Blog | Thursday, February 4, 2016

Disconnect between technologists and the real world of frontline medicine


I attended a health care networking meeting in a Boston suburb. The room was filled with interesting folk from a number of different backgrounds. After an informal breakfast chat among the attendees, we all settled into our seats to hear the presentations. The keynote speech, given by a well-known local entrepreneur, focused on his ideas for revolutionizing diabetes care. The presenter had a compelling and distinguished business career, and had now switched focus to healthcare. He seemed pleasant and sincere enough, genuinely interested in addressing some major challenges in diabetes management.

Indeed, anyone who knows anything about health care also knows what a huge public health crisis diabetes is. With soaring rates and the subsequent implications on morbidity and costs, it's certainly an issue we need to address. The presenter focused on his solutions to help improve peoples' compliance including wearables, mobile and cloud-based solutions, and the role of “big data.”

All interesting ideas, but I couldn't help thinking to myself as he spoke, that he was missing the main point of why we have an explosion of diabetes. At no stage did he spend any significant amount of time talking about diet, sedentary lifestyle or the association with other chronic conditions. It's all very well to invent solutions to improve compliance, but anyone who works at the frontlines of healthcare knows that the problem is much deeper than that. Why would the world of technology think that if you give people an expensive wearable device, they would suddenly become more compliant and motivated to improve their health? And if we're also talking about cost-containment, will billions of dollars spent on devices and technologies really suddenly make the population healthier?

The solution actually lies much closer to home. It would have been nice to hear him talk at least a little about the role of some simple common sense frontline measures, like more frequent appointments with physicians (and more physicians in the first place), nurses, health coaches, and a more intense focus on follow-up and education. Surely that may be cheaper too.

That's not to say that technology doesn't play a big role in the future, but spending precious resources and dare I say, enriching a few technology entrepreneurs along the way, must only be done if it's proven to actually work.

The best solution is likely to combine information technology with real life practical changes that get to the real root of the problem. This holds true for all major health care challenges we face.

Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care. This post originally appeared at his blog.