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Article: “Health care’s best bet: technology”

This article ran last week after I did a talk for one of the world’s leading heart research / hospital institutions, the University of Ottawa Heart Institute.

Health care is the most complex issue that our society faces in our time. We really need some big and bold and very innovative thinking to deal with the scope of the challenges.

Health care’s best bet: technology
Ottawa Citizen, May 16, 2012 

AT&T is developing clothing with built-in sensors that monitor blood pressure, perspiration rates and other health indicators. One smartphone app tracks every mouthful of food you eat. Another links to a device that monitors blood glucose levels in diabetic children as they sleep, and notifies parents through an alarm if they spike in the night.

As Jim Carroll would say, this is real stuff. This isn’t science fiction.

Carroll, a 53-year-old resident of Mississauga, is one of the world’s leading futurists. And as he told a room full of nurses at the University of Ottawa Heart Institute last week, technology is driving rapid changes in the way we treat the sick and care for our own health.

That’s a good thing, he said, given the health-care challenges we face. Chronic disease caused by poor lifestyles is driving massive future demands on the system. Society won’t be able to afford nursing home care for all the boomers who will need it. The number of people with Alzheimers and dementia is rising exponentially.

And because longevity is increasing — a baby girl born today can expect to live to 100, Carroll said — the elderly will need costly care for more years than in the past.

“Health care is the most complex issue that our society faces in our time,” said Carroll. “We really need some big and bold and very innovative thinking to deal with the scope of the challenges.”

Fortunately, there’s lots of that going on, it seems, largely driven by lightening-fast advances in technology. The cost of mapping the human genome has fallen from $3 million to $10,000 and is expected to fall to just $1,000 by year’s end.

“Five years out,” Carroll said, “we’ll be able to buy genomic sequencing machines for $5 at Circuit City. This is a staggering transformation.” That means increasingly, doctors will be able to shift from treating illnesses to preventing them, Carroll said.

Another key trend is “pervasive connectivity” — the notion that everything we own will be able to plug into everything else. In health care, that’s called bioconnectivity, Carroll said. And among other things, it can be used to monitor patients from afar.

One example is Medcottage, a 12-by-24-foot modular building that offers an alternative to institutional care for the sick or elderly in their family’s back yard. The unit provides round-the-clock medical monitoring while giving occupants some privacy and independence.

Ottawa’s heart institute already is using technology to monitor the health of about 150 elderly patients in their homes. Patients use the devices to record their blood pressure, heart rate and blood glucose levels, then plug them into their phones to download the information to the hospital.

The results have been impressive, said Heather Sherrard, the heart institute’s vice-president of clinical services. “The group that gets the home monitoring has anywhere between a 30 and 40 per cent reduction in the amount of times they have to come back to the hospital,” she said. Thanks to the remote devices, “we can see them every day and tweak them.”

The heart institute also uses automated phone calls to check up on patients who’ve had a heart attack. “You can’t financially afford to call everybody,” said Sherrard. “So the system does all the calling, it gives them a series of questions we know are based on evidence, and that allows us to just go ahead and deal with the 10 per cent who are the problem.”

One thing the hospital discovered is that about 40 per cent of patients were substituting Tylenol for their prescribed Aspirin, because they liked Tylenol more. But unlike Tylenol, Aspirin is an anticoagulant, which helps reduce the risk of another attack. “When you’ve had a heart attack, you cannot substitute Tylenol for Aspirin,” Sherrard said.

Canada still has a long way to go to catch up with the United States when it comes to innovative health-care thinking, Carroll said. He credited insurance companies with driving much of the innovation south of the border.

“I get insurance companies that are actively talking about rolling out wellness apps to employee groups,” he said. “It’s not going to happen in Canada, because they don’t control what we spend.”

That’s part of the debate we need to have in Canada, Carroll said. “We all love the Canadian system in terms of the structure and the fact that we don’t become bankrupt if we have a serious medical condition.

“But given the rapid rate of change and opportunity that is happening, we need to somehow figure out how to speed up innovation in the context of health care. Instead of just talking about wait times, we need to think really big.”


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