Medicine and Electronic Medical Records are way overdue for improvement/disruption.
My analysis is that the primary barrier is the economic model most practices operate under is focused on insurance reimbursement not patient satisfaction or outcomes.
My hypotheses for this area that the starting niches for truly disruptive offerings would be doctors or medical practices that:
- are paid directly by their patients
- are focused directly on outcomes (and/or measured on outcomes) and therefore have an incentive to improve outcomes
Here are a couple of areas to consider:
- Cosmetic Surgery – direct pay for most part. Huge productivity improvements in laser eye surgery for example.
- Veterinary Medicine – direct pay, robot doctors for dogs will take another decade or two to make it to mainstream (probably via military applications first)
- Workers Compensation for companies that are committed to “return to work” not “medical cost minimization.” Here the focus is on evidence based medicine that gets results to allow employees to return to work.
- Military (enormous innovation in surgical supply chains in Iraq theatre as an example, Atul Gawande goes into some detail in “Better” about how much better medical personnel in combat zones maintained patient info than anything he had seen in private practice. and it has had an enormous impact on patient outcomes).
One good blog in this area is by Jay Parkinson, MD who has now started a design and consulting firm for health: The Future Well.
One other interesting development is the “Archimedes Model” developed by Kaiser. It brings the same simulation (or in silico biology) modeling approach to modeling health care decisions that is used for the design of complex systems on a chip.
The Archimedes Model can analyze a wide variety of questions for health care decision makers that would be impossible to address empirically because of the enormous cost, number of people, and time required. The Model provides a method to explore important questions at a fraction of the cost and time of empirical methods, with a high degree of realism and accuracy.
The Archimedes Model is fully customizable and can be tailored to represent the population of a region, a target market, or even an entire country. Clients can also provide their own data to represent processes, behaviors, and costs customized to their settings. The Model addresses the full range of variables and outcomes that are important in making healthcare decisions:
- Clinical physiology, biomarkers, signs and symptoms, clinical outcomes
- Prevention, screening, diagnosis, treatment, follow-up care
- Physician and patient behaviors, performance, and compliance
- Protocols, guidelines, practice variations
- Delivery systems, logistics and utilization
- Quality of life
- Financial costs