reflecting on problems in healthcare systems

Healthcare Series Part 1. Starting thoughts

It’s almost another year. Upon researching into the multitude of problems that plague the healthcare industry in the previous few months, I’ve decided to summarize my observations. After all, getting clarity into root problems (if there are indeed root causes) would mean solving the right problems and not only the symptoms of the problem.

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Lack of interoperability because of conflicting interests amongst EHR vendors.

While this is changing because of pressure from tech giants enabling solutions that allow interoperability, historically, there are still a lot of end user complaints regarding the lack of accessibility to the right patient data at point of care from a physician’s standpoint. Patients don’t usually only see one doctor. They could require seeing several different specialists before finding the right type of specialist if they have certain complex conditions. After all, if the primary objective and use case for the EHR (Electronic Health Record) is to manage billing and only secondarily about tracking and not delivering optimal, adequate care to the patient, then it would appear that there needs to be another system built that caters specifically to doctors’ objectives for patient care.

Motivating factors: Money motivated and marketing tricks

Private equity firms are a driver to consolidating health practices and enforcing patients to sign (non-legally enforceable) arbitration agreements prior to seeing their doctors. Cost cutting apparently can be high risk from a legal liability perspective if you’re cutting the cost where quality medical equipment and trained medical doctors are required. If you have to use unqualified personnel to treat your patients, that is substandard care and could make things worse rather than better. The result is tricking patients into accepting substandard healthcare despite them having to pay full price for the healthcare. Cheaper insurance rates for medical practices that deploy these arbitration agreements further drives this practice adoption. The further implication here is that doctors that are employed won’t be able to do much with their relationship with patients even they find this practice ethically questionable. And of course, much of the known excessive costs in the hundreds of billions is caused by the billing and administrative work required because of the fragmentation of the healthcare insurance industries.

Limiting approaches and inconsistent definitions that can cause wrong diagnoses. For example, neurodiverse conditions are not mental illnesses. They are, not, curable. Even more problematic is that symptoms overlap, and any lay person without pre-conditions can read the criteria online for their choice of mental condition du jour, and then (because of the effects of cold reading or Forer Effect) subjectively decide they have that condition. You only need to go on to Quora to understand the numerous use cases of people misdiagnosing one condition over another because they have the same expression of symptoms. The contemporary approach is that if you do not fit into the rigid normative criteria in the strictest, systemized form, you must be ill. This gets into other dilemmas in practicality: if you’re diagnosed and then prescribed a psychotropic drug, you could react badly from it and cause even more problems. You can sort of imagine the frustration and emotional exhaustion that these unfortunate people have to go through in their mental healthcare research journey. How many of these people are misdiagnosed and costing the healthcare system? What are the secondary mental illness conditions that these lifestyle predicaments have caused? How are any of these symptoms manifesting differently from prevalent cultural stereotypes stemming from high school? It sounds extremely easy to pathologize. If you look into the overall rising numbers in neurodiverse conditions and the costs associated to them, you begin to wonder if the strengths of these neurodiverse perspectives are underutilized, with marketing promoting a certain learned helplessness rather than enabling these people to self-discover and differentiate better. Other than that, another logical conclusion would be that earlier, precise diagnosis and interventions would be necessary to lower these socioeconomic costs.

Healthcare in rural regions. Demand and supply of healthcare specialists and solutions are uneven geographically. Doctors and medical practitioners aggregate disproportionately toward urban centers. Machines require skilled technical expertise to operate in order to generate meaningful results from tests, and in this case, the successful identification of tumors. Unsuccessfully conducted tests due to incompetent specialists mean delayed diagnoses and unnecessary costs for repeated testing.

Enough musing, here are a few takeaway questions that would stay with me on my healthtech entrepreneurship journey:

• What is the point of having healthcare if people cannot afford it? What if people can’t get access to traditional healthcare in time?
• What is the point of having the right technology if there aren’t enough qualified personnel to operate it and generate sufficient meaningful use of these machines?
• What does accessibility mean if not about increased awareness of available options, choices and solutions?

If you’re also passionate about solving problems in healthcare or have alternative viewpoints you’d like to share, please drop me a message at jacqueline@healthilymatch.ca