Hackable Areas of Medicine

We are just 12 hours aways from Hacking Medicine #2.

Its been 4 short months (almost to the day) since we ran the first Hacking Medicine and since then we have learned a lot!  What follows is my own personal list of the most hackable areas of medicine with some comments about the challenges within each one.  This is by no means a complete list – it is simply the one I sit with every morning and evening before bed:

Consumerifying Health: Consumers are rarely in charge of their own healthcare.  Tools that help us end users take control of our own care are going to be increasingly important.  Specifically, here are some areas that I think need work:

  1. Making better decisions: we are notoriously bad at researching alternative options.  Our doctors tell us one thing and we go with it.  We need tools that help us first understand what the options are, but second these tools need to go past simple access to information and they need to help us truly appreciate the tradeoffs.  What is the difference in risk of one treatment over another?  How does the research in a given area of medicine support each of the different treatment options?
  2. Getting to choose our doctors and access them whenever we want: It is difficult to find reliable ratings on doctors and schedule appointments easily.  ZocDoc is working on various aspects of this problem, but we need a lot more.  We still cannot easily get a second opinion (or first opinion) online at any time (though HealthTap is working on this).
  3. Financial Control: increasingly, our health costs are covered by a complicated mixture of different benefits.  We don’t have a Mint.com (a good one) for managing our health benefits.  Furthermore, we dont have anything to help us manage and understand how much we are spending on “wellness” – yoga classes, gym memberships, etc.
Moving down the specialty and facility curve: Increasingly, we are able to turn complex operations into simple devices, shrinking those devices and making them cheaper.  At each step we save significant money.  For example, moving complex open heart surgery out of the OR and into a doctor’s office by the introduction of modern stents can really bend the cost curve.
Accelerating Data: Data!  Data can be used in a variety of ways to transform healthcare, but one particular area is how to accelerate data?  Can we disrupt the way clinical research is done (ie PatientsLikeMe)?  Can we use data to better drive decisions inside of a hospital or to empower patients to make better decisions?
Population Health: In the New Yorker piece The Hotspotters, Atul Gawande pointed at that a very small portion of the population is costing a very significant amount of the overall healthcare costs.  How can we change this?  How can we use screening to prevent these acute cases from developing and turning into ER visits?  How can we selectively direct resources to specific citizens who need them most?
Behavior Change: Much of today’s consumer healthcare companies are focused on behavior change.  While this remains an elusive target there is no question that it is a holy grail worth seeking.  Most of the rise in healthcare costs is from chronic disease.  These are conditions (ie diabetes, obesity, etc) that can be dramatical affected by changing behavior.
Personalized Medicine: This can mean many things.  While there are challenges here for who will pay for this, it is clear that as we collect more data we will begin to know more about ourselves and what treatments work best for each of us.  How can we accelerate this?  Much of the research here is focused on using biomarkers and genetics to characterize “who we are”.   What other data sources should we be considering in order to characterize “who we are” and selectively suggest what treatments would work best for us?
Hospital Operations and Supply Chain: Our hospitals are notoriously inefficient.  What are we doing to apply operations research to hospitals to make them more efficient?  What about their supply chains?  They are ordering equipment they dont end up using and it is costing us tons of resources.  What can we do to help these institutions improve their efficiency and decision making processes?
These are but a couple of the areas worth working on, but hopefully it gets you fired up for this weekend and thinking about the potential.

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