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OCTOBER, 2018

Modern technology
Vested interests
Secrecy

Heath technology is hot, right?

Virtual Reality to take elderly people back to a past they feel comfortable with. Artificial Intelligence to crunch big numbers for big pharma. Affordable genetic testing to give everyone a glimpse into their future.

Before you get carried away with the hype, here are five things that you didn’t know about health technology.

S o, you have decided that you want to use new, innovative health services.

That’s great. You are taking control of your body.

Now, where are you going to find it?

There is currently no eBay or Alibaba for health technology. You might find a simple fitness or weight monitoring device. But software to help you improve your speech after a stroke, or a smart walking frame will not be sold on Amazon.

You could try a Google search. But what keywords are you going to use? Healthcare? Technology? All you are likely to see is ads for health insurance and large technology companies.

Despite being the biggest disruption in the history of Western medicine, health technology doesn’t even have a website to sell it’s wares direct to the public.

The first thing you will discover in your search for health technology, is that it’s like a unicorn.

Almost impossible to find.

Y ou turn to your Doctor, a trusted source of medical advice. You ask about him or her about health technology. What should you use? The response will come as a shock.

Like patients, if Doctors want to know anything at all about health technology, they have to resort to Google searches.

Their clinic software doesn’t automatically supply them with a list of the latest health technology services, all sorted nicely into medical specialties.

If Doctors are tech savvy, they will probably know about one or two personal-interest sites run by Doctors, that advertise a small number of diagnostic apps.

It is very unlikely that they will know about the startup and entrepreneur networks that pick up on new innovations, as they come on to market.

And they would never have the time to read through dense, industry focused hospital-technology websites.

The British Government has cautiously set up a NHS apps library, where it displays a very limited amount of health apps, that has been approved as ‘safe’ by an army of bureaucrats.

Both Governments and health insurers tend to view modern technology like a tiger. Inherently dangerous, a threat to public safety and always needing to be ‘controlled’.

The fact is that modern health technology is far superior to current hospital technology. Very few of the errors that currently plague the health industry would occur, if modern technology was made compulsory.

The second thing to realise is that Doctors and patients are both in the same position when it comes to health technology.

In the dark.

A fter scouring the internet and pestering your Doctor, you finally found the app, smart device or home alert system that you need.

Congratulations.

Now, how are you going to pay for it?

Government and health insurers are very unlikely to cover the costs of personal health technology products.

No matter how quickly they speed your recovery from a serious illness, or help keep you out of Emergency Departments.

Healthcare has traditionally been a third party payment system. Governments and private insurers do deals with large companies, then ration out their products to patients who are covered by their plans, as they see fit. Decisions about cost and quality are not made by the end users, patients or Doctors.

Governments and insurers are passive purchasers. It’s not their money. It’s not their bodies.

They also have no way of knowing if the products they are buying are effective and affordable.

The billing system for the health industry is based on a massively complex pay-per-item system.

One blood pressure = $5. One blood test = $10. One ECG – $50. As overall treatment payments are not bundled together, health payments can’t be linked to positive outcomes.

One hospital admission for a hip fracture resulting in surgery and a week of recovery, will trigger thousands of separate billing codes, all of them unrelated.

A great hip replacement in one hospital and a terrible one in another, will result in the same amount of money being paid out. There is no financial incentive for hospitals to improve.

The third thing to learn, is that you will have to pay for your health technology, out of your own pocket.

Even if it is far more effective and cheaper than anything used by busy hospitals.

F inally, you have decided to use health technology, spoken to your Doctor, found the product you want and paid for it. Your health is improving and you are very happy.

You are relieved to be able to predict blood sugars for the next 8 – 10 hours, using an algorithm. Or you have found a surgeon that does an anterior hip replacement, with a hospital stay of overnight and minimal rehab. Perhaps your mother is in a nursing home using smart incontinence pads. Or a chronically unwell family member is now using a home Intensive Care program.

How can you share your great experiences with others?

You could try contacting a health consumer group.

However, these groups are often very conservative, with a pro-traditional medicine and anti-technology slant.

They are good at seeing sick people as passive recipients of health services, or unlucky victims. But not good at seeing them as pro active consumers who can learn about new technology and go on to improve their lives.

The Government or health insurer didn’t pay, so they are not likely to be interested in your positive experience.

Having gone through this big journey, your only option is to share your experiences on your own, personal, Facebook page. Public forums and blogs discussing people’s experiences of health technology don’t yet exist.

The fourth thing you will discover is that it is very difficult to stop others being left in the dark, as you once were.

A nd finally, you see the founder of your app or smart device, being interviewed on uTube. You listen to their journey, identifying problems in healthcare and create their own unique solution. And then you hear them talk about the difficulties bringing it to the market.

‘We are struggling to reach our customers. It’s very difficult to get Doctors to write reviews. Governments and health insurers are happy with bricks and mortar services and traditional products that cost more and do less.’

Startup founders can be frustrated and confused. Isn’t it obvious that what they have to offer is faster, more accurate, lower cost and solves important problems?

This is what makes healthcare so different to other industries. The perverse incentives keep costs high and productivity low.

The fifth and final thing you didn’t know about health technology, is that both buyers and sellers have the same problem.

They lack a way to connect with each other.

W hile health technology is futuristic and full of promises, unless sellers can be connected to customers, you might be in a nursing home before you get to actually use it.

Which is why Wikihospitals is setting up an online store for health technology.

Health reform doesn’t have technology problem.

It has a vision and a business model problem.

@Wikihospitals October 2018

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