| | December 20188UTLOOK HealthcareTech When My Stethoscope Reaches Your Living RoomBy Dr. Chris DeRienzo, System Chief Quality Officer, Mission HealthAt the dawn of America in 1776, the everyday practice of medicine reached deep into citizens' homes. Colonial physicians lived on house calls, and for the next two centuries the home environment served as the primary locus of the doctor-patient relationship.That's all changed in just two generations, as the rate of doctor-patient interactions taking place in the home fell from 40 percent for our grandparents to near zero for those born in the 1970s and `80s. The shift has been driven by a number of factors, including:· How Medicare, Medicaid, and most commercial insurancecompanies reimburse for care, · The movement to increased specialization among physiciansand surgeons, · Technology-enabled advances that have increased overalldemand for care, and· The relative provider-focused (though not patient-focused)efficiency gains inherent to an office-based practice versus a traveling practice. Yet the wave that drove healthcare out of people's homes is about to recoil. While we will always need hyper-specialized places for patients with the most serious conditions to engage with care, the recoil is being driven by the shift in healthcare's core focus from treating disease to preventing disease and nurturing health. This is a once in a generation shift, and in its wake the practice of medicine is marching by necessity out of doctors' offices and hospitals and back into people's homes. Yet the world awaiting healthcare's return into the home environment looks much different than the world it left just two generations ago. Today's world lets us buy airline tickets, choose seats, check-in and board a flight, track frequent flyer miles, and respond to an experience survey all from the comfort of our smart phones. At least three companies that all begin with an "A" (Alphabet, Amazon, and Apple) are spending billions right now to figure out how to do the same in healthcare, and both government and private payers are actively experimenting with how best to pay for it. When they do, brick-and-mortar based entities are at risk of being on the wrong end of the healthcare equivalent of a Blockbuster/Netflix-level disruption.Yet the world awaiting healthcare's return into the home environment looks much different than the world it left just two generations agoDr. Chris DeRienzoIN MY OPINION
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