A Few Suggestions to Simplify Healthcare

I keep waiting for Bezos-Buffet-Dimon to call me (I know they will one day) but in the meantime, cyberspace is a good place to share my thoughts on healthcare redesign.

The front door to healthcare delivery should be an easy-to-use smartphone application which is pre-populated with a healthcare calendar, set up with you and your doctor, to remind you of milestones including appropriate checkups for medical, dental and vision care. This would also link up to the doctors’ offices to periodically remind you if you are overdue for appointments. The employees’ share of costs should be punitively tied to keeping and complying with this calendar. No one should be forced to take care of themselves but if an individual doesn’t do so, they shouldn’t get subsidized by the compliant group. It would be great to see compensation to providers linked to their protocol compliance as well. 

When in need of non-routine care the portal should be telephonic and at the point of intake the patient should be triaged to the appropriate care setting, which may even be telemedicine. This should be linked to an electronic medical record where copies of lab work, EKGs, x-rays, etc. are on file for the caregiver to access. Once a diagnosis or treatment plan is determined, the healthcare calendar should be modified and follow-up care or drug reminders be put in place. 

Selecting your provider has to be easier. We all want to know the same information about our doctors: 

  • Are they in my network? 
  • Are they conveniently located?
  • What are their medical experience and specialty skills (i.e. what conditions are they best at treating)?
  • Will they provide a good user experience – is their waiting room clean and how long does a patient typically need to wait for care?
  • What was their medical training and do they have any negative indications?

I can’t understand why national insurance networks have been unable to streamline this data.

And drug costs are too confusing. At the time the prescription is given, a cost estimate and any plan rules restricting access to the drug should be provided, along with generic and therapeutic equivalents. And costs should be transparent – drug rebates should be eliminated. Many doctors are e-prescribing; surely tying this piece in would not require much effort.

Doctors’ offices should be paperless. When selecting doctors for the Amazon-Berkshire-JPMorgan network, this should be mandatory.

Care management for chronic and acute cases can also be triaged to different levels of oversight with the more complex situations assigned to a nurse case manager to help navigation of more difficult medical conditions.

Care must be taken to avoid infringement on individual liberties – but I believe this can be handled with cost levers where noncompliance triggers higher costs. At 20% of GDP and no end in sight to runaway inflation, creative solutions are needed.

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