Overcoming Massive Cost, Complexity, and Non-Coordination Problems in Current Health Care Systems
Approximately 50 years ago, health care was simpler with general practitioners mainly being male, diagnosing diseases based on experience, and often working from home without much support staff. Today, health care faces serious challenges due to increased cost, complexity, and lack of coordination. The content discusses how modern systems can break down and explores futuristic health care problems.
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Presentation Transcript
Topic 1: Overcoming Massive Cost, Complexity, and Non-Coordination Problems in Current Health Care Systems the Serious Challenge We Face Topic 2: Discussion of important futuristic health care problems Walker Land, Dave Schaffer, Michael Walker Land, Dave Schaffer, Michael Hultner Hultner
Content O 50 years ago 50 years ago O What we had 50 years ago What we had 50 years ago O How about today? How about today? O Patient treatment today Patient treatment today O How modern system may break down How modern system may break down O How might CAS help? How might CAS help? O Serious Serious cost problem+ futuristic health care cost problem+ futuristic health care question question- - Dr. Michael Dr. Michael Hultner O Serious Serious complexity problem+ futuristic health care complexity problem+ futuristic health care question question- - Dr. J. David Schaffer Dr. J. David Schaffer O Q and A period Q and A period Hultner
50 years ago O Approximately 50 years or so ago, Approximately 50 years or so ago, health care was much simpler than it health care was much simpler than it is today. is today. O Today, irrespective of the medical Today, irrespective of the medical discipline or level or location around discipline or level or location around the world, health care is the world, health care is O more (1.) costly, (2.) complex, and more (1.) costly, (2.) complex, and (3.) uncoordinated (3.) uncoordinated. .
What we had 50 years ago O Most general practitioners were male Most general practitioners were male O Mainly diagnosed diseases among their patients based Mainly diagnosed diseases among their patients based on experience on experience O Then dispensed pills themselves and /or wrote Then dispensed pills themselves and /or wrote prescriptions to pharmacies prescriptions to pharmacies O Generally conducted their practice from their home Generally conducted their practice from their home O Did not have a support staff beyond a wife/husband, Did not have a support staff beyond a wife/husband, who was generally the nurse, bookkeeper, mail clerk and who was generally the nurse, bookkeeper, mail clerk and the office staff the office staff O Worked long hours Worked long hours O Totality of problems Totality of problems described totally in terms learned in described totally in terms learned in medical school many years earlier medical school many years earlier
How about today? O Today patient may well find himself / herself in a Today patient may well find himself / herself in a clinic, a walk clinic, a walk- -in in surgi surgi- -center, or emergency room center, or emergency room O Only because Only because a computer driven admissions system, a computer driven admissions system, or a nurse practitioner, a care coordinator, a or a nurse practitioner, a care coordinator, a physician s assistant and maybe physician s assistant and maybe even a real doctor said he or she should be there said he or she should be there O Based simply Based simply on the patient s answers to a form on the patient s answers to a form questionnaire during a current and/or previous visit. questionnaire during a current and/or previous visit. even a real doctor
Patients Treatment Today O Treatment: Treatment: Treatment today dictated by the Treatment today dictated by the evidence evidence O Evidence Evidence: This evidence is a shared : This evidence is a shared management decision regarding the management decision regarding the patient s particular illness. patient s particular illness. O Solution Solution: Solution to patient s problem is : Solution to patient s problem is less likely to come from a prescription bottle, less likely to come from a prescription bottle, but may well come, instead, in the form of but may well come, instead, in the form of highly disciplined services of a highly disciplined services of a multidisciplinary team multidisciplinary team
Modern system can break down O Regrettably modern system often Regrettably modern system often breaks down. breaks down. O Experience of ever Experience of ever- -increasing (1.) cost, (2.) complexity, and (3.) non (2.) complexity, and (3.) non- -coordination O In both practical and personal terms ( in In both practical and personal terms ( in today s health care delivery systems) today s health care delivery systems) leads to leads to frustration frustration and, in more and, in more extreme cases, disillusionment cases, disillusionment. . increasing (1.) cost, coordination extreme
