The future of health will be mobile
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I lived in Indianapolis for a little while in the late 00s. At that time it was a city on the cusp of change, just before people wanted to live downtown and before the new bar and restaurant scene took root. When I visited recently to speak with Roger Bradley, Director of Operations at Indiana University Health West Central Region, there were multiple places to eat and drink, and a small movement of micro-distilleries where one could enjoy unique handcrafted libations. Where in the past the sidewalks would roll up after dinner and the streets would go dark, the city has a new glint, a twinkling, a shine.
“It’s changed a lot since you lived here, hasn’t it,” Roger nodded at me with a knowing smile. We were standing in front of the Indiana University Health (IU Health) offices.
“Yeah,” I said, looking at the view of downtown, “there are lots of new apartment buildings.” New pillars of glass towers stood tall from former empty lots and abandoned buildings.
“Everybody is moving downtown, the apartments are rented or sold before they are even finished,” Roger confirmed, holding open the wide-glass door to the building as we entered.
Roger Bradley is tall and broad with a baritone voice, and a warm and friendly demeanor. He’s straightforward with a sly sense of humor who enjoys being with people. He’s a person of trust, integrity, and I’m glad to know he’s a person with a leadership position in health care. I hope that the roster of health care leadership across the country resembles his character.
He invited me to speak with him about the future of mobile health at the Indiana IU Health offices on the near west side of Indianapolis. If you’re not familiar with Indianapolis, you wouldn’t be aware of the city’s history and focus on health care. Eli Lilly is based right downtown (and the story of their full employment during the great depression is lore of local pride), and there is a cluster of well-established hospitals, such as Riley Hospital for Children, just south of where Roger and I were meeting.
We sat upstairs in one of the lecture halls. Roger would occasionally go to the board to illustrate a process. While at the board, he turned to me with excited eyes. “Health care is in a different place these days. We’re in a golden age, “ he shared joyously. “There’s so much change related to health care delivery right now that there’s a lot of opportunity for those of us who chose to stick with health care and see it through to its next level. Technology is what’s going to get us there.”
“What’s a specific example, as it relates closely to your role as director of operations?”
“When we start looking at technology, the facility perspective is that it’s very expensive to support health care delivery through the old means. The focus over the last few years has been how do we reduce the costs that are basically carried onto our patients. In a not-for-profit organization (IU Health is a not-for-profit health care system), we don’t have stockholders. We have stakeholders. So our stakeholders are people. So when we reduce our cost, it’s a value add to peoples's lives.”
“So, you can solely focus on the good of the patient?”
Simple first steps can make a big difference
“Yes. When we look to the future, we look at streamlining and optimizing our facilities through the lens of transitioning from services that address sickness to those focused on wellness.” Roger sits down in the chair across the small table from me. His body faces the board, he spins the marker between his fingers and he turns his head to engage me. “We have assets: the first is our patients, the next is our facilities, the other is medical equipment and then it’s IT. Our patients are very precious to us. So how do we utilize our assets? When we start looking at asset utilization as it relates to facilities, it would be the time and effort it takes to manage that facility. To help solve this, as a simple example, we’re looking at ways patients can use their phones to make an appointment. Or how can we use that device to start tracking throughput. For example, we can use the mobile device to notify a patient that we’re running ahead or behind schedule. We’re also in the process of looking at how we can streamline the maintenance of the buildings and medical equipment. We would do this by utilizing CMMS systems (computerized maintenance management systems) so we can basically manage our physical assets. Now our staff can use TMS. It has an app that goes on the mobile device to allow staff to do work orders through their phone. They can use voice to complete forms as well. This device enhances their ability to cover more area.”
