Exponential Medicine for Dummies

exmed

 

October 8-11, San Diego

I had the privilege of attending Singularity University’s 2016 Exponential Medicine conference. XMed features brilliant faculty with expertise in genomics, nanotechnology, robotics, longevity, and cutting edge oncology, to name a few.

I am none of those things. The neophyte in a sea of intellectual giants.

I tend to focus on nuts and bolts problem solving. I left the conference with two fleeting questions:

How do we harness all this knowledge and technology to make the big healthcare impact in the U.S.?

Then, How will we pay for it?

XMed is about solving problems on the population health and global health landscape. The biggest population health challenge in the U.S. is finding a way to implement effective preventative care for high risk patients.

The U.S. has 150 million+ Americans  facing chronic health issues. How do we change the behaviors of individuals? The changes seem easy on paper but very hard in action: nutrition, lifestyle, sleep, and social conditions.

The last decade brought the “appification” of healthcare- wearables are increasingly getting better (AliveCore ECG wristband), big data tracking, personalized medicine, all of which seems beneficial for health optimizers. But the tech has not impacted the high risk chronic condition populations that cost our health system trillions of dollars.

Many of the faculty addressed the need for a paradigm shift. Patient centered care was a core concept in many presentations, including Dr. Stefano Bini, who championed a model of Provider as Coach.

patient-centered-care

The Provider as Coach or Patient Centered Care emphasize a team based approach, with physicians, nurse practitioners, registered dietitians, case managers, etc., working together to improve outcomes.

Dr. Stanley Shaw, of Harvard’s CATCH, criticized the medical community for only focusing on physical science. Physician’s don’t like to talk about behavioral change because it’s harder to measure, label and “treat.” Dr. Shaw challenged the status quo encouraging multidisciplinary teams to implement population health interventions with evidence based behavioral change techniques.

Non-medical fields have made huge strides in the science of behavioral change and decision making. Perhaps the best approach is to expand who we include in the modern healthcare team. it’s time for the physical science of medicine to better integrate with psychiatrists, psychologists, and perhaps behavioral economists to make population health interventions more effective.

As Dr. Mark Hyman noted, one of the founders of Functional Medicine, interventions that involve health coaching have a 70% success rate, while interventions with only physician instruction leaving the patient individually accountable lead to only a 10% success rate.

The U.K. is battling many of the same chronic health issues as the U.S.

Tony Young, National Clinical Director at NHS, is driving change in the U.K. by leveraging NHS procurement, how the country pays for the healthcare of all U.K. citizens, as a way to vet and support innovative companies and ideas that actually lead to better outcomes. This seems like a novel concept as the U.S. continues a decade long attempt to define value based reimbursement.

XMed attendees included many innovative companies tackling my “How?” questions.

One example, wellness company Arivale, trains it’s dietitians in behavioral change techniques to help guide clients to healthier outcomes over the long term.

Other XMed Innovators included several standouts in remote patient monitoring and communication, offer resources supplementing frontline providers to engage with patients more regularly leading to long lasting health outcomes and provider reimbursement.

Despite thousands of high-tech intervention ideas in healthcare, as Dr. Lucien Engelen pointed out, text messaging remains the most scientifically validated intervention tool. So, how will we change population health? Our patient care team psychologist will text you.

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While at XMed I had the pleasure of speaking with GuideWell on this topic. GuideWell is an incredible catalyst for innovation in better care delivery and a better way to pay for valuable care.