offers a convenient networking platform, but compression and bandwidth improvements are needed to reduce the huge time penalty experienced in most settings. Processing power is no longer an economic or technical limit to medical applications. Software in all imaging, diagnostic and treatment devices is entering the era of real benefits, leveraging the tireless efficiency of computers with the real-world
challenge of doctors treating individual patients. Aspect Medical has proven that signal analysis can revolutionize anesthesia, making everyone’s life and work better.
Information systems — The electronic patient record has not made its way to my doctor’s office yet. When it does, the front office staff may learn to behave like humans again. Can somebody smart please figure this out? Surely, a big individual spreadsheet or database could provide some benefits today.
Communications technology — Everything is going wireless and, if you believe the phone companies, it will all be available from your cell phone. I’m not sure I want a radiologist reading images on a Nokia, but, then again, I might. Unplug and get connected sounds strange, but appears addicting. I know I certainly could stand a few less wires in the back of my computer, and wearable computers are on the way. Remember, IEEE 802.11 is the new standard for wireless communications. Remind yourself to include wireless opportunities in your new product and business development market evaluations. Voice recognition technology still is struggling. The challenge is not the content of words, but their meaning in a specific application. Get it wrong and the cost of a mistake is very high!
Materials technology — If communications and computer technology represent the digital world, then materials technology is the focus of the analog side of science. However, X-ray detector technology is driven by hybrid marriages of materials science and electronics, resulting in the development of digital X-ray systems. New stents, radiation delivery devices, coatings for medical devices used inside the body, batteries, hip/shoulder/knee replacements — all are driven by exotic (and economical) materials that result in improved performance and lower the total cost of treatment.
Economics Technology
Technology developments are almost universally pursued with the dual objective of also reducing the total cost of care. The U.S. healthcare system almost ensures that better quality is accompanied typically by reduced costs, since most hospital and HMO systems continue to operate on the financial edge. They can afford technology, but not at any cost. Economic forces drove most of the changes into today’s system of HMOs, PPOs and managed care organizations. While doctors have not formed a union yet, the trend lines continue to point that direction. On the flip side are patients who are taking a larger role in their own healthcare. The Internet has enabled a large and growing group to rapidly find information formerly buried in libraries and specialists offices. Even doctors are discovering the benefits of online research to keep up with their wired patients!
Doug Orr, president of J&M Group (Ridgefield, Conn.), consults with medical device companies in strategy and business development for emerging growth markets, notably radiology and cardiology. Comments and suggestions can be sent to [email protected].
