The imbalance of global healthcare system and the opportunities of IT
Healthcare is expensive in the United States. It is much more expensive than healthcare in other country. The difference between these two healthcare system contributes to the difference of the cost and the quality of the care.
The salary for the physicians are different.
In the United States, a physician can make 150K to 300K depending on his/her speciality. That is about 3 to 6 times household income in US. In China, a physician is typically paid with 40K RMB per year, which translates into 7K USD per year. The average household income at China is about 10k per year, thus you can see doctors in China just make the average income when their American colleagues are making a much higher salary even if we factor the geographic differences into the consideration.
The education system for the physicians are different.
In the United states, a physician needs to take six to seven years training on top of his undergraduate education before starting his own practice. The cost of the medical training is high which often incur significant student loan for students with limited financial support from the family.
In China, the medical training is much shorter, a MD can be obtained after five years training after high school. It is three year basic science training with two years clinical practice. This may also contribute to the lower wages that physicians have in China.
The business models are different.
Comparing with China, there are more physicians practicing in private in US. This is due to culture and historical reason. In Mao's era, private practice is considered a small business which does not fit into the ideology of communism party. Physicians typically work in the large public hospital and considered government employees. In the United States, many physicians work as individual practitioners after obtaining his/her medical license. Even large private hospitals are popular.
The pharmacies are different
In US, the pharmacies are typically independent from the hospital. In China, the pharmacies are a part of the hospital and drive a significant portion of the revenue of the hospital.
The workflows are different
In China, the workflow of patient administration and discharge are different. Chinese hospitals are pretty much like government agencies, when you go to hospital, you feel like to to getting a drivers' license at the United States. You go to a waiting line to get a number and when it is your turn, then you go to your physician's room to get care.
In the United States, in most of the private clinics, you got a receptionist who let you wait without a number or expected waiting time. Depending on your luck, you will likely first get the attention of a nurse who is going to measure your vital signs regardless of your condition. The nurse will take notes of the patients' condition. After some serious waiting, the physician will appear, finalize the diagnostics and prescribe procedures and medications.
All these differences contribute to the difference of the cost of the care and the quality of the care. These also elude some cues on potential options to reduce the cost of care at US via technology.
a. reduce the cost of medical education using technology and combined program, expand the labor force of medical doctor.
Medical education require hospital facilities which incurs the expense of medical education, by using distant learning, virtual reality laboratory, the cost of medical education can be reduced to a factor of the current price. We should also provide the option for those students who are determined to be medical doctor to start their medical training earlier. Instead of starting medical school after four year college, medical education can be combined with undergraduate education as eight year BS/MD degrees. More medical doctors should be trained so that high quality of care can be served for more people.
b. IT based workflow optimization to reduce operation cost.
The waiting time at US is much longer, and the information gathered by the nurses are redundant, there are just too many front desk clerks at US hospital than necessary. All these can be streamlined using technology. Patient can simply just checkin at the front desk of the hospital using a kiosk, after admitted to the waiting room, most of the patient can measure/report their vitals using computers by themselves, afterwards, they can interact with the physicians directly. Content management software can be employed to facilitate physician/patient communication so that during those downtime, the patients can get information that are pertaining to his/her condition, thus the physician can spend less time talking. The improved workflow can reduce the cost.
c. Improve the liquidity of the healthcare market using online review system.
Yelp was originally designed to be a healthcare review system, however, over the time, the more popular use case is probably restaurant. It lacks some healthcare specific features such as the procedures performed by the physician, the rating of each procedure, the price of the procedure, etc. How many times have you run into a doctor who wants to do some procedure that is not right for you?
The net is healthcare IT can be very very useful in reducing the cost of the care and at the same time, may also poise some great business opportunity.