I recently attended Exponential Medicine in San Diego, a conference that attracts thought leaders and a broad cross-section of people involved in healthcare.  Daniel Kraft, the physician/inventor/founder of the original FutureMed conference, does a masterful job of attracting an elite mix of technologies, providers, and brilliant thinkers from a diverse realm of healthcare endeavor.  Daniel is brilliant, and the Exponential Medicine conference is unlike any conference I’ve ever attended.  To me, for anybody involved in trying to drive the future of healthcare, Exponential Medicine is THE PLACE.

That said, the most insightful assessment of healthcare today came from a woman who I adore – Dr. Jennifer Brokaw, daughter of the brilliant journalist, Tom Brokaw.  Jennifer started out as a physician, and has evolved into areas related to case management and helping patients navigate the impossibly difficult world of managed care.  Like so many people who I’m drawn to, Jennifer is committed to making a difference.

I shared with Jennifer our platform for patients with heart failure.   I told her that even though we have a mobile solution that can help patients avoid re-hospitalization, finding cardiologists willing to adopt/implement our solution was a missionary task.  It requires finding other forward-thinking physicians who want to look beyond the status quo.

And then Jennifer shared with me an insight that blew my mind.  She told me the following:

“The system is not designed for better patient care…it’s designed for revenue. When the ACA was passed and the incentives were supposedly re-aligned, entrepreneurs lined up to create solutions. Many have found, like you, that it is still “business as usual.”

Wow!  Business as usual.

Here are these heart failure patients who are being discharged, after being hospitalized.  And, they’re sent home where they have nothing.  Managing their chronic disease is a total crap shoot.  50% are re-hospitalized within 6 months.  We believe there’s a significant portion of those patients that can avoid being re-admitted if they’re given a simple tool to track basic functions (e.g. medication compliance; vital signs tracking; alerts to medical staff in a risk situation; etc.).  And it’s free!  Who wouldn’t want to at least pilot with MyDigitalHealth Network to determine if those patients can better manage their chronic disease at home.

And yet, the nurse practitioners and cardiologists balk at doing anything that isn’t “business as usual.”  Let’s run it through a grant program; let’s evaluate it through an IRB process; we need to assign resources to determine the impact; etc.

But here’s the thing –  1 out of 2 patients are coming back within 6 months anyway.  Why not see if you can do better.  One cardiologist told me, “if they just take their BP and heart rate; if they just get on the scale; and they take their meds the way they’re supposed to – they’re going to avoid re-admission.”

But the system is so cautious; the drive to prove lower cost/improved outcomes so pervasive; the approach so overwhelmingly risk-averse and status quo inert; that any additional step or new technology must be established as the standard of care.  In other words, “come back and see us when everybody else is doing it.”

When I started MyDigitalHealth Network a year ago, it was clear that heart disease was the #1 killer in America (700,000/year).  It was clear that Heart Failure cost $32 Billion annually and that there was an opportunity to bend the curve on readmission.  Our goal was to keep CHF patients at home and managing their chronic disease; not simply get them to Day 31 when somebody else would pay for the cost of readmission.

But it was Dr. Brokaw who enlightened me – that beyond simply building a great solution for CHF patients, we must fight the “business as usual” syndrome and enlist progressive medical professionals who are prepared to experiment and explore new ways to treat chronic disease, and break the status quo.