In 2008, the US racked up a $2.3 trillion tab on healthcare. For perspective, that number represents 16% of the US total Gross Domestic Product! 16%! That equates to the US spending more than $7,681 per resident on health care costs, nearly 13% more than any other country in the world. Why is that? For starters nearly 70% of our country is still overweight and it is only getting worse. It is no surprise that diseases of the heart is the number one killer in America totaling to 28% of all deaths. We are a country that forgot about health and only thinks of convenience. And why not? Aside from the obvious issue of fast food, have you been to the grocery store lately? There are aisles and aisles of instant food ready in minutes. The other day I saw frozen, pre made, peanut butter and jelly sandwiches. I mean is it really that difficult to spread peanut butter and jelly on two pieces of bread? What have we become? More importantly what are we teaching America’s youth? It is downright shameful and we owe future generations more than debt and obesity.
Problem #1: Lack of Accountability
In a country where the average household can afford the Internet and a LCD TV there seems to be no need to venture outside. Add a Playstation 3 and you now have hours and hours of entertainment without even leaving the couch. (Check out this infographic on sitting and what problems it leads to). In 2009, 31% of Americans above the age of 18 could not take the time to exercise for even 30 minutes in a whole week. Only 18% of Americans could exercise a maximum of 1 hour per week. This is just exercising, what about eating proper foods? There is no slap on the wrist for being lazy. After the age of 18 who is around to push you in the right direction or motivate you to skip the TV show and go for a run. In 2010, watching TV was the leisurely activity that occupied the most time, on average 2.7 hours per day! If television was cut by just 20%, Americans could average 3 hours of exercise a week! We, the people, need to be held accountable for our actions. In a time where knowledge and information is ubiquitous there is absolutely no excuse for able bodied Americans to not properly control their diet and exercise. With a healthier country we will have a stronger work force ready to tackle very real challenges of the 21st century.
For youth 18 and under parents and educators should be held accountable and make sure children are exercising on a daily basis and eating the right foods. There are countless studies and articles proving that healthier lifestyles lead to happier and more confident children. The real key will be educating the younger generations on the importance of diet and exercise. By spreading awareness and knowledge to these generations we will be able to tackle this systemic problem at the route. I remember my PE (physical education) class where we would play some sport for the day or go for a run. The only reason I kept fit was because I wanted to beat my friends at everything possible. What I don’t remember is being educated on the science of exercise and how vital of a role it plays. These types of programs are starting but need to be widely adopted into every education program. Kids should not be able to get a letter grade C in PE. How embarrassing is that? They should have to pass health tests, just like they do class, in order to leave elementary school! (Ok this is a bit much but you get the idea).
Problem #2: No Personalization
Does anyone remember the paperwork that was filled out when registering with your HMO or PPO? I don’t. All I remember is the first time I got sick and actually used my insurance card to make an appointment with the doctor. This means that my health care provider knew absolutely nothing about me yet was able put a price tag on my cost per year. They must have taken my age and some other trivial data and associated their risk calculations and sent out a card. During my first physical visit to the office is when they asked me more personal questions like if I smoked, am I allergic to any medications, and my favorite being how often I consumed alcohol. The doctor’s last question was simple but interesting. He asked me how often I exercised and for how long. My answer? I thought for a second and proceeded to tell him about 4 to 5 times a week for about an hour, hour and a half, during each session. After the words came out of my mouth I thought to myself, that is probably on a good week. Did I correct myself? Nope.
Is it not obvious how flawed this system is? Based off some trivial facts in conjunction with the patients (lack of) information they built a personal profile of me. This is why healthcare is broken. With generic information they put everyone into some category cluster and wipe their hands. Years later hard working Americans pay taxes to fix the holes created by the lack of time put into learning about patients.
