The Evolution of Healthcare, or How Did We Get Here?
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Brief history of health care delivery for Patients 2.0 session at Health 2.0, Santa Clara, CA, 9/2014
The Evolution of Healthcare, or How Did We Get Here?
- 1. The Evolution of Healthcare or How Did We Get Here? Daniel Z. Sands, MD, MPH Society for Participatory Medicine Beth Israel Deaconess Medical Center Harvard Medical School Boston, MA 息 Copyright 2014 D. Z. Sands, All Rights Reserved
- 2. Beliefs about health and disease Evolution of the physician Payment for health care services Access to information and rise of consumerism 息 Copyright 2014 D. Z. Sands, All Rights Reserved Interlocking Themes Photo 息 Copyright 2014 Michal Pikula
- 3. Illness as Punishment Sermon on the Mount and Healing of the Leper, Rosselli 1482 息 Copyright 2014 D. Z. Sands, All Rights Reserved
- 4. 息 Copyright 2014 D. Z. Sands, All Rights Reserved Physician as High Priest Imhotep, 27th Century BC, Egypt
- 5. 息 Copyright 2014 D. Z. Sands, All Rights Reserved Physician as Professional Hippocrates of Kos, 3rd Century BC, Greece
- 7. 息 Copyright 2014 D. Z. Sands, All Rights Reserved Physician as Scientist Paracelsus, 16th Century, Switzerland
- 8. Physician as Learned Professional 息 Copyright 2014 D. Z. Sands, All Rights Reserved The good physician treats the disease. The great physician treats the patient that has the disease. Sir William Osler, 1849-1919
- 9. 息 Copyright 2014 D. Z. Sands, All Rights Reserved
- 10. 息 Copyright 2014 D. Z. Sands, All Rights Reserved Health Care Payment
- 11. Mid-20th C: Medicare and employer-sponsored private health insurance costs rise Late 20th C: Managed care declining reimbursements & shorter patient visits; rise of concierge medicine Early 21st C: patient contribution; shift from FFS to FFV 息 Copyright 2014 D. Z. Sands, All Rights Reserved Health Care Payment
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- 14. Medical Records Electronic health records 1980s-present HIPAA 1996; patient access to records Patient portals ~2000 New documentation requirements New audiences 息 Copyright 2014 D. Z. Sands, All Rights Reserved
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- 16. Access to Health Information Whole Earth Catalog 1968 Our Bodies, Ourselves 1971 Medical Self Care 1975 Medical textbooks at general bookstores 1970s Health websites ~1996 PubMed free to public 1997 息 Copyright 2014 D. Z. Sands, All Rights Reserved
- 17. Online Population Rising 息 Copyright 2014 D. Z. Sands, All Rights Reserved - @DrDannySands
- 18. Online Health Habits of US Adults Sources: www.pewinternet.org; PwC HRI Social Media Consumer Survey, 2012 80% of online adults have looked for health info Each day, more people search for health information than see a physician! More than half act on the information 1/3 have read about others health experiences 1/4 have tracked their health information online 1/3 use social media for health 息 Copyright 2014 D. Z. Sands, All Rights Reserved - @DrDannySands
- 19. http://participatorymedicine.org Participatory Medicine is a cooperative model of health care that encourages and expects active involvement by all connected parties as integral to the full continuum of care. Society for Participatory Medicine Community Advocacy Research Education 息 Copyright 2014 D. Z. Sands, All Rights Reserved
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- 21. Health Care Today Forward-thinking practices establishing patient-family advisory boards Patient increasingly able to view records and e-message providers, but resistance remains (despite MU2) Patients pushing for more transparency of information and charges Heterogeneity of payments models, with value-based payment models not yet changing most medical practice Declining reimbursements and increasing bureaucracy frustrated physicians opting out 息 Copyright 2014 D. Z. Sands, All Rights Reserved
- 22. 息 Copyright 2014 D. Z. Sands, All Rights Reserved
- 23. 息 Copyright 2014 D. Z. Sands, All Rights Reserved
- 24. Questions? 息 Copyright 2014 D. Z. Sands, All Rights Reserved Danny@DrDannySands.com http://www.DrDannySands.com @DrDannySands