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WHAT IS MEDICINE WAITING FOR?
ADVANCING HEALTHCARE IN THE AGE OF TECHNOLOGY
Marc Dean, MD, FACS, FICSDecember 4th 2016
OBJECTIVES
• Highlight the role telehealth has played in outreach to Kurdistan and the lessons learned• Discuss barriers to the advancement of
technology in healthcare today.• Describe necessary steps and challenges
required to implement an integrated telemedicine program in todays healthcare landscape.
KURDISH HEALTHCARE DILEMMA
• Existing healthcare infrastructure and training is rudimentary at best
• KRG leadership currently sends >80% of citizens to other countries at the cost of 3 Billion Dollars a year.
• Overwhelmed by over a million Syrian Refugees
THE SOLUTION
• Nation wide Tele-Healthcare System• Central tele-health oriented tertiary
care medical center • Tele-medicine, tele-surgery
fellowships• Mobile tele medicine based regional
clinics.• Home based hospital care• Monitoring via wearables• Mobile nursing and ancillary
services
TELEMEDICINE TODAY
MAJOR BARRIERS TO ADOPTION OF TELEMEDICINE
Cultural • Physician bias • Patient bias, • Social differences
Financial • Equipment• Infrastructure• Sustainability
Regulatory • Licensure• Liability• Legality
EHR ADOPTION
43% HAVE REGAINED PRIOR PRODUCTIVITY LEVELS
31% HAVE EXPERIENCED A DECREASE PRODUCTIVITY
IMPACT OF EHR
27% OF PHYSICIAN TIME SPENT ON DIRECT CLINICAL CARE
49% OF PHYSICIAN TIME SPENT ON EHR AND DESKWORK ACTIVITIES
37% OF TIME WITH A PATIENT IS SPENT IN FRONT OF A COMPUTER.
CURRENT STATE OF MIND
THE LOWEST-RANKED REASON FOR PHYSICIANS TO ADOPT DIGITAL HEALTH TOOLS:
THAT PATIENTS DEMAND THEM“FROM INEFFECTIVE ELECTRONIC HEALTH RECORDS, TO AN EXPLOSION OF DIRECT-TO-CONSUMER DIGITAL HEALTH PRODUCTS, TO APPS OF MIXED QUALITY – IT’S THE DIGITAL SNAKE OIL OF THE EARLY 21ST CENTURY,” – DR JAMES MADARA, AMA CEO
SUPPLY AND DEMAND
20% of patients report difficulty accessing a primary care physicians.
33% of the physicians are PCPs today compared to 50% of physicians in 1960.
80% of physicians believe they are at capacity or over-extended.
43% of active physicians in the United States are age 55 or older.
Primary care shortage range between 14,900 and 35,600 physicians by 2025
Specialist range between 37,400 and 60,300 by 2025
Supply of surgical specialists is projected to decline by 2025
“The treatment of a disease must be completely impersonal; the treatment of a patient must be completely personal.” - Francis W. Peabody, MD
Sources of dissatisfaction - Poor EHR usability. - Limits of electronic
communication. - Regulatory and payment
compliance.Core Principles for success:- Integrates seamlessly with
traditional workflow- Improves outcomes, efficacy, or
reimbursement- Allows for complete diagnostic
evaluation- Provides avenues for effective
treatment
IF YOU BUILD IT . . .
TELE-DIAGNOSTICS TO
TELE-TREATMENT
11% of the global burden of disease can be treated with surgeryAccess to essential surgical procedures would prevent 1.5 million deaths a year.
TAKE HOME MESSAGE• Forced advances can have negative impact on
patient care when not implemented correctly• Patient safety, regulatory, and reimbursement
concerns are significant barriers in advancing medicine in the technology age.• Integrated partnerships and collaborations
between physicians and key players of industry, payers, and governing bodies are fundamental to a successful transition to a digital connected healthcare system.