The Solution: Health Technologies and Mobile
Luckily the tech gurus of the world are already hard at work. Using modern technology we will be able to solve many of the problems addressed above. One of the leading problems with accountability is that even if people do exercise there are no accurate solutions of tracking their progress and comparing results other than physical looks. There are and have been products in the market such as watch and heart rate monitor combos offered by Polar and Timex, but most stopped at the device level and didn’t accurately track progress with statistical data in a service format. On top of that there were also no means of socially connecting the data to keep track with friends, family, and the general public.
Today, we are entering a whole new genre of products that are sure to take part in the future of, what I call, Personal Health Management. Some of the products and companies include: fitbit, Striiv, BodyMedia, and releasing shortly Jawbones UP and Basis (side note: Basis has a great advantage by having a heart rate monitor incorporated directly into the watch). These products will be able to track an individuals health based on a multitude of measurements including daily activity, exercise routines, and even sleeping patterns. Most also include a web app or mobile application service that allows you to visualize and keep track via a clean and easily understood dashboard. Bodymedia and fitbit take it one step further by offering two extra tools; they allow users to enter daily nutritional habits to monitor calories in vs calories out and they offer a social tool to rank users against their own peers. (Athletes and trainers may want to look into Under Armour new technology as well as the new Polar RCX5 for more detailed views of performance driven data). These new devices in the market will really help people track their progress and accomplish smaller, more attainable goals. Also, with the help of todays social games, friends and family will be able to compete and rub their championship health title in everyone’s face. Hopefully these companies will also begin offering children driven products so parents can easily make sure their kids are getting the exercise they need.
How can this help solve the problems above? Simple. Devices such as these can begin integrating with EMR companies and add insight into individuals behavior and habits. Once enough data has been collected health insurances companies can make more educated decisions on what kind of pricing to offer on an individual basis. Sure this brings up some controversial topics but the idea is simple: exercise more and pay less. We all know how people function, only when something hits the wallet do their habits begin to change. On the patient side, doctors will get a better idea of their patients habits and tailor more discussions around the education of nutrition and exercise. Device companies should look into partnering with modern doctor offices like One Medical Group (article), together they can pave the way into a more personal and accountable health future. At least for now products like the ones mentioned will begin offering more tools to help users attain realistic goals for healthier lifestyles.
Note to Public: We have major problems at stake; Education, Energy Independence, Environmental Meltdown, Water Security, and Food Security to name a few! Please eat an apple and run a mile so we can concentrate our efforts, and money, to ensure our humanity.
A Peek In to The Future: Preventative Maintenance
Like in any industry the trick to saving money and stream lining efforts is to be able to preemptively diagnose a problem and make any necessary repairs before a catastrophic failure. The same goes with medicine. The tools listed above will definitely help people lead healthier lifestyles, maintaining a status quo, but the real trick will be to help the individuals seeking real medical attention. Enter Telemedicine. With the help of the ever-evolving World Wide Web, along with sophisticated, yet inexpensive, personal health devices individuals can maintain an active digital relationship with their health care physicians allowing for increased observations without the need of physically being in the office.
Already we are seeing products break into the market allowing for ECGs and cardiac rhythm monitors to record anywhere and anytime: Smart Heart, AliveCor, and iRhythm. Remotely, I am assuming through some algorithm, physicians will be able recognize when there is a possibility of an event occurring (i.e a heart attack) and alert their patient before a heart failure. Very cool. Another type of patient who needs specific attention is a diabetic. Today's technology still forces patients to prick their fingers and check sugar levels. Companies like VeriMed are working away on RFID based technology which will completely revolutionize the way diabetics monitor their blood sugar. Add a mobile device and now patients will be connected anywhere around the world. A farther look into the future may involve commercialization of stem cells and effectively curing diseases at the root but ill leave that topic for another day.
It will be exciting to see what comes next in an industry where technology has always been over looked. The remaining question is if the general public will be able to handle all of this information. With companies like 23andMe it maybe information overload for the common user. Fear not public, SHL Telemedicine is here to help!