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At a Live Chat today with Dr. Jason Hwang co-author of The Innovator’s Prescription: A Disruptive Solution for Health Care, (Sponsored by the World Healthcare innovation and Technology Congress) I asked him how he saw the recent and fast paced developments in mobile phone applications and technology having an impact on health care. He replied

Similar technologies which decentralize care typically commoditize expertise and bring care closer to the patient. If we can encourage business models that fully capitalize on the advantages of these decentralizing technologies we will dramatically increase the value delivered by the health care system.

Other questioners ask:

“Given your view on decreasing reliance on hospitals and physicians, how do you think the practice of surgery will be affected.?”

Patients are not going to be doing surgery on themselves, nor are non-surgeons going to be doing anything beyond biopses. However, for diseases which have causes the can be targeted with medications or devices the need for surgery can be precluded and disrupted.

“So with that response, how do you foresee Google and Microsoft’s initiatives playing out?”

The problem with Google and Microsoft initiatives is they maintain control for the data in that the data is still seen as the primary source of value. This is no different from how hospital systems already view their data. We would prefer to see a system that commodotizes data warehousing and in which profits shift to the companies that develop innovative applications through which to use that data.

“Can you give an example of truly disruptive technology that you see coming?”

The technology is already here but the importance is on how we employ it. Technologies can be utilized in a disruptive or sustaining fashion . . . Technologies help providers deliver more and more complex care. But that tends to increase overall cost of the system. That very same technology could be employed in a disruptive manner and a prime example today is telemedicine.

“EMR adoption is anemic. Will rising consumerism in health care prompt a rise in adoption?”

My view is that EMR (implementation by hospital systems and physicians) will likely remain stagnant. PHRs under the control of patients should disrupt the information and data infrastructure provided that we give patients a reason to collect and manage their own health care data.

On telemedicine:

Again there are two ways in which we can implement telemedicine. One way is we use technology to help our specialists see more patients more efficiently than they could in the past. However, the second way in which we use telemedicine is to help support less expensive caregiver and technicians to care for those very same patients is what will be disruptive to the system. If Web 2.0 technologies are used to help patients take better care of themselves thereby reducing the need to utilize costly expertise and expensive facilities, then that would truly be disruptive. I believe this can happen.

On electronic personal health records:

For disruptive innovation to get any traction we must identify areas of non-consumption. So in the united states there are a lot of affiliated health companies that have no access to the existing records database. I imagine that companies like spas, fitness centers, nutrition stores and wellness centers would be an ideal market in which to establish a disruptive PHR system. Eventually, traditional health care providers will see value in linking their system to the newer disruptive one.

On my question about virtual home visits:

For a growing number of conditions virtual home visits are more than adequate. In order to encourage adoption once again we need changes in our payment model. As I said before, we would suspect that these types of innovations would arise first from the integrated delivery systems that are able to capture the value gained by new delivery models such as this one.