The expected increase in healthcare costs due to the aging population is simply not sustainable.
The US has the second largest oldest population in the world. In 2050, 21.4 percent of our population will be 65 years or older. Heart disease and stroke are the leading causes of death in the US population, accounting for a third of all deaths in the US each year. The cost is staggering, with direct costs of $ 214 billion and an additional cost of $ 138 billion in lost job productivity.
Cancer is the second leading cause of death in the United States and costs the healthcare system around $ 174 billion. Diabetes, obesity, and Alzheimer’s are endemic and will continue to increase as the population ages. The expected increase in healthcare costs due to the aging population is simply not sustainable.
A new approach to care is needed. We are dealing with expensive, inefficient healthcare IT (HIT) that has destroyed the personal connection between doctors and patients and between nurses and patients. If we don’t change care in this country, the health system will collapse in a sea of red ink.
The transition to values-based care is sometimes cited as a way to prepare for an aging population. However, value-based models depend on sufficient patient volume for the model to work. Doctors and nurses are stressed enough from inefficient HITs such as EHRs, which are designed as billing systems that don’t do justice to healthcare workflows. HIT needs to make the transition from data collection to supporting higher productivity.
Adequate strategies to reduce the incidence of chronic diseases and the associated health system costs are critical if all Americans are to have adequate access to health care. Even a 10 percent decrease in chronic disease would save the health system more than $ 100 billion. The use of primary and secondary prevention strategies based on lifestyle changes is extremely cost effective and will improve the quality of life of the aging population. In particular, better education of the population at risk will further increase the positive impact on costs on the health system.
The 21st Century Cures Act mandates that patients have unrestricted access to their medical records. Navigating the maze of lab and picture reports and doctor’s notes with the latest technology is a daunting task for patients. We need to provide an organized approach to this information, with patient-approved secure access to medical records for all providers involved in patient care. Using Artificial Intelligence (AI) to improve patient medical literacy is a critical part of cost-effective management.
Better technology will also support remote patient monitoring of patients with chronic diseases. This will enable the development of virtual care paradigms that further enhance the ability of healthcare providers to expand and improve care for the at-risk population and focus efforts on the costly patient using Population Health based on better data and analytics.
The healthy lifestyle program that I have overseen at Roper St. Francis is an example of one type of program that is needed in preparation for the aging tsunami. It is a cardiometabolic program aimed at reducing the risk of chronic disease, normalizing metabolic abnormalities, reducing the need for medication, and improving the patient’s overall fitness and functionality.
Fine-tuning your diet and setting fitness goals are essential to this approach. Patients meet with a nutritionist regularly and adapt their diet to a more balanced and healthier plan. Regularly planned small group exercises with “homework” on non-training days improve fitness. This reduces general metabolic abnormalities and improves functionality, especially in patients who have previously been limited by orthopedic problems. Programs like these have to multiply many times over and ultimately become the standard in care.
It is high time technology enabled efficiency and performance gains, as has been the case in other industries. Despite its previous shortcomings, improved HIT is the only way the current system can deal with our country’s aging population. Technology developed by clinicians for clinicians can re-establish the doctor-patient connection, enable remote care, and make public health more efficient. Only then will the current health system be able to cope with our aging population.
Dr. John M. Ciccone is the Chief Medical Officer of DSS, Inc. A practicing cardiologist since 1982 and a leading advocate for better health IT, Dr. Ciccone started his career in New Jersey and moved to South Carolina in 2012. He is board certified in internal medicine, cardiovascular diseases and has an additional certification in integrative and holistic medicine.