Visions of The Future of Health Care
The AcademyHealth Annual Research Meeting, which I recently attended in Minneapolis, Minnesota, represents the largest gathering of health services researchers in the country. It presents the opportunity for clinicians, researchers, and students to convene and share cutting-edge knowledge on health services research. Of the plethora of topics covered at the conference two stood out to me: the impact of the Affordable Care Act (ACA) on health care costs, and the use of information technology (IT) and Big Data in the future of the U.S. health care system.
The ACA aims to improve health insurance coverage and lower health care spending. The cost crisis in health care is ostensibly one of the most pressing issues we face today. Health care spending makes up a whopping 17.2% of the country’s GDP, but differences in political and economic viewpoints prevent much consensus on how to address the issue.
Various speakers at the AcademyHealth conference, most notably Melinda Beeuwkes and David Stevenson of Vanderbilt University, have analyzed the early effects of ACA from a cost-centric perspective. In their research they pay particular attention to the most costly aspects of our health care system such as post-acute and hospice care. They note a slowdown in the spending in these areas since the implementation of the ACA. There are many possible causes of this slowdown, and questions remains - are these changes due to the law, or are they simply endogenous changes in how the health care system provides care? Although it is possible that changes from health care reform have precipitated reductions in costs, it could also be that spending habits have changed and that care has naturally shifted towards more preventative methods of care.
The other topic that caught my attention at the AcademyHealth conference was Health IT and Big Data, and the increasing importance of mobile technology and social media for health care and medicine. The advent of electronic health records has given hospitals and providers unparalleled access to clinical data, and efforts are increasing to extend this to knowledge of patient populations. Big Data, extremely large data sets that can be analyzed computationally to reveal trends and associations, is already utilized heavily in various sectors of our economy, and can have positive impacts on the efficiency and quality of health care provision. The operational use of data could help for the creation of predictive modeling for patients, fill gaps in care, and provide the necessary access to health and insurance data to ensure low cost and high quality. Of course, the large collection of patient-centric data is not without risk, and measures will have to be taken to ensure the privacy and confidentiality of patients, as well as quality of the data.
As the U.S. health care system continues to evolve, especially with its renewed focus on population health, it’s necessary to utilize Health IT to coordinate care. Technological advancements also hold the potential of making the system more open to disruption and change by varied stakeholders (patients, providers, and other innovators).