“Keep Austin Weird.” It’s a slogan the Texas capital city adopted in 2000 to promote small business, and the South by Southwest Conference fully embraces that vibe, including in its health care track.
Health-related sessions during the nine-days included some carrying the titles: “A #)$%(*% Crisis: Training the Newest Gen of Docs;” “Advocating VR (virtual reality) and Gaming in Hospitals;” and “The Return of Psychedelic Research in America.” And although many of the health sessions were pitted against the likes of actor Julia Louis Dreyfus (of Seinfeld and Veep fame) there were still a number of attendees from various backgrounds eager to learn and talk about important issues in health care.
A theme that came up frequently is the disconnect between physicians and patients, which was reflected in a number of ways at various sessions. I saw speakers describe such issues as the contrast between physician-oriented health goals versus what a patient wants, and how docs view technology within the care continuum as opposed to the on-demand instant tech-based care consumers want. Many audience members grappled with how health tech could help close that gap, while other sessions suggested that disconnect must be tackled at the foundational level with the way we teach future physicians.
After wandering around Austin looking for weird, and sitting in on as many health-focused sessions I could, here are a few takeaways that stuck with me:
Technology Can Be Powerful
It seems obvious, but an afternoon session demonstrated, first-hand, the true power technology plays in affecting health. The session revolved around neurotechnology and the impact it has on people living with a disability.
“It’s an exciting time …. You’re witnessing tremendous technology here, now, in the halls, as you’re walking the exhibits, said Ali Rezai, M.D., associate dean of neuroscience and the director of the neurological institute at the Ohio State University’s Wexner Medical Center.
On the same panel as Rezai was quadriplegic Jennifer French, executive director, Neurotech Network, who was injured in a 1998 snowboarding accident and demonstrated what technology can do. French flipped a small switch on a little black box attached to her waist and almost instantly her back straightened and she sat upright with perfect posture.
The little black box, called a neuroplastecis, connects to electrodes inside the muscles and nerves in her body. After she flipped a different switch on the box, French grabbed the walker in front of her and was able to stand upright with the slight help of her arms.
“You’re challenged to keep yourself healthy,” she said. And advancements like this help her to stay active and limit other chronic conditions associated with paralysis.
Disconnect Between Providers and Patients
Patients and providers don’t always see eye-to-eye, but as patients get increasingly involved in their own care, the large divide has to be narrowed. For panelists and audience members during a session I blogged on previously, that starts with health tech.
“Many in the room will think of this as heresy, but imagine a snapchat type interaction with your physician,” proposed Nick van Terheyden M.D., chief medical officer, NTT Data (formerly Dell). Care needs to move toward where consumers are, and clinicians need to be a part of that, he stressed.
But, many providers don’t have the same feeling, said Kristi Henderson, vice president of telehealth and innovation at Seton Healthcare Family, part of Ascension Healthcare. “Tell that to your health team,” she said after someone from the audience agreed with Terheyden. “I hear from clinicians that their patients don’t want that.”
Another session that focused on the cost-of-care made that divide even more clear. “Right now, no matter how good your doctor is, there’s a question that they are unlikely to be able to answer for you,” said Chris Moriates, M.D., assistant dean for healthcare value and associate professor of internal medicine, Dell Medical School at The University of Texas at Austin. “And that is, how much will that cost me?”
Health care costs are usually unknown by doctors and patients alike, but, often come up as one of the top priorities for patients. Similarly, patients don’t want to go to the pharmacy and have to choose between medicines because they can’t afford them all, and docs can’t help patients if they aren’t following recommended treatment plans.
“We feel like as an organization we’re at a pivot point,” said Neel Shah, M.D., assistant professor at Harvard Medical School, who is also founder and executive director at Costs of Care, a global nonprofit that curates insights to improve health care and lower costs.“I think at the point of care there’s probably an opportunity to provide some kind of guidance that could allow us to become more consistent and at least help us structure how we can have these conversations with patients,” said Shah.
Even incorporating these three questions into patient visits can help bridge that communication cost gap, says Shah.
- Do your medications cost too much?
- Have you ever cut back on medications because of cost?
- Have you ever cut back on other things due to high drug costs?
The Kids are our Future
And that brings us to the final, succinct point. It’s hard to retrofit a health care system that has been operating with an army of clinicians entrenched in a largely fee-for-service model with a new value-based strategy. If health care wants to truly move into the value-based world, it needs to change the thinking of the future physicians.
Erin Kane, M.D., a physician in the department of emergency medicine, Johns Hopkins, put it this way: "There are these huge forces in health care and to be able to make change in health care medical students really need to understand the broader health care system, and that's where I think there's a role for more education."
I'll be writing an extended feature on this topic in coming months, if you'd like to discuss it, email me at email@example.com.