Health On Demand: Insider Tips to Prevent Illness and Optimize Your Care in the Digital Age of Medicine - Tapa blanda

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Dr. Ramesh Subramani is an emergency room physician, former venture capitalist and McKinsey consultant who has been directly involved in transforming health care as the Chief Medical Officer for one of the largest telehealth companies in the US.

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The digital health revolution has offered a singularly unique time in our history where all people can truly become engaged in their own health. This notion that patients (like you) can finally take better control of their health destiny is how this book was born. The digital health promise, I believe, is faster, better, smarter and lower cost care which will help you to stay healthy, pre-empt disease and get optimized care.

Patients are confused about their care options. They don’t know how to access care in an effective way. They are tired of being nagged about their eating or exercise habits. They are worried about their increased cost burden. They are worried about healthcare reform, but they don’t really know much about it. They don’t know how to communicate about health concerns and needs. By empowering patients, this book aims to fix these problems.

To define digital health from a patient centric view, I would say it is the combination of the hardware (devices, sensors, platforms, diagnostic tools) and software (apps, websites, algorithms) that together create solutions that enable patients to become more active co-pilots in diagnosing conditions and receiving care more efficiently.

Even though I have been in healthcare for almost 2 decades, ironically, I personally am in search of a better health experience. So in many ways this book is for me and for my fellow physician and nurse colleagues. I hope they use it to help their patients and themselves.

In fact, I find that most doctors don’t know what is contained in these pages. They’re busy keeping their practices going: dealing with the ever-increasing patient loads & the huge amount of often conflicting scientific information being thrown at them. Most were trained in the practices of the 1970s, 80s and 90s---long before the remarkable technological changes that were brought on by the Internet and other advancements. So don’t expect your doctor to be up-to-date with all these innovations. In this sense, you may have to coach your doctor.

So this book is for you, them, and me. We are all health consumers in the end.

In contrast to books about fixing the system, this book is also about changing the game. And empowering patients is the only way this “game” will truly change! With 2 trillion dollars of health expenses providing “life support” for the current system, all stakeholders need to focus on patient empowerment because this concerted focus is the only way the system can change course. For those of you who are wondering---we have already lost the original system, it is broken beyond repair.

This book, however, will not attempt a detailed discussion of how expensive our healthcare system is. Too many other books have already covered that topic. The current focus of the system is that we need to control costs. But singularly focusing on and struggling to control costs in a broken system doesn’t fully make sense. We have options to actually change the paradigm.

That said, I don’t want to make light of the complex system needed to deliver healthcare. We want smart & incentivized doctors, safe & effective medications, technologies that will keep us well and hospitals that focus on healing and providing outstanding care.

And there are real improvements, really notable trends happening:

Patient safety initiatives; preventing errors like wrong medication or surgeries on the wrong limb

Navigation & care coordination efforts for better patient experience and more efficient flow through hospitals and clinics

Reducing hospital purchasing costs and waste

Improving clinical trial efficiencies so that drugs can be developed faster

These are some of the innovations, I believe, that will dramatically improve our current healthcare system. I applaud all the scientists, doctors, nurses, hospital workers, innovators, technologists, and all health stakeholders who work tirelessly to improve our system.

But in the end, to save healthcare, we need a consumer revolution! Consumers will need to realize that they will need to drive care. In fact, what you do as an engaged consumer will likely be more important than what your doctor does towards ultimately having a long and healthy life! Don’t expect it to come from the current system which has too many inherent dependencies and is ultra-focused on high utilizers of care. Due to all of these issues the current system is too clogged to truly get us to a transformed health experience which we deserve.

From my vantage point as an emergency physician-turned- strategy consultant, venture capitalist, and Chief Medical Officer for a disruptive health tech company; I see digital technology enabling the development of four major changes in the delivery of healthcare. Let me briefly sketch them here. In short, medical care, with your help, will become:

1. Faster - in diagnosis, treatment, and outcome realization; less centralized, more distributed and available on demand in bite-size units of care.

2. Better - with more predictive and pre-emptive rather than reactive care.

3. Smarter - meaning more individualized or personalized treatment tailored to your genes, cells, culture, gender and ethnicity.

4. Cheaper - providing more value for your healthcare dollar and better utilization of resources.