“The mobile device becomes…”
“It’s great for efficiency because now one person can complete a preventative maintenance item using their phone or monitor 3-4 buildings with one app. We can assign work orders as well. We looked hard and heavy at how we can utilize the mobile phone in this industry. In the past we’ve used pagers, but now for the same price we can give everyone a phone. We also have GPS tracking in the phones, which serves as a safety feature. Utilizing mobile phones is also a great way for us to interact with patients and cut down the waste – we consider 'waiting' as a waste. Relatedly there are apps that can monitor the use of medications. Also, in recent years we’ve been talking about telemedicine. In the future we can use tech to check the status of patients. It’s a tool of the future and something we’re probably all behind on, but we’ll eventually see a huge shift towards this.”
“How does this impact the patient’s control of their personal data? Maybe they don’t want their health conditions in a mobile-accessible database?”
Roger nodded, rocking in his chair as if he was about to bound up. This seems to be a pressing question, and his answer was wise and unexpected, on a different perpendicular track.
“We should focus more on health promotion and disease preventions,” he replied.
Of course, I think to myself, the mobile usage for health doesn’t have to replicate the existing process, it should lead to a new one, a new way of thinking about health. Roger continued…
Prevention is the future of health
“Plus, technology allows us to do promotion and prevention through utilization of the cell phone. You’re never going to get away from hospital facilities, but not all patients are able to come into an office on a typical 9-5 day. Technology will enable us to move past that.”
I think of wearables and fitness trackers. These function 24/7. Health care should too. “What if all of the data is crunched to find trends and cures?” I ask Roger.
“The issue with medicine right now is the lack of sharing of knowledge. It is quite limiting at times because people try to work on projects on their own. We’re never going to seek the cure of the future if we don’t have collaboration. To reach the masses, there needs to be some sort of community opportunity. I believe that people will have to give up some of their privacy to get to that level, but there’s ways of doing that without even sharing your name.”
Roger sits back in his chair, his hands upright. He touches his fingertips together and continues his line of thinking. “Right now, there’s a trend for health care organizations to be large. You’re not going to see any small businesses in the future. The trends are to become big businesses. As we become larger organizations, we’ll eliminate a lot of our competitive nature. We’ll reduce competition because we’re becoming larger. I see the collaboration being internal versus external. I still think this is a problem no matter how large an organization becomes. Until you can break this down, you aren’t going to be the best.”
“Ok.” I lean back in my chair, rocking, now understanding the highly interconnected pieces, and seeing how the future of medicine is dependent on a cultural shift away from managing disease and towards prevention. I ask Roger, “If you were to dream, what is the health care of 10 years from now?”
It’s about being holistic
Roger turns towards me, placing his elbows on the table and widening his hands, as if he’s just dropped a basketball on the table. “I think we’ll use technology to monitor people’s health physiologically and maybe emotionally. We’ll have the ability to monitor people’s diets and daily exercise. We’ll be able to look at the continuum of care from the cradle to the grave. Patients will also be able to interact with physicians without having to go to the office. They will communicate via FaceTime, which will eliminate 30 percent of the visits. It’ll open the ability to train and educate health care workers as well.”
Roger had a hard-stop, so we ended our conversation on this note. As we exited the room and turned towards the elevators, I envisioned the future of health care as an always-on interface, sometimes obvious though a device, but mostly running algorithms behind the scenes, prompting a person when or if they need to be prompted. Hopefully a little of the mystery will be removed and the prevention will be clearer, with specific action to be taken. I’m reminded of my conversation with Ting Kelly (to be published soon), and her interest in bio-hacking for better health and wellness, of eating superfoods and using new technologies to reduce stress. The notion of prevention is something I also discussed with Spencer Nam of the Christensen Institute. That conversation will also be published soon.
The sun was setting as I reached the parking lot. The tall downtown buildings were glowing in the orange light against a brilliant darkening blue sky. Cars buzzed by, on their fast way to all the new places in this rejuvenated city.
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Jason Moriber is a creative communicator with a background in social and digital for CSR, tech and start-ups. He’s working within the Communications team at Verizon, charged with developing a new model for corporate and brand communications. Connect with him on Twitter @jasonmoriber or on Instagram @designinginnovation