3 lessons for the future of hospitals

11/17/2014 - Qualcomm Life Vice President and Chief Medical Officer James Mault calls it “Uber-izing health care.”

But where the ridesharing company Uber used mobile devices to disrupt the cab companies, Mault wants to use phones, tablets and laptops to shake up a sturdier target — the American medical system.

Here are three lessons for all businesses Mault shared at the 2014 Business of Healthcare Conference at the Kellogg School.

1. Manage the exceptions, not the process

If buying an airplane ticket online goes smoothly, the first person you talk to is checking your bag at O’Hare. You’ll only talk to a customer service rep if something goes wrong — the flight gets canceled or your luggage went to Jakarta.

Similarly, you shouldn’t have to talk to a doctor for a routine blood pressure check unless something is about to go wrong. It’s called exception management: Have an automated process where humans only step in if needed.

For that blood pressure check, that could be as simple as a sensor that plugs into your phone and sends data to the hospital.

“What I need are intelligent systems with exception management that are going to look at that data and then tell me, ‘Hey, red flag! This patient right over here — see the red? This one’s headed for trouble and in about three days this person will predictably and reproducibly end up in the emergency room unless you do something about it now,’” Mault said.

2. Keep digital records

“I can go online right now and pull up my Starbucks transaction from this morning. But if I trip and hit my head and you’re wheeling me over to NorthShore Hospital, they can’t find my medications or my allergies to save my life,” Mault said.

Medical records need to be accessible in as many places as medical emergencies happen, Mault said. That means everywhere, which means online.

A darker example of this need came from Hurricane Katrina, which devastated New Orleans in 2005. Evacuated patients found their entire medical histories erased. People died.

“They didn’t know where they were in their cancer treatment, they didn’t know what their tumors were, because all the records were on paper and they disintegrated in the hurricane,” Mault said.

3. Eliminate ‘perverse incentives’

Doctors are paid for the job you don’t want them to have to do.

“They don’t get paid to help you stay healthy. They get paid to take care of you when you’re sick. And that’s called a perverse incentive,” Mault said.

The problem is particularly bad with hospitals, Mault said. Hospitals get paid more for a full bed than for a widget that lets people monitor their condition from home.

“In 2006, if you went to a hospital and said, ‘Hey, we’ve got this great technology to help your patients stay out of the hospital,’ the hospital would say ‘Why would we want to do that?’” Mault said.

Mault supports programs that would fund hospitals in one lump sum, rather than per patient.

“Now, in this new world, an admission to the hospital will become an expense,” Mault said.

This will make the invisible hand work for the patients, meaning hospitals will have an economic incentive to keep people out of the hospital and keep costs down.