Mark Blatt, who is both a medical doctor and a business school graduate, had a revelation in the mid-1990s. This was before there was Skype, or Apple’s Face Time or smartphones with video. He was then a managing partner for a family medical practice when he went “on call” for the first time, covering the bases over a holiday weekend for 12 primary care doctors.
Blatt received about 200 phone calls between 7 a.m. and noon that he had to triage. “By noon I had taken care of more people than I did in a whole week in the office. I had probably done something substantive for about 80% and around 20% of them needed some sort of follow-up test or care. I sat back and realized this was not a bad idea. It wasn’t just improving cost savings by 3% or 4% — it was actually changing the care into an affordable product.”
The lesson stuck. Now Blatt is the worldwide medical director for Intel at a time when everyone is desperate for ways to cut health care costs without sacrificing – and possibly improving – patient outcomes.
Health care in the United States, in all its forms, including Medicare, is probably the nation’s most formidable economic challenge. Today’s U.S. health care industry is unsustainable, with the world’s most unaffordable fixed-cost infrastructure, said Blatt, who was a panelist on the “Physician Restructuring” session at the recent 2012 Wharton Alumni Health Care Conference. It’s “in a bubble. What the U.S. needs is a Moore’s law for health care. Let’s double the number of people we see and cut the cost in half.”
Some would suggest the clearest path to that goal would be to adopt health care systems closer to those of other major industrialized countries, which typically spend about half the amount per capita that the U.S. spends, often with better health outcomes.
But Blatt’s ideas cut another path to savings, with the tools already in place for execution. “Most of you have a smartphone, which is capable of video communications with anyone anywhere on the planet,” Blatt said. Then he asked: “How many times have you been to the doctor in the last year when he didn’t touch you?” The implication was clear. We don’t need time- and money-consuming, face-to-face doctor visits nearly as much as we make them.
For the last decade, Intel has been pioneering telemedicine systems that substitute virtual connections for face-to-face doctor visits for large patient populations. The experience holds lessons for the health care system in the U.S., Blatt suggested. To achieve major gains in health care in the U.S. would take a new workflow approach that merges nearly all of the trends in digital technology to create coordinated communications and control matrices that would connect patients, clinicians and care facilities.
In addition to slashing the number of doctor’s visits to save money, Blatt sees another “fundamental” problem – coordination. “Did you ever show up to a specialist and he doesn’t know why you’re there because the primary care doctor didn’t tell him? Did your doctor’s office ever call you and say ‘Come in and we’ll tell you your test results,’ but when you get there no one can find the test results? We practice health care the same way we did — not in the twentieth century but the nineteenth century.”
Intel, in partnership with GE, today offers hospitals large-scale remote health management systems for regional populations. It also has joined with the Mayo Clinic to launch a telehealth home-monitoring system for chronically ill patients. In addition, the company also co-founded mPowering Frontline Health Workers, a U.S. Agency for International Development project advancing mobile health technologies in developing countries. In related projects in China, India, Brazil and the Middle East, Intel is involved in telemedicine pilots focused on refining “high volume routine care” systems that largely eliminate the need for face-to-face visits between doctors and patients.
Information for this article originally appeared in The LDI Health Economist, an online magazine about health policy published by the Leonard Davis Institute of Health Economics at the University of Pennsylvania. You can view a video of Blatt’s comments along with the original article here.
