During the two days of the Transform 2013 conference in Rochester, Minnesota, sponsored by the Mayo Clinic, I took notes during the series of eighteen-minute talks on a wide variety of healthcare subjects. There were too many points made to communicate all of them in this brief blog. I will attempt to briefly summarize as many of them as possible. They were just too good not to share!
- One percent of American patients consume 25% of healthcare costs. 20% of patients consume 78% of healthcare costs!
- $6.5 trillion spent overall (worldwide) on healthcare.
- Your zipcode is more indicative of your potential health than your genetic code. That is, where you live is very important for your lifelong health prospects.
- “Merchants of Doubt” – title of book about how tobacco companies for many years exploited the fact that there was not 100% agreement on the harmful effects of tobacco to discredit the majority of evidence and block reform. The same strategies have been used by the petroleum industry to discredit the evidence of global warming and promote continued fossil fuel dependency.
- Because of fear of costs, people put off interacting with the healthcare system until they absolutely must. Postponed care = more expensive care.
- Worldwide: 6.6 billion telephone connections worldwide; 2.2 billion have broadband! One billion computers. There are more cellphones worldwide than there are toilets and toothbrushes!
- 50% of the population of India will never see a doctor their whole lives.
- Qualcomm, a multi-billion-dollar corporation, is sponsoring a $10million prize contest, for the design of a Star Trek-like “tricorder” device. To win, the device must be able to diagnose fifteen common medical conditions better than a committee of five physicians. This technical solution is more possible than ever because physicians don’t know their patient’s history/experience, and there is no multiple drug reconciliation among various physicians treating common patients.
- Doctors’ “house-calls” are becoming common again, because care delivered at home is cheaper than in the hospital. All records are available electronically. Through cellphones and electronic monitoring, patients are able to be diagnosed remotely.
10. “Alert overload” = when too many machines broadcast too many alarms. Doctors and nurses end up ignoring all of them. Patients die.
11. The “doctor shortage” is a perception problem. The healthcare system cannot be victim to one chokepoint (physicians). Care will be administered by nurses, physicians’ assistants, home care, clinics, and wearable electronic sensors, etc.
12. Violence in society exhibits characteristics similar to disease epidemics, and can be treated with the same approaches.
- Transmission: exposure to violence/disease leads to more violence/disease
- Geographic clustering/mapping is similar
- Prevent disease/violence relapse (i.e. retaliation)
- Disease & violence are both contagious
- Violence could be reduced by treating it through scientific understanding instead of simply regarding it as a moral issue (cf. epidemics/plagues = acts of god)
- Violence is the number one cause of death in young people in cities; number two overall in the country
- 13. Health journalists, e.g. Dr. Phil, Dr. Oz, Dr. Sanjay Gupta, deliver “infotainment” which reaches many more people than other healthcare education methods.
14. Emergency Room, aka Emergency Department (ED) care is expensive and not as good as primary care.
- 83% of ED visits are not acute emergencies
- 63% of ED patients don’t pay
- 22% come to ED for trauma, but only 3% get stitches and 0.3% are treated for broken bones
- More than 120 million ED visits in US in 2010
- Conclusions: ED visits are not just for emergencies; thus it’s necessary to increase the value of ED usage by decreasing the cost of care, improving visit outcomes.
15. 70% of people say they want to die at home, but 70% die in hospitals.
16. The medical article claiming that vaccinations cause autism was thoroughly discredited. Yet, many people cling to the false/fabricated premise. This is unfortunately the manifestation of societal scientific ignorance. It mirrors the false belief in some Moslem countries, e.g. Pakistan, that vaccinations are a Western plot against Islam. The result is the resurgence of polio, previously thought to have been eradicated via universal vaccination.
17. The retail store chains Target and Walmart are exploring the limits of healthcare delivered in a retail setting. They are applying retail research results to the healthcare choices offered. For example, it’s been shown that when a customer is offered more than ten choices for a particular item, they are less likely to choose any of them. They are overwhelmed. The ideal number of choices (as determined by market research) is six. Look on the shelves at Target: There will rarely be more than six different choices for a particular item. The same psychology applies to healthcare choices.
18. One doctor spoke about the experience of experiencing the deaths of patients on a daily basis. Life is fragile. A 1800’s Japanese haiku embodies this sentiment as witnessed on a typical humid morning:
A world of dew
A world of dew indeed
and yet…and yet…