How might CAS help? OHow might complex adaptive systems How might complex adaptive systems (CASs) help address these challenges (CASs) help address these challenges in the ever increasing :(1.) cost, (2.) in the ever increasing :(1.) cost, (2.) complexity, and (3.) non complexity, and (3.) non- -coordination of health care? health care? OLet s Let s summarize summarize some of the possible some of the possible ways as stipulated the following three ways as stipulated the following three categories described as follows categories described as follows: : coordination of
How might CAS help? O (1) CASs provide important concepts, as well as tools, for (1) CASs provide important concepts, as well as tools, for responding to many of today s health care challenges by using responding to many of today s health care challenges by using them as the foundations for them as the foundations for developing highly precise decision developing highly precise decision- - support support- -systems (DSS), systems (DSS), O (2) CASs also provide (2) CASs also provide new and adaptable frameworks new and adaptable frameworks, which incorporate dynamic, emergent, intuitive and non incorporate dynamic, emergent, intuitive and non- -intuitive, and creative methodologies to replace traditional methods and creative methodologies to replace traditional methods based primarily on experience and educated based primarily on experience and educated- -guesswork , O (3) CASs also provide an (3) CASs also provide an integration methodology integration methodology for combining the use of all kinds of data, including clinical combining the use of all kinds of data, including clinical practice, organization, information sharing and management practice, organization, information sharing and management O (4.)CDSS research translated into clinical practice (in terms of (4.)CDSS research translated into clinical practice (in terms of operational second operational second openion openion diagnostic aids) , as well as diagnostic aids) , as well as professional development data (all of which are unique but professional development data (all of which are unique but interdependent), that are produced around interdependent), that are produced around self systems that learn from environment adaption. systems that learn from environment adaption. , which intuitive, guesswork , for self- -adaptive adaptive
Question: Question: How can CAS s help in How can CAS s help in reducing the ever increasing reducing the ever increasing (1.) cost, (2.) complexity, and (1.) cost, (2.) complexity, and (3.) non (3.) non- -coordination coordination problems of today s health problems of today s health care systems? care systems?
Serious Cost Problem+ futuristic health care question O This This serious cost problem serious cost problem will be addressed head head- -on using a CAS on using a CAS- -based decision support support- -system (DSS). system (DSS). O And will be presented by Dr. Michael And will be presented by Dr. Michael Hultner O Michael will also address the following Michael will also address the following question: question: Assuming that efforts to create new Assuming that efforts to create new life forms are successful, how will these new life forms are successful, how will these new life forms effect humanity life forms effect humanity O He will also integrate these two topics He will also integrate these two topics will be addressed based decision- - Hultner
Serious Complexity Problem+ futuristic health care question O The serious complexity problem will also be The serious complexity problem will also be addressed head addressed head- -on using a CAS on using a CAS- -based decision decision- -support support- -system (DSS). system (DSS). O This topic shall be presented by Dr. J. David This topic shall be presented by Dr. J. David Schaffer as well as addressing the topic : Schaffer as well as addressing the topic : How can, say, can, say, medical research medical research transition from the current defensive based medical approaches current defensive based medical approaches to validated outcome based approaches? to validated outcome based approaches? O He will also integrate these two topics He will also integrate these two topics. . based How transition from the
Q and A Period O In the early 20th century the average life span was around 31 years [Wikipedia,]. O Today, it is almost triple with many countries have citizens living to 100 and over. At the same time, many developing and under- developed countries cannot adequately feed their growing populations. O There are great variations in life expectancy between different parts of the world, mostly caused by differences in public health, medical care, and diet. The impact of AIDS is particularly notable on life expectancy in many African countries [Wikipedia] . O With all the advances made and being made in medicine and health care practice, it is a reasonable assumption the at the beginning of the 22nd century, the average life span may well be between 200-250 years ( I have heard estimates of up to 500 years), leading to a significant worldwide over population. O These collective conditions, given that they might occur, leads, again, to the following question: How do we balance medical advances with the cost of an aging global population? advances with the cost of an aging global population? How do we balance medical
