Healthcare: What is stopping the trillion dollar industry from functioning optimally

Globally, healthcare is a trillion-dollar industry. In fact, according to a report by Deloitte, the global healthcare expenditure is projected to reach $8.7 trillion by 2020.  It is the third largest industry in the United States if you ignore the state spending, after Real estate and the financial sector.

With the massive scale and numerous players in this arena, healthcare delivery is anything but smooth. To begin with, it is not uniform throughout the world. Even in a developed country like the US, the level of care differs from hospital to hospital.

AI can tackle major hiccups in the delivery of healthcare. To understand how, though, let us look at the various nodes in the network of healthcare.

Healthcare delivery model

Healthcare is not simply a patient seeing a doctor. There are many stakeholders involved in the process. Even though the level of care might vastly differ from hospital to hospital, these stakeholders remain more or less constant.

  • Patient
  • Doctor
  • Hospital
  • Pharmaceuticals
  • Insurance company/payer
  • Caregiver

A Patient’s journey

In a simplistic scenario, a patient feels ill and in most cases, Googles his symptoms. He then decides to see a doctor and seeks an appointment. The doctor examines the patient, seeks the previous medical records, diagnoses the illness, probably orders some lab tests, and prescribes medicines. The patient goes to the pharmacy and obtains the medicines, takes them and the condition may improve. If it does, he is out of the loop for a while. If not, he goes to see the doctor again and the cycle continues.

There are several pain points in this workflow.

Pain points for stakeholders

For the patient, getting credible information is difficult. Getting to see a doctor quickly is the next big hurdle. Sure, if there is an emergency, the doctor sees the patient right away. However, if it is not, the patient has to wait. There are very limited diagnostic tools that a patient can use on his own.

When he books an appointment, he might have to wait to see the doctor. He has to carry the medical records with him and remember to take his insurance details. When he takes the medicines, he won’t always see the doctor once he is alright.

And lastly, he might not have anyone who is undergoing the same trauma to discuss this with. In a doctor’s mind, an illness is serious or not-so-serious. However, for a patient, no illness is small if it is affecting his daily life!

For the doctor, there is only a limited set of patients he can see in a day. They often don’t have their medical records with them. In the recent months, more and more patients have been using health trackers to track fitness, Electrocardiograms, Blood pressure, just to name a few. This information is often not captured because of the plethora of apps used by the patients.

The feedback in the form of follow up from the patient is limited after the treatment. So, there is very little way of knowing the degree to which the treatment worked.

For the hospitals, it is a challenge in exchanging information as not everybody is using the same enterprise systems. So, when a patient is transferred from say, a primary care hospital to a tertiary one, there is no seamless flow of information. It is even more challenging when one of the hospitals is overseas.

For the Pharmaceuticals, they know the value and volumes of SKUs (stock keeping units) sold. However, it is often impossible to know exactly what a particular medicine was prescribed for and to whom, including the prognosis.

For the insurers, the reimbursement workflow is difficult to follow and much efforts go into tracking the existing treatment options, medicines prescribed, as well as treatments given. In addition, it is difficult to track overseas treatments.

For the caregivers, the challenge is knowing what is going on! They get a limited set of instructions to take care of the patient as most of the professional attention is given to the patient. They really have no one to talk to anonymously, and they have to join a support group, if one is available nearby.

To conclude

Healthcare industry has its challenges because the various stakeholders are not connected seamlessly. There is a loss of information at each interface and it deters the whole machinery from operating optimally. And this is where Aimedis comes in the picture.

How is Aimedis going to tackle these pain points? Read our next article: How Aimedis Is Adding Value to the Trillion Dollar Healthcare Industry

(Images: Pixabay, Pexels)
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