March 3, 2017

TIME TO STOP FIGHTING THE LAST WAR:

Forget Obamacare -- AI is driving the real health care transformation (ALEX TURKELTAUB, ROAM ANALYTICS, MARCH 3, 2017, Venture Beat)

Three key trends have converged to make AI-driven health care a necessity. First, the Affordable Care Act has fueled the industry's focus on value over volume. We simply cannot afford to treat patients under the old model of "provide as much care as possible, regardless of the costs." We need to get the right intervention to the right patient at the right time, while avoiding as much as possible doing things that add no value and cost a lot of money.

Second, the advent of electronic health records and the associated explosion in data has made it ever more important to learn what the data is telling us, and respond with new models of care.

And finally, the realization that treating "the whole patient" -- not just isolated conditions, but attempting to improve the overall welfare of patients who often suffer from multiple health challenges -- is the new definition of success, which means predictive insights are paramount.

In the emerging reimbursement environment, pharmaceutical and medical device companies will have to offer solutions instead of widgets -- they will be paid based on the value their products deliver, value that is tied to a complete solution for a particular patient's condition that improves outcomes and promotes both health and wellness. Providers, whether large hospital systems or individual doctors, will need to optimize patient pathways and drive to best outcomes; otherwise they will not get paid. And payers will make coverage decisions based on outcomes rather than clinician and patient requests.

As Republicans are finally realizing, the question of whether America will have universal health coverage has already been decided.  It's the shape of the system that remains to be determined and where conservative principles--decreasing consumption and increasing personal savings--can still prevail.

Posted by at March 3, 2017 5:28 PM

  

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