John Taylor: January 17, 2014
It’s amazing how keeping people out of hospitals and getting crooks into jail can travel along similar paths. The other day, healthcare futurist Joe Flower reflected on the important forces driving the biggest change in healthcare in anyone’s memory --- demographics, economics and technology. A day after he spoke live at Clovis Community Medical Center and teleconferenced to other Community Medical Centers audiences, Fresno Police Chief Jerry Dyer told more than 200 people at a Fresno Chamber of Commerce breakfast that, well, those are some of the same significant influencers in fighting crime.
There are finer details and nuances in each of these strategies, but here are a few of the most salient points.
Healthcare -- The population is getting older, with more chronic medical needs. The younger population needs a head start on a cradle-to-grave system of medical care and education that keeps them out of the hospital, and healthier longer.
Law enforcement – The bad guys continue to educate the younger guys on their “values,” whether when they’re in jail or out on early release. Alternative education/intervention is needed to break the cycle where, on a good day, only eight cars are stolen in Fresno.
Healthcare – Just about everything costs too dang much, and how the costs are calculate make no darn sense. The old ways have to die – now. Payment will be made based on performance, not volume. Empty hospital beds will be a mark of success. (We forget that some life insurance companies still require a nurse to come to your house to do an evaluation before they sell you a policy. Now the problem is finding some MD willing to take you as a patient because you’re suddenly insured under the Affordable Care Act, but haven’t had any lifestyle guidance to this point.)
Law enforcement – Just about everything costs too dang much, and the system isn’t structured to resolve that. You can’t hire enough cops, prison guards and parole agents --- or arrest your way – out of a network of often integrated (and ingrained) social problems.
Healthcare – Instead of investing in another MRI, think Smartphone technology that can read, record and send to your MD real-time analysis of your heart, glucose levels, etc. Sure, that won’t work for those in need of hospital care, but what about those being monitored at home – before they feel the need to take a costly trip to the emergency department? (For those who find the idea intriguing, and those who view it with disdain, may I suggest the book by Dr. Eric Topol, “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care”? I got to hear him last year in San Diego.)
Law enforcement – Gizmos that track where shots were fired from, cameras on officers’ chests, real-time analysis of crime patterns, street-level cameras – and tapping into cameras of non-police organizations when active shooters are at work, street lights whose illumination can be intensified in areas of high crime and, of course, drones.
A good many of these changes, tools and techniques will rub some people raw in healthcare and law enforcement as well as those with keen interest in privacy, social justice and civil liberty. But we certainly have immense failures in these two areas of our daily lives. Doing more of the same mistakes, well, we don’t have enough mental health services to cope with such mistakes either.