The NSA and the Future of Healthcare

In the “Brave New World” of Healthcare, futurists insist the primary focus will be on prevention, with the help of technology to gather data.

That doesn’t mean just jogging a few miles a week and cutting back on the pork rinds.  In fact, in one futurist scenario about the Patient-Centered Medical Home (see #4 “I am my own medical home” pages 14-16), citizens will use home-based bio-monitors and other devices to constantly update electronic medical records, resulting in more timely preventative care. They will have access to a digital health coach (avatar), a virtual person who condenses online medical information to provide advice on behavioral changes to improve their health.

This scenario also predicts that employer-sponsored health insurance will give way to health insurance exchanges where employees will have to gravitate toward high deductibles and catastrophic coverage. The basic theory is that if people have to pay more for their healthcare they will try to take better care of themselves.

As a result of the Affordable Care Act, those health insurance exchanges are already a reality, and some smaller employers have pushed their employees into those exchanges rather than deal with higher insurance premiums, penalty fees or layoffs.

But some healthcare visionaries believe the “Medical Home” concept will require daily readouts from sensors implanted in or on the body (earrings, wristwatches, “sleep pads”) to keep people healthy and those with chronic conditions from getting worse.

Given recent revelations regarding the National Security Agency’s highly controversial information gathering activities, how likely are American consumers to accept monitoring equipment either in their homes or their bodies?

Perhaps this is a generational issue.  Citizens who grew up with their privacy relatively intact may have significant problems with the idea of constant monitoring by a third-party. However, children of the Internet Age most likely will have less of a problem, since they currently give up so much of their personal information online now.

Prevention is what health insurers and providers are banking on to save the U.S. health system. The Brave New World of Healthcare will be driven by whoever pays the freight. Insurers will be ratcheting up their efforts to keep people out of the hospitals. Government will continue to put the squeeze on healthcare providers to do more with less.

What will be the role of hospitals in the future? Will they become advanced care institutions solely treating those who are really ill? Or will some tertiary centers close as community hospitals gain a growing role in promoting overall population health?

One thing seems clear. Unless hospitals define their future role by self-imposing much greater efficiencies and cost reductions, that role will be largely defined for them.

What’s your opinion?