How Does Technology Transform the Practice of Medicine?

Session Description: A top practitioner talks with a medical technology expert about the many ways doctors’ work will change.
Below is an excerpt of the panel, How Does Technology Transform the Practice of Medicine? The full transcript can be found here.
David Kirkpatrick: I have with me Brian Donley, who is chief of staff of the Cleveland Clinic and is an orthopedic surgeon, who has done a lot of work in administration of healthcare systems. But the Cleveland Clinic, as has been mentioned a number of times during the day, is really an extraordinary American success story and really just is a center of excellence in so many things. And Dr. Donley, Brian, is really involved in a lot of that and so we’re so happy to have him here to join us. Also with Brent Shafer, the CEO of Philips North America. And Brent, you’ve spent so much time talking to so many parties in the system. I’m just curious any thoughts you had about the last conversation or your assessment of how the attitudes may be shifting in the ecosystem of, for particularly providers, who are a lot of your customers, right?
Brent Shafer: Yes. It was very interesting to hear that, because those are certainly the big topics. And I’m glad they addressed all the easy ones and left us—
[LAUGHTER]
But I think we know what you can’t miss as you go across the United States—and really, it’s not only the United States, it’s the world. But you have aging populations, you have, as they age—you take the United States, 75 million baby boomers aging, coming through the system, who are going to have increased needs, and we need to address that as a society. As they age, there tend to be more higher instance of chronic conditions and this is something we have to think through. So this whole discussion about working across the continuum, delivering care across the continuum is certainly one of the big themes. And I think it’s a challenge for policy, it’s a challenge for reimbursement. The technology in many cases is there and makes it possible, but lining up the care delivery is what we need to do now.
Kirkpatrick: So as a healthcare technology company, you would say the technology is increasingly going to be there to reduce the cost of healthcare, it’s just a matter of applying it and understanding how to integrate it with the existing systems. Is that over-generalizing?
 Shafer: I think that’s true. I think it’s moving very quickly. And I think in many cases the technology’s not the barrier. It’s how we think about it, how reimbursement works, how we deliver care. And our goal is to work with key institutions like the Cleveland Clinic and other thought leaders to help develop those solutions so that they can address those issues.
Kirkpatrick: Because sometimes you can do things but there’s no reimbursement structure for it. Is that part of the problem? When you’re really doing the right thing, you know it’s the right thing for the patient or the person, but it’s not so much a reimbursable code.
Brian Donley: Maybe I can answer a little bit on the provider side.
Kirkpatrick: Yes, please. Go right ahead.
Donley: I think that it can be a little bit of a barrier if you take the short-term look. But I think if you take the long-term look—and some of the previous comments were about for profit or not for profit. And I actually think healthcare, from the provider side, clearly is a not for profit and sees a mission-driven orientation to our work. So when you take the long-term approach, I think you can fight through many of those barriers.
Kirkpatrick: And is Cleveland Clinic taking a longer-term approach?
Donley: Absolutely.
Kirkpatrick: Is that one of the differentiators you’re trying to bring to it?
Donley: I think we do take a long-term approach. And I would say not just us, but I think across this country, and I think to Brent’s point, across the world. We need to take a long-term approach. And the three approaches we take are, we have a constant focus on how to improve access, we have a constant focus on how to improve quality. And in healthcare or in any industry that you’re in, as you improve quality, it’s our third focus is reducing the cost of care. And cost always goes down as quality improves. And I think across the continuum, you see that. You see that keeping people healthy, you see it in the acute setting, and you see it in the post-acute setting, monitoring at home.
Kirkpatrick: So this does go to—so we were saying before, you think really that we will apply tech and we will reduce the cost of healthcare in the United States, regardless of what happens with the payment structure. Is that a fair summary?
Donley: I would say more than—I think—your quote was, “I think.” We must. We must use technology to reduce the cost of care, improve the quality, and we will be able to do that.
Kirkpatrick: We will.
Donley: To the earlier point, though, that we must collaborate. There’s some complex problems that all of us face here in healthcare and we must collaborate with industry, provider, payer, and a disruptive innovator. It’s the only way we’re going to solve this problem.
Shafer: I think that’s a—if I may, I think that’s such a key point. Because in our past, and maybe we’re used to somewhat is selling the widget, making the device. And what we’re talking about here is much longer term. So if we’re going to deliver solutions to these problems, you really have to have shared goals, shared mission, a shared understanding of what problem it is you’re trying to solve. It’s not something you do in a month or with a single device. It takes sustained work and it’s one of the things we’re trying to do as a company is partner with key providers to help make that happen.
Donley: Maybe I can give you one example.
Kirkpatrick: Okay, yes. Examples are good.
Donley: So we’ve had a focus on our internal medicine patients, our general patient population, on blood pressure. And so we’ve used technology to try to decrease the blood pressure problems in our patients to have better control of blood pressure. We use technology with texting patients, contacting patients proactively. We’re able to increase the number of our patients that have better blood pressure control from 67% to 73%. That may not sound like a large increase of 6%—our goal is to get to 90%. But with the 6% that we increased, we had 160,000 patients. That’s 10,000 patients over two years that had better blood pressure control. And if you look at that data, that’s 131 people who did not have a stroke, that’s 71 people that didn’t have a heart attack, and it’s about 70 people that didn’t have earlier death. Just by increasing that using technology.