On Thursday, the Supreme Court delivered its ruling as to whether the Affordable Care Act (ACA), which was shepherded — some would argue force-fed — through Congress was constitutional. In a complex ruling that arrived amid a flurry of confusion, the High Court upheld the individual mandate, which rested at the heart of the law. Now, it is time to look forward to how we can indeed do what is right and provide health-care coverage for everyone. Many people are pessimistic that health care will consume a disproportionate share of our national resources, but I see a reason for optimism.
There is a path to correcting the fundamental problem of health-care costs, and it is carved by technologies that are advancing so rapidly it may now be possible to make health-care abundant and available to all. But we need to focus our energies on harnessing these rapidly emerging technologies and removing bureaucratic and overly burdensome regulatory hurdles.
Vivek Wadhwa
Vivek Wadhwa is Vice President of Innovation and Research at Singularity University and Arthur & Toni Rembe Rock Center for Corporate Governance at Stanford University. His other academic appointments include Harvard, Duke and Emory Universities as well as the University of California Berkeley.
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Let’s start with medical records. One of the least controversial parts of the ACA was the incentives to bring health records online. Electronic medical records (EMRs) not only improve record keeping, reduce medical errors, and provide quick access in emergency situations, they also provide the data necessary to analyze health information across populations and improve medical care. Imagine being able to do Google-esque searches to determine which medications people with certain diseases took, and the results those medications achieved over time. Daniel Kraft, a Harvard and Stanford trained physician and my colleague at Singularity University, says that we need more programs like the Health and Human Services Health Data Initiative, and public-private collaborations like the recent Health DataPalooza’s (held June 5-6 in Washington, D.C.), to bring new innovators, energy and ideas into leveraging the massive amount of new data that will be available from EMRs and the data sets that the government is making available.
And then there are smartphones, which are rapidly increasing in capability and are becoming health-care platforms. An example is the iPhone case that I have been testing as part of a clinical trial, which turns my phone into an EKG monitor and automatically transmits data to a cardiologist. This case is being developed by a startup called Alivecor. If approved by the FDA, this product will allow heart patients to check their symptoms whenever they want, wherever they are, and get quick feedback from their doctor. The product is expected to cost $100 or less—which is comparable to the cost of a single EKG test today.
With health data captured and transmitted from outside of the traditional health-care setting, vast improvements in feedback loops and outcomes can be achieved. Take hypertension as another example: according to the Centers for Disease Control and Prevention, 32 percent of American adults have high blood pressure, yet less than half are adequately controlled (with their measured numbers reduced to a safe range), resulting in significant morbidity and mortality rates (i.e. from strokes, vascular disease). Now, for less than $100, one can purchase a mobile phone-enabled blood pressure cuff, and a patient can easily measure, track, visualize and share their blood pressure readings. They can also enable optimization of interventions be they diet, exercise or drugs. Significant downstream savings can be achieved through such smart innovations, but they need to be integrated and reimbursed with the health-care system to fulfill their capability.
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