By LAURA LOREK
Founder of Silicon Hills News
But what happened to all the innovations in healthcare that allowed technology to be embraced, Dr. S. Claiborne “Clay” Johnston, Dean of the Dell Medical School, asked during a keynote lunch address at InnoTech Austin.
“Healthcare is really Moore’s Law in reverse,” Johnston said.
Moore’s Law states computer processing power doubles nearly every two years. That makes innovations easier and cheaper and leads to dramatic advances in computing.
But that hasn’t happened in the healthcare industry, Johnston said.
“Healthcare, it’s really a broken system,” he said. “It’s really a broken innovation system.”
Johnston presented a list of ten reasons why the healthcare system is broken including the costs of care are out of control, no one pays for prevention and it’s tough to find a doctor.
When Johnston moved to Austin it took him several months to find a good pediatrician.
“If I wanted to find a great Italian restaurant that has a table for four tonight and I can see reviews and they make a great tiramisu, right now I can make that appointment,” Johnston said. “I can’t find any information about a doctor who is taking new patients. Are they any good? Do people like them? Which is more important? “
The system is also broken because no one reminds patients to take their medicine, office visits are shorter and shorter and flu management requires a doctor’s visit even though the doctor can’t prescribe any antibiotics to make the patient better, Johnston said. It would be much easier to diagnose the patient through email or through a phone call, he said.
“We force this really, really inefficient process on everyone that no one benefits from,” Johnston said.
The system is broken because vending machines have all kinds of bad junk food and sugary drinks, Johnston said. People can’t find apples in vending machines, he said.
Doctors are spending more time documenting patients than spending time with them, Johnston said. All of those documents don’t benefit the patient or the doctor, he said. And patients can’t email their doctors, he said. Instead, the system forces an office visit on patients, he said.
Also, Johnston mentioned those pesky hospital gowns that expose a patient’s rear end to everyone as the number one reason the healthcare system is broken.
“This is in jest, but it’s actually real,” Johnston said.
Doctors and nurses don’t have to access a patient from behind, but from the front, he said. Where they came from, no one knows, he said.
One of the big divides in healthcare right now is the difference between what is research and what is care, Johnston said.
The goal is to create a better ecosystem for healthcare and increase value for society with better health outcomes for less money, Johnston said. The system must encourage innovation, he said.
At his former job at the University of California at San Francisco, Johnston created an online platform to crowdsource suggestions on how to improve the healthcare system in the hospital. They got 144 ideas. They narrowed it down to 20 proposals. Then they created teams to implement three selected proposals on switching drugs from intravenous to oral administration, from expensive respiratory treatments to inhalers and to prevent the overuse of blood products. They spent $35,000 gathering data on blood transfusions and analyzing it. They were able to use the data to educate the physicians and others in the department on over use of blood products. Overall, they spent $220,000 on three projects and got a return of $11 million in savings in two years, Johnston said.
“That’s a pretty good return on some projects,” he said. “And the program continues and grows….the system has worked so successfully it has been implemented in other places in San Francisco.”
“The key with it, it created a way to get a funding stream to start to do the right thing within this broken ecosystem,” Johnston said.
The bigger priority is to look at the city’s health and improve the community overall, Johnston said.
Very few cities have taken a snapshot of the health of its citizens, Johnston said. San Francisco analyzed the data. And it provides a framework for prevention and intervention, he said. Johnston hopes to do the same thing in Austin to provide a snapshot of the health of its citizens.
To change the system, value has to be embraced by the medical institutions, doctors and patients. Doctors shouldn’t given unnecessary tests and MRIs.
Austin needs better data, Johnston said. And all of the stakeholders need to be brought together to work on improving the system, he said. And doctors need better training, he said.
The ultimate goal is to push Austin as a model of a healthy city, he said.