Joe Flower: Health Care Futur(and Optim)ist

Health care Futurist Joe Flower will keynote the Health 2.0 Fall Conference next month. Joe is the author of the book Healthcare Beyond Reform: Doing It Right for Half the Cost and a blogger at his personal site Imagine What If. For more posts from the conference speaker interview series, click here

Matthew Holt: This is Matthew Holt, delighted to be talking with one of our keynotes for the Health 2.0 Conference coming up in just about four weeks now. I am with my friend, Healthcare Futurist Joe Flower, who has been talking to hospitals and all the people in healthcare for, if I were to guess, about probably 25 years now Joe, and he is also the author of a new book called ‘Healthcare Beyond Reform: Doing It Right for Half the Cost’.

So Joe, I know you have been to Health 2.0 a number of times and you have been also probably far more on the sort of traditional delivery side and the finance side of healthcare than many of the technology folks that we tend to have at Health 2.0. But tell us why is the time ripe now, and how do we do it right for half the cost?

Joe Flower: The time is ripe now because besides reform, there are a number of things, underlying things, like demographic shifts, people like myself, baby boomers getting older, and economic changes in the healthcare that are pushing healthcare to change its economic underpinnings. And it’s those economic underpinnings that are pushing healthcare to — the core part of it is that it is slipping off of the strictly fee-for-service model and beginning to do a lot of healthcare in different kinds of economic models, and that changes what people are actually trying to do in healthcare.

The technology is a great enabler of doing things in new and different ways, and I think it will be really fun to talk about that at the convention of the Health 2.0 in San Francisco.

Matthew Holt: So talk a bit about how the organizations you have met with who are doing it right for half the cost, give me the faith that it can be done, because we talk about bending the cost curve, but saying you can do it for half the cost is a lot better than saying you can do it for a little bit less than the big increase we are expecting. So what ways do you believe that half the cost is possible?

Joe Flower: Well, there are organizations out there that are doing it for 15% less, 20% less, 25% less now. When I get to half the cost, I am looking at systemic effects when large sections of healthcare start doing things differently and you get a kind of competition curve that actually is kind of hard to imagine until you flip it into what we have experienced in computers and consumer electronics and those kinds of fields over the last 30 years. In which we have seen a tremendous cost power curve that has made the iPhone that I have in my pocket has way more power than any computer you could have bought even as little as 15 years ago and costs a fraction of the cost.

There are actually possibilities like that in healthcare, but they don’t come online until different parts of healthcare are competing for the thing that we actually want to buy, which is our health, and getting better and staying better as opposed to a list of things off a list that they can charge for on a fee-for-service system, which may or may not lead to our healthcare.

Once you have made that shift, I think there will be a fairly rapid series of changes in healthcare that will lead to much lower cost.

Right now though, in the atmosphere we have now, if you do it in an isolated organization, you change the way you do things, you can actually drive down the cost of your healthcare by 15%, 20%, 25%.

Matthew Holt: So what’s the jump we need to make to get to a sort of systemic change rather than just having these isolated incidences and these isolated systems that we have talked about over the years, what’s that jump that needs to happen system-wide, and how do we sort of get the ball rolling?

Joe Flower: I think the jump is what’s already happening and we are reaching some kind of tipping point. There are a number of organizations who are taking on the financing of healthcare and the provision of healthcare in ways that are — whose economic underpinnings are different, in which they are actually getting paid not to do specific things to you, but for your outcomes, that either your outcomes that you want a new hip or you want a baby or you want your diabetes taken care of, and can they do that well, or your overall outcomes, how healthy are you? How much can they keep you out of the ER or the surgical suite because you don’t need that kind of care, because they have taken care of you earlier and faster?

And those kinds of organizations, those kinds of attempts are now some small percentage of healthcare; maybe 5%, maybe 10%, but in different aspects of it, they are growing rapidly.

I have a Twitter feed which I constantly put out stories of different examples from around healthcare where it’s already happening. When you reach a point where it may be something like 20%, 25%, 30% of the market is competing in this different way, then all the people who supply to them, all the people who make up their value chain, all the people who make up their financing chain will have to adapt to it.

If you are supplying healthcare in some way, whether as a freestanding surgical center or as somebody who makes a machine of some kind, and there is 1% or 2% of your market that is seriously interested in getting to this outcome in a very much lower cost but high quality way, you can safely ignore that.

But when that becomes 10%, 15%, 20% of your market, at some point in there you are forced to compete, you are forced to come out with new models, new business plans, new ways of providing whatever the outcome it is that you are providing healthcare, not for a little bit less, but for half the cost, for significantly less than you are now, and finding a way to do that.

As we are used to in all other markets, especially in computers and the high-tech market over the last many years, we are doing things now that would have been considered completely impossible two decades ago, or even less, and the breakthroughs in that were not just technical, they were also in how people went about, what kind of business models they invented to get there, and that’s what is happening in healthcare.

I think we are going to hit that tipping point fairly soon. I think we may be going over it now. I think that when we look forward, I think I could say safely that within this decade healthcare will look profoundly different than it does now, and it may well cost a lot less than it does now and be better for everyone.

Matthew Holt: So if you want to hear more optimism I suggest you come to the Health 2.0 Conference, where he will be telling us, not only about this new future, but also how to get there. And there are actually five things Joe, I won’t have you repeat them now, that have to happen that are all described in your book, ‘Healthcare Beyond Reform’. Really looking forward to seeing you at Health 2.0!

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