Health care is the single largest budget item for every province in Canada, ranging from 34.3 percent of total program spending in Quebec to 43.2 percent in Ontario in 2016. - Fraser Institute
So what are we to do? The cohort of aging baby boomers is just beginning to stress the system further, and we are unprepared. The costs are, and certainly will be, unmanageable. The system is dogged by fragmentation and as a result is extremely difficult to navigate as a client and manage as an administrator. The breaking point is coming, and perhaps is already here.
Technology, combined with innovative approaches to achieve outcomes has the ability to revolutionize systems and enable leaps forward. Incremental change will not work here. We could try increasing funding to the current model, but to say that funds are in short supply is an understatement. It will not work. A revolution in healthcare is coming.
What this means is, with the top-down method struggling, the population will react and innovate. This must be encouraged and enabled. Not by abandoning a public system, but allowing the market the room to generate solutions. Solutions which can be rewarded by becoming part of that public system.
Bottom-up, or revolutionary, solutions are coming. Some early examples of this are Akira and EQ Virtual. They provide a new method for being seen by a provider. These are demonstrations of a population moving away from the current method, and trying something entirely new. Obviously, as sensor, camera, battery, and display technology continue to improve, the necessary ingredients will increasingly be there to encourage and enable this revolution.
Medical records are an area that cost untold millions of dollars to attempt to maintain. It doesn't look like the dream of a single comprehensive record will come from the current system. Valiant attempts to integrate and share are ongoing, but the required technology and complex agreements between organizations are barriers.
What is more likely is that people will take ownership of their own records, and share them with the providers they see. They will do this in a database of their choosing. News just leaked that Apple Health is being expanded to allow for centralizing of medical records. For the time being, it is pulling from other sources, however we can anticipate a market for consumers to hold their own records will come soon.
Even from a technology perspective this is easier to imagine. Medical providers' systems could be configured to read from an Apple medical record when onboarding a new patient. When huge players (Google Fit?) decide to play in a space, standards are more likely to emerge.
There will be a transition period, where some patients maintain their own records, and others depend on providers. In time, the value of holding your own records will make current models obsolete, and in doing so, save the public system massive amounts of money. It will also drastically increase the quality of the record, as it will finally all be in one place.
What makes Apple's expansion even more attractive is the increasing availability of inexpensive medical sensors. When the population takes their medical records into their own hands, and they start also measuring their status, the quality and completeness of their records will far exceed what is currently available.
Technology is absolutely just one element of a new strategy. Obviously there are other tactics, such as more mobile community health workers and effort to encourage healthy lifestyles to help prevent the chronic issues Canadians face. Such innovative techniques will complement and often leverage the emerging technology.
These revolutionary solutions are being driven by the struggles of the current model. Canadian decision-makers should look for ways to tap into this trend in innovative healthcare delivery systems to make it a big part of the solution. We have no choice but to think way outside of the box here.
It may just mean that the best way to cut the ever-increasing costs of health care around the world will be to provide cheap smartphones with Internet service to those who otherwise could not afford to buy them. - Eric Topol, Author of The Patient Will See You Now: The Future of Medicine is in Your Hands