A Tech Revolution Is Quietly Taking Place In Healthcare

While policymakers, and the country, struggle over challenges facing and created by the Affordable Care Act, real healthcare reform is happening almost completely outside of that loop, driven by technology and innovators, many of whom are from outside the healthcare industry.

Health IT or Digital Health-the generic terms used to describe these disruptions that include the use of mobile devices and telemedicine, among other changes-are breaking almost every standard healthcare paradigm. It's that "creative destruction" that economists frequently refer to, transforming how care is delivered, received, tracked, paid for and even understood.

And unlike traditional healthcare, where the more money you have the more healthcare your get, the health IT revolution largely ignores those barriers. That's because the poor have mobile devices in almost similar numbers to the rich.

According to the Pew Research Center, 90 percent of U.S. adults have cell phones. And while about 99 percent of those making above $50,000 are cell-phone users, 90 percent of those between $30,000 and $50,000 and 84 percent for those making less than $30,000 also have them.

Medical services and products are reaching out to patients, especially through their mobile devices, transforming these mobile devices into a new type of medical home.

Physicians and other healthcare providers used to be at the heart of the healthcare system-driving all of the decisions, monitoring patient care, determining the best therapies, and serving as gatekeepers to hospitals, tests and prescription drugs.

But increasingly it's technology-empowered patients who are at the heart of the system. While they aren't doctors, nurses or case managers, they have access to information that once was only available to healthcare providers.

Technology is also encouraging better self-care. A few years ago the Institute for Policy Innovation hosted the "iPhone Physical of the Future" at one of its communications briefings. A Johns Hopkins Medical School student demonstrated on volunteers how easy it is to monitor many of your vital signs using only an iPhone and some relatively inexpensive adaptors.

Smartphones can track those stats, assess them and forward them to your doctor if something is amiss.

National Public Radio recently aired a story about how researchers at the University of Texas at Arlington are exploring a high-tech apartment where "health-tracking technology is built into the appliances, furniture and even the floor."

We are entering the age of any "anytime anywhere care."

But access avenues aren't the only factors seeing disruptions. We normally think of a prescription as a device, pill or injectible, but now there is mobile prescription therapy (MPT)-software as a drug or medical device.

The U.S. Food and Drug Administration has already approved one mobile app for such use-BlueStar, which targets type 2 diabetes. A healthcare provider must order it, a pharmacist can supply a code to download and activate it on a mobile device, and insurance can cover the cost. The outcomes patients derive from its use are better than those derived from most drugs in diabetes alone. And a significant drop in ER visits and hospitalizations through use of the product signals a big dent in healthcare costs.

But how do we turn increased access to care into better and more affordable care?

First, those devices and apps that go beyond information and actually play a role in providing care should go through the appropriate approval process to demonstrate both safety and effectiveness. Depending on the therapy, that could mean double-blind, placebo-controlled studies, or a note to file with the regulatory agency. A company can't just claim its product improves quality; it needs to demonstrate it.

Second, the innovation and competition that have been the hallmarks of the technology industry will help drive lower costs. In healthcare, once a drug or device is invented, it seems the prices only go up. In technology, once a product or software is invented, the prices only seem to go down. Fortunately, technology is driving this new healthcare revolution. Letting engineers and entrepreneurs invent and compete is the best way to change the old health system paradigm.

Third, the government must refrain from its worst impulses. Health IT innovations will be disruptive and will likely change the way we think about and practice healthcare. Those whose companies and industries are being disrupted often complain to government and elected officials in an effort to disrupt the disrupters. Government can be a catalyst for change, but it can also be a roadblock.

But government is also a consumer of healthcare. Medicare and Medicaid finance the care of more than 100 million Americans. And the government is providing subsidies for millions more through the Affordable Care Act. No entity will benefit more from this new healthcare paradigm, saving taxpayers billions of dollars while improving health outcomes.