Monday

[Healthcare] "The Hot Spotters" by Atul Gawande


"Can we lower medical costs by giving the neediest patients better care?"

In places like Camden and Atlantic City, they're changing the execution of health care. Doctors like Jeffrey Brenner (Camden) and Rushika Fernandopulle (AC) open clinics that focus on high-cost patients due to complicated chronic illnesses worsened by patient noncompliance ("hot spots"). Their clinics are stationed in low income areas and emphasize on high-touch, more personal care. Another unique thing they did was to hire social workers, hired from retail and service, not a healthcare background, called "health coaches" to stay in contact with patients through phone, email and visits.

Source: The New Yorker

It's a great read if you can spare some time. It is quite long, but it gives a new perspective to healthcare.

Some IT companies compile all the medical history of patients through insurance companies and they can analyze the health patterns. Analyzing this data, doctors can better evaluate their patients, especially when they visit various doctors. Of course, there'd be issues like HIPAA, but this information will improve (and potentially reduce the cost of) healthcare. Healthcare must focus on quality one patient at a time to reduce overall healthcare costs. We must move away from the attitude that "one man’s cost is another man’s income" and move toward one that rewards quality and keeps patients out of the hospitals.

Also, this shows that there seems to be a potential market in innovating products to improve patient compliance, especially in areas of low socio-economic classes. For example, patient education, alarms or devices to help enforce proper medication intake, off-loading of diabetic foot ulcers, refilling asthma inhalers, managing blood-sugar levels, understanding the on-set of a heart attack, etc.


Another area of innovation is continuous monitoring. There are plenty of medical devices with wireless technology that periodically sends information to a smart phone, computer or the doctor's office. These devices will become more common in the near future like implantable blood pressure monitors (Source: MIT Tech Review).


Or, you can listen to a talk by Dr. Gawande.
Source: NPR

And then the critics of the widespread use of this program, the Defeatists, Catastrophists and Triumphalists, and Dr. Gawande's responses.
Source: The New Yorker