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.