The health care system in this country, depending on who you ask, is either under attack, changing for the better or changing for the worse. The following is an attempt to count a few of the challenges the health care industry currently faces. Some have been mentioned in previous editions of C Force.
While in a recent report I talked about the ever-increasing presence of artificial intelligence applications in medicine, as recently outlined in a Forbes report by health care and public policy specialist Dr. Sai Balasubramanian, the mere growth of digital health delivery systems comes with risks. “With this transition to cloud and internet based applications, the risk for cyber attacks and security breaches has also significantly increased, rendering the entire healthcare system incredibly vulnerable,” says Balasubramanian.
He goes on to say that “as the wireless and remote monitoring device market has grown significantly in the last decade, regulators are especially concerned that these devices, which often use wireless communications, are particularly susceptible to cyber attacks.” Recognizing this growing concern, the Food and Drug Administration has issued “a detailed note providing the guidelines for security measures, specifically for medical devices.”
Balasubramanian believes that a significant amount of work has yet to be done by the health care industry in strengthening its cybersecurity defenses. He cites a recent report by the American Hospital Association, published in collaboration with Censinet RiskOps, that indicates that “healthcare organizations are still mostly reactive rather than proactive when it comes to cybersecurity, especially when it comes to identifying cybersecurity risks. … More than 40% of organizations are not compliant with conducting response and recovery planning with suppliers and third-party providers.” They continue to be reactive rather than proactive, he claims.
“Organizations tend to respond to cybersecurity threats and issues rather than plan for them before they occur,” says Balasubramanian. “This lack of investment in the right infrastructure and safeguards poses a huge risk for healthcare infrastructure generally, as hospitals are just one cyberattack away from becoming incapacitated.”
As I previously reported, primary care medicine is one of medicine’s lowest-paid fields and is currently facing a growing shortage of primary care doctors. “So why are multibillion-dollar corporations, particularly giant health insurers, gobbling up primary care practices?” writes New York Times reporter Reed Abelson.
“The appeal is simple,” he writes. “Despite their lowly status, primary care doctors oversee vast numbers of patients, who bring business and profits to a hospital system, a health insurer or a pharmacy outfit eyeing expansion.”
Corporate consumption of medical care is now for many a growing concern. According to a recent analysis by the Physicians Advocacy Institute, nearly seven out of 10 of all doctors are either employed by a hospital or a corporation.
“(Some) experts warn these major acquisitions threaten the personal nature of the doctor-patient relationship,” says Abelson, “especially if the parent company has the authority to dictate limits on services from the first office visit to extended hospital stays. Once enrolled, these new customers can be steered toward chains of related businesses, like a CVS drugstore or Amazon’s online pharmacy.” Some worry that this continued shift toward corporate consumption of medical care could also bring a shift in the balance of care from quality treatment to profits. Pointing to a recent report showing fewer medical school graduates going into the field of primary care practice, the concern is that the corporate investment trend may not halt “the rapid disappearance of the doctor still sought by so many people for ordinary care.”
Serious issues related to folks in rural areas getting proper health care services and access to primary care doctors, let alone specialists, are well documented. I have written often about the ordeal of people in remote areas having to drive for hours and hours to reach a hospital. Telehealth has been looked at as one solution to this provider shortage. One program recently announced by the Mayo Clinic is addressing that issue. They are calling their new service Advanced Care at Home, a telehealth approach that allows patients to receive comprehensive medical attention through a “hospital-at-home model of care.”
According to the Mayo Clinic, the study looked at 686 patients who were admitted to the Advanced Care at Home program at two Mayo Clinic campuses in Jacksonville, Florida, and Eau Claire, Wisconsin. “A few of the most common diagnoses for patients within the program were pneumonia, heart failure and bloodstream infections,” says the report. “Health care professionals monitored patients’ care from a distance while deploying a team of community paramedics and nurses that visited patients’ homes for hands-on care.”
Reports Margaret Paulson, lead author of the study and medical director of Advanced Care at Home in the Mayo Clinic’s Northwest Wisconsin region, “What this program allows is, if we can take someone home for hospitalization who is sick but stable, that patient is able to be more comfortable, with improved clinical outcomes, while simultaneously opening a bed in the hospital.”
One patient in the study named Chad Semling was admitted to the hospital suffering from multiple compression fractures within his back, a collapsed lung, fractured ribs and severe lung blockage. He spent 113 days in the hospital before being admitted to Advanced Care at Home.
“The number one impact is that I was able to be home and my wife and kids did not need to do anything,” says Semling. “It allowed for a less stressful environment.”