Healthcare spending in the USA is growing at a compound annual growth rate of 6.4%, reaching $2.5 trillion in 2009, and expected to top $3.5 trillion in 2015 (Dept of HHS). Our spending is almost twice that of the highest spending European countries. Notwithstanding our outspending every nation on earth, a study released yesterday by the Commonwealth Fund found that we as a nation are fairing relatively poorly compared to other countries. The study compared the U.S. healthcare system as a whole (42 indicators of healthcare quality, access, efficiency, equity, and healthy lives), and the top 10% of states, regions, and other high performing countries. Surprisingly, the US was found to have the highest rate of deaths attributed to lack of timely and preventative care than any of the other 15 countries in the study. We had an infant mortality rate that was the highest of all countries in the study. Of note is that regional variation in care in this country was striking as well. The U.S. as a whole had an infant mortality rate that was 35% higher than the top rates states in the country. Not surprisingly the U.S. scored 53 out of 100 in the efficiency category. Anyone who is involved in the care of patients wouldn’t be surprised at this. The amount of duplicate (triplicate, and more) work necessary to meet regulatory and diverse payer requirements and lack of coordinated electronic health records, and patients without a primary care physician (44% in 2008) leading to disjointed and expensive care are all significant contributors to this inefficiency.
All of these findings set the stage for the white knight of this kind of healthcare system’s failures. Wireless health technologies will not solve all these issues. But these statistics beg for solutions as soon as possible. Mobile health is a unique solution in that it addresses many of these findings simultaneously. It will tie patients to primary care physicians in a more continuous fashion, it will increase efficiency by collecting data which may lead to treatment changes before a critical stage which would otherwise lead to an office or emergency department visit, and will save huge savings. Infant mortality is a problem that has been studied extensively and mHealth may not impact that as much as chronic diseases (which the U.S. has the most of compared to countries in the study). Mobile health technology will hopefully increase care coordination with patient-centered solutions, having the engaged patient taking more responsibility in the coordination process. The Text4baby program by the DHHS may impact this, and the results will be interesting.
We proponents of mHealth do not need studies like this to understand the potential benefits of the technologies. But stakeholders in healthcare certainly do: The government, other payers, and the public. Perhaps these glaring and embarrassing statistics can get the ball rolling, and fast. Did I see this on the evening news last night? No..the review of the Republican debate took up too much time.
The entire Commonwealth Fund report may be found at:http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2011/Oct/1500_WNTB_Natl_Scorecard_2011_web.pdf