Wireless Health and Real Health… What is the difference?

On Friday the 18th of February I attended the inaugural Wireless Health conference at beautiful Bondi beach in Sydney. If you have to go to a conference, Bondi in summer is the place to go. The conference was organised by the folk of BCS Innovations, a local consultancy that has spread its wings to the US market.

I was asked to give the opening presentation, focusing on innovation in wireless health. I may have disappointed a few people because I started my talk by criticising the name of the conference and how the term “Wireless Health” is a misnomer. If any of you were offended, I apologise, but with my tongue a little bit in my cheek.

Over the last decade or so we have seen a bunch of new names be conjured up for the use of technology in healthcare, the ubiquitous ehealth, the more recent mhealth, health and medical informatics, health IT and so on. The problem with this varied and seemingly random use of new prefixes and suffixes for health is that it forgets what we really do. We provide care to people with health issues, so first let’s stop talking about health as a term in isolation, and talk about healthcare. Secondly in focuses on the technology component not the service delivery component.

So once I got that off my chest, I proceeded to look at who needs healthcare, why they need it and how we currently deliver it. The recent COAG announcements about yet another reshuffle of hospital funding models remained in my mind, so I emphasised the need for us to stop thinking of hospitals as the nirvanas of healthcare delivery, and start focussing on the needs of the classical patient. Like it or not, healthcare is something we increasingly provide to those who are getting older. The bell curve of services versus age is way over to the right. So we need to better understand what they want, and deliver it as a customer friendly service. Whilst in retail they may say “the customer is always right” you very rarely hear the same said about patients.

Following me were 2 very smart gentlemen from the USA, Dr Stan Pappelbaum and Jay Kunin, both from the San Diego area. Dr Pappelbaum was the CEO of Scripps Health an innovative health provider in the southern California region. He spoke about the transformation occurring in the USA under Obamacare. It has its problems, and the funding is in doubt thanks to the recent congressional elections, but 40 million more people are now eligible for health cover, which to us in Australia sounds like a good thing. Jay Kunin had a more technical background, having worked with the original developers of Electronic Medical Records in Boston many years ago. Like me he disagreed with the term wireless health (which is why I called him a smart gentleman). He emphasised the need for innovation not just in gadgets but also in business models.

In the afternoon we got to hear from Peter Farrell, one of the original founders of ResMed, an Australian medical device success story. Peter is not known for pulling his punches. He did provide us a great insight into what is needed to go from a good idea based on research to a thriving business with presence around the world.

The enthusiasm of the participants was very satisfying, especially for those of us who have been involved in this space for a long time. The inevitable question arose of why it has taken off yet. This led to the old blame game, it’s because the doctors are resisting, it’s because the government fears change, it’s because the data is not strong enough. All are seemingly valid reasons. For my 2 cents worth, I think it is because we don’t pay healthcare workers the right way. We know what good practice looks like, we understand the need for delivering to evidence based care plans, but we still reimburse for piecemeal fee for service treatment. Whilst we maintain that payment model, we will keep the current system. Health care workers are both astute managers of their and their families’ wellbeing, financially and socially. Sure they understand the flaws in the system, but if that is what they need to do to put food on the table and pay the mortgage, well that is what they will do. No one can blame them for that.

Medicare Locals came up again in the recent announcements from the prime minister. She said we would double the number of Medicare Locals out there. Considering to the best of my knowledge there are none now, that doesn’t mean much. However when we start to get our heads around what a Medicare Local is, we may start to see it not only as a tool for improving collaboration and improving quality of care, but also as the first step in a revamping of our reimbursement model. I watch with great interest.

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