Sunday, August 21, 2011

Software Eating The World of Health Care

Munch, Chomp, Swallow
In an August 20 WSJ Weekend Edition article on "Why Software Is Eating the World," IT investor-entrepreneur Marc Andreessen argues in favor of an intriguing "disruptive" business model.  While he's at it, he's also defending IT behemoth HP's new non-PC strategy against considerable investor ire

His thesis is that it is internet-based programming - a.k.a "software" - that is providing goods and services in an increasingly digital marketplace. While the more obvious examples of this transition include books, the entertainment industry, photography, gaming, job recruiting and communications, the Disease Management Care Blog didn't appreciate software's newly dominant role in energy development, agriculture, financial services and national defense.  For example, FedEx is really a "network with trucks" while U.S. soldiers can be thought of as an "application" on the business end of a computer program.

While Mr. Andreessen makes only a passing reference to the implications for healthcare, the pseudo-Luddite  DMCB agrees that he may be onto something.  While healthcare is a decidedly different industry, it's possible to envision a hospital setting in which patients are embedded in an intranet that noninvasively monitors vital signs, assembles data into user-friendly displays of summary information, robotically ensures safe medication delivery every time all the time and enables nurses and physicians to focus on what's really important - aided by artificial intelligence that ranges from alerts to best practices.  In fact, it's already begun and bound to get better.

And it won't be too much longer until this care model spreads to the outpatient setting.  Persons with diabetes will have their Bluetoothed blood glucose and activity levels non-invasively monitored, while face-recognition software will then be able to calculate portion sizes off of a picture of a plate and recommend insulin doses.  Frail elders living at home won't have to trigger a "fallen-and-I-can't-get-up" Life Call because movement and position monitoring algorithms will do that for them.  Think asthma inhalers with RFID chips, blood pressure cuffs tethered to the internet and Skype-oid communication for every patient 30 days after discharge.

Of course evidence-based purists will quibble over the lack of published proof. Skeptical managed care actuaries will fight to have health care software excluded from the insurance benefit.  Patient advocates will fret about privacy and its Big Brother intrusiveness.  Not a problem, says the DMCB, because the world is changing.  Physicians will demand it, insurers will cover it and both partners in the new "doctor-payer" dyad will use bundling or other flexible means of payment to get it covered.  What's more, the price point for most of this stuff will come down anyway, especially if it ends up being commoditized just like that PC business that HP is dumping.  Last but not least, the "settings" can be calibrated in a patient-centered way that meets individual preferences.

Software with a health care application. Mr. Andreessen raises the concept, the DMCB fills in some of the substance. 

Image from Wikipedia

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