Inoculating Health Care Against the Status Quo
WHY YOU SHOULD CARE
Could this be health care’s moment in the sun?
Leerom Segal is co-founder and CEO of Klick Health, a consultancy that focuses on health, business and tech.
Fifty years ago, President Lyndon Johnson boarded Air Force One, flew to Independence, Missouri — Harry Truman’s hometown — sat down at a small table surrounded by smiling politicians and, with a few strokes of his pen, signed an innovative idea into law. The law was Medicare.
There are those who would argue that Medicare and innovative do not belong in the same sentence. But back then, the law absolutely disrupted the status quo. And that should be our goal today — to inoculate health care against the status quo. Which is one reason, among many, to support the 21st Century Cures Act, a bill with strong bipartisan support that the House of Representatives is debating this week. The legislation aims to modernize health care and streamline the FDA-approval process — and give both the FDA and the NIH the resources they need to do it.
Some have argued that the drug-approval process is already pretty efficient and that hastening it would pose risks to patients. Caution and innovation must strike the right balance, of course — health care is far from what some in the innovation community might call a permission-less venture, and patient safety is paramount. “I will take care,” the original Hippocratic oath reads, “that they suffer no hurt or damage.”
Still, too much caution can stifle innovation. The exciting part of the 21st Century Cures Act is the careful debate in Congress about how to remove obstacles to innovation while preserving what we need to make medicine safe and effective. This is not a time when we can afford to stand still. Not when 50 percent of all men will experience cancer — as will 1 out of 3 women. Not when diseases like Parkinson’s and Alzheimer’s are on the rise. In the 1980s, 1 out of 10 American boys was obese. Now it’s 1 in 3.
Even with all the sobering statistics, we live during a time when convergence is possible, a time when we are extending human life at an unprecedented pace. We talk about the promise of personalized medicine — when patients can have their doctors look not just at germs invading one’s body but also at the genes that belong there. We have learned how people in rural areas far from a clinic can go online for help. In a survey we recently conducted with our partners at Google and the Digital Health Coalition, we discovered that chronic patients who regularly use technology to monitor and manage their condition have a more positive outlook about their condition. And we’ve seen empowered patient communities not only share information but become advocates for change — recall, for example, the startling success of last summer’s ALS Ice Bucket Challenge.
We have also witnessed how disruptive technologies continue to erase the disparity between doctor and patient. In his new book, The Patient Will See You Now, Dr. Eric Topol discusses how smartphones and other wearable technologies enable people to not simply access and store data but, with the right sensors, collect it in real time. The result is nothing short of transformative. Medicine, treatment and entire health care systems are becoming increasingly digitized, personalized and now democratized. Soon, health innovator Dr. Daniel Kraft predicts, we will prescribe not just drugs but apps. Even better, in his words, “the integration of exponentially growing technologies is beginning to empower the patient, enable the doctor, enhance wellness and begin to cure the well before they get sick.”
Yes, better health care is not only within our reach; it is literally at our fingertips. There are important questions left to answer, including those of the 21st Century Cares Act. What will happen with reimbursement? What’s the evolving role of the FDA? How do we balance cost and conflict of interest? How do we ensure that health care is delivered and experienced at a rate that equals, or at least comes a lot closer to, the exponential laws of technological progress?
We shouldn’t shy from the debate. That day when President Johnson went to Independence, he looked to Truman, the feisty leader known as Give ’em Hell Harry. He went to Truman’s town “not because he gave us hell but because he gave us hope.” In the labs of drug companies and universities, in clinical trials monitored by doctors, around the conference tables of both startups and nonprofits dreaming of new technologies and planning new campaigns and even in the halls of Congress — we see hope too.