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article imageDr. Noah Minskoff says medicine needs a tech revolution

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By Tim Sandle     Aug 18, 2014 in Health
The U.S. medical industry is in need of more technological innovation to improve overall health and reduce the costs of patient care, according to Dr. Noah Minskoff, a leading medical professional. However, this technology needs to be fit-for-purpose and affordable. The main problem is that the medical technology industry is not set up to deliver this result.
The rising cost of U.S. healthcare is an issue of medical, social and economic importance. One of the key reasons for the spiraling costs is the exponential rise in new technologies for diagnosis, treatment and care. Medical technologies are expensive to produce, requiring large investments in research and development, and the companies behind the technologies seek a significant return on investment within a short period of time once the technology has reached the market.
According to a report issued by the White House in 2009, if health care costs continue to grow at the current trajectory, the share of U.S. Gross Domestic Product (GDP) devoted to health care in the U.S. is projected to reach 34 percent by 2040. This has significant implications for the health insurance system. For households with employer-sponsored health insurance, this trend implies that a progressively smaller fraction of their total compensation will be in the form of take-home pay and a progressively larger fraction will take the form of employer-provided health insurance.
This technology-cost relationship makes healthcare very unusual in relation to innovation in other sectors, Dr. Minskoff argues. With most other sectors of the economy, technological innovation leads to a reduction in costs. Look, for example, at the cost of tablet computers today compared with five years ago.
A further weakness with the healthcare system is that the technologies being developed are not always the most appropriate in terms of their medical application. Moreover, the technologies could be designed in “smarter” ways: the technologies could be produced at a lower cost; and the final products could be more appropriate for physicians and patients.
For instance, each year millions of echocardiograms (ultrasounds of the heart) are performed in specialised laboratory settings using equipment that costs millions of dollars. However, as MIT Technology Review points out, it is feasible for medical doctors to be issued with pocket ultrasonic devices, at a far lower cost, which would enable exams to be conducted in a doctor’s office, thereby lowering technological expenditure for the medic and reducing the cost to the patient for the exam.
According to Dr. Noah Minskoff these fundamental weaknesses are mostly due to the gulf between the specialists who identify medical problems and those who are developing and investing in technology. “Physicians walk around all day and see tons of problems with the current standard of care that we're delivering to patients, and we have an idea of how to make it better, but we don't know what to do with the idea, the process of taking an idea and translating into a meaningful change in healthcare practices is so daunting that these ideas seldom emerge as innovations,” Dr. Noah Minskoff notes.
This gap between medics and medical technology firms can, for example, lead to several companies developing similar types of high-cost technologies (such as MRI scanners) rather than diversifying. It also stands that many of the technological innovations that companies are investing in are centered on expensive treatments rather than on disease prevention or health promotion. All this leads to higher rates of utilization and costs for the healthcare sector.
In terms of solutions, Dr. Minskoff has identified the need for affordable technological products in the medical field; improving the channels of communication between those employed in healthcare and companies that are investing in medical technologies; and, in the longer-term, the importance of tackling the way education is structured.
Looking at affordable technologies first, the smartphone presents remarkable opportunities to help with disease prevention and at a low cost. Smartphones can also deliver healthcare solutions in a way that empowers the consumer. Look at how a smartphone keeps track of vital signs for people with diabetes. Programs are available for smartphones that can collect key data on blood pressure, glucose readings and measurements from digital scales, all of which can be collated to build up a daily picture of the health of a patient. According to U.S. News and World Report, patients employing sophisticated diagnostic and monitoring technology on themselves, through mobile computing devices, offer the potential to trigger a major shake-up of health diagnosis and delivery.
On the educational front, Dr. Noah Minskoff has identified university curricula as often being too narrowly focused in a way that limits students applying their knowledge to other fields. “Through the education process, medical students are not taught anything about business or engineering. Engineering students are not taught about healthcare delivery, or current problems with healthcare technology that is used to treat illness and disease,” Minskoff notes. "Business students have very little exposure to the metrics that drive real world healthcare decisions or the engineering processes involved in new technology development. However, in order to solve many of the critical issues in medicine it requires that all of these disciplines collaborate and contribute in order to successfully bring innovative technologies to market.”
He goes on to add: “The education system is so stove-piped, their fields never interact in their training, and then you get out into the workplace and you have a lot of talented people who have no idea how to talk to each other.”
Dr. Minskoff’s argument is supported by the Association of American Colleges and Universities (AACU). The ACCU issued a report in 2011 identifying the barriers to interdisciplinary working across the U.S. university and college network. One of the key recommendations of the report encourages incorporating interdisciplinary program needs with individual student goals and into course programs. Greater collaboration within industries could help achieve this goal, the report adds.
Focusing on his third point – communication - Dr. Noah Minskoff identifies the jargon and specific definitions associated with different subjects as a barrier to professions working together and understanding each other’s work. “They don't speak the same language, have no familiarity with what each other are doing, and it creates this invisible wall where a lot of ideas don't come to fruition because you can't easily interact within those different disciplines.”
Mutual understanding is not the only problem. The confined areas of an academic subject can drive thought processes in certain directions, making it difficult to “think out of the box.” One area for improved communication that Dr. Minskoff identifies is creating better flow between subjects as well as for greater interdisciplinary learning and information exchanges. “Different students think about problems differently. All of these people, individually, hold the keys to the larger puzzle, but there is a fundamental difficulty in the ability to interact, and that idea is never provided to them in their education.” Succinctly Dr. Minskoff notes: “This kind of cross-communication should be part of a student's core training.”
In essence, Dr. Minskoff’s core argument highlights breaking down the barriers so that better technology can be brought on-line more rapidly and at a much lower price. The barriers in place explain “why innovation and new technology is so hard to bring to the market.” The ideas proposed by Dr. Minskoff, if supported by consumers, politicians and the medical profession could see these barriers removed leading to better utilization of medical technology for all.
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