AMERICAN HOSPITALS REPORT 2018 Future Trends in U.S. Medical Innovation: Technology and Partnerships Will Bring Expertise Closer to Home By Andrew N. Garman, PsyD, Executive Director, U.S. Cooperative for International Patient Programs (USCIPP); CEO, National Center for Healthcare Leadership; Professor, Department of Health Systems Management, Rush University; Tricia Johnson, PhD, Research Director, USCIPP; Professor and Associate Chair of Research & Education, Department of Health Systems Management, Rush University; Director, Rush Center for the Advancement of Healthcare Value; Jarrett Fowler, MPPA, Senior Manager, USCIPP; Callie Lambert, Research Manager, USCIPP he U.S. has a longstanding reputation to continue expanding disproportionately to over time it will increasingly take the form for advancing the science necessary overall population growth. of incentives for consumers to get their care to develop and sustain medical As average life expectancy increases, the from providers who can demonstrate they are breakthroughs. Over many decades, ratio of working-age adults to retirement- delivering better outcomes at lower costs. Tsubstantial investments from the National age adults will continue to shrink. The ratio Institutes of Health as well as charitable of healthcare professionals to retirement Trend #4 - Medical innovation will foundations have led American academic age adults will also continue to decline, and accelerate – and costs along with it medical centers and health systems to become health systems will need to find ways to The group of innovations collectively known hubs of medical innovation, attracting patients evolve their care delivery models to address as ‘precision medicine’ holds promise for rapid from many countries who travel for advanced these greater needs with fewer people. improvements in addressing many current care. This, in turn, means the clinicians medical challenges. However, all of these in these centers are able to gain greater Trend #2 - Demand for universal breakthroughs will come with new costs. experience more quickly, which is essential to health insurance coverage will Therapies for smaller number of patients are standardizing care that can be more rapidly continue to grow especially prone to higher costs because the disseminated to providers worldwide. For many years, there has been a very strong research and development investments are While this ‘destination medicine’ model global trend toward expanding health insurance spread across a smaller number of beneficiaries. has worked well for many years, how might we coverage for all individuals across countries. Taken together, these first four trends expect it to evolve in the years to come? To help Once citizens have access to care, pulling back point to growing consumer demand and shed light on this question, the US Cooperative from this access becomes quite unpopular and growing consumer costs – a combination for International Patient Programs (USCIPP) thus extremely rare. Expanding coverage is that is unsustainable over time. This brings monitors trends in technology, demography, therefore a trend that seems unlikely to stall rise to our fifth and final trend: political climate, and other socioeconomic factors out any time soon, let alone reverse. Over time, and their potential implications for the future of improvements in access tend to create more Trend #5: Technology will make healthcare. Comprising 66 of the leading hospitals sophisticated consumers who demand higher- healthcare more efficient – and bring and health systems in the United States, USCIPP quality, more convenient, and more easily it closer to the consumer taps into the wisdom of organizational leaders accessible care. At the same time, healthcare Several technology trends hold particular promise as well as quantitative analyses from a variety of spending is increasing at rates exceeding for expanding access to better care at lower cost. objective sources in developing its perspectives. In overall economic growth, a trend no payer will The most exciting involve analytic platforms this article, we take a closer look at five of these be able to sustain indefinitely. collectively referred to as ‘artificial intelligence,’ trends and what they may mean for U.S. providers or AI. While AI is not new, there are several in the years to come. Trend #3 – Consumers’ share of important advances powering its renaissance, healthcare costs will also continue including much lower-cost computing and Trend #1 – Healthcare needs will to grow storage, the availability of much richer health- continue to expand Long-term cost trends in healthcare are leading related data associated with sources such Average life expectancy has been rising many countries to explore greater roles for as electronic medical records and continuous globally for decades, a trend that is predicted commercial insurance. As both governments monitoring devices, and our expanding ability to continue through at least 2030, at which and commercial insurers grow increasingly to analyze data from whole populations point it will cross the 90-year mark worldwide. concerned about rising costs, consumers will be of consumers. Efforts such as the recently While people will live longer, health concerns asked to chip in a greater proportion of these announced ‘All of Us’ study from the U.S. National and healthcare needs also tend to increase in costs directly. While this cost sharing may Institutes of Health speak volumes about what older ages, so the need for healthcare is likely come first in the form of higher deductibles, may be possible in the near future — and how www.arabhealthmagazine.com AMERICAN HOSPITALS REPORT 2018 seriously these possibilities are being taken. hospital facility – Cleveland Clinic Abu Dhabi. AI is also being combined with innovations Cleveland Clinic rolled out its new Cleveland Clinic from consumer services in ways that will expand Connected international program this year, which the on-demand availability of medical expertise allows hospitals outside of the U.S. to benefit to people at the time of need. Recent years have from collaboration and guidance from Cleveland seen the expansion of diagnostic devices such as Clinic in the areas of best practices and clinical EKGs at consumer-accessible prices that can be guidelines for patient care, distance health plugged into the mobile phones and other devices and second opinions, clinical and executive they often already own. When paired with clinical education, and continuous quality improvement videoconferencing, many of the health concerns and advisory services related to clinical carepath and questions that might have previously caused implementation; clinical program development; someone to make a doctor’s appointment can Joint Commission International accreditation; now be managed in the moment. The increasing Andrew N. patient-centric facility design; patient sophistication of telepresence technologies Garman experience; and quality and patient safety. will also increase the availability of remote n In 2016, Orchid Reproductive and Andrology subspecialists to care providers. Services in Dubai launched an affiliation with Northwestern Medicine, a recognized What do these trends mean for U.S. leader in fertility treatment, research, and healthcare globally? education. Northwestern Medicine offers an These future trends suggest both challenges array of comprehensive services, advanced and opportunities for U.S. care providers’ technologies, and medical staff dedicated to relationships globally. One significant challenge excellent patient care and pioneering research is balancing the tradeoff between quality into the causes and cures of disease. The and costs. Providers will need to continue affiliation allows Orchid’s team of experts to focusing on delivering high-quality care in an cross-train and share knowledge with leaders environment where the risks of escalating in their field. Together with Northwestern costs are ever greater. This challenge will be Tricia Johnson Medicine, Orchid Fertility is setting a new especially acute for academic medical centers standard for the highest-quality fertility care and other providers of highly specialized and and outcomes across the UAE. experimental care modalities – in other words, n In 2016, the American Hospital Dubai the very places international patients are most became the first hospital in the Middle likely to pursue care for their most complex East to join the Mayo Clinic Care Network, medical challenges. Pressure is likely to increase providing access to the physicians and to standardize these emerging care approaches expertise of Mayo Clinic for the betterment of faster so that they are more quickly available patients in the UAE and surrounding regions. from lower-acuity, lower-cost providers. International members of the Mayo Clinic Care On the opportunities side, all of these Network share Mayo Clinic’s patient-centered pressures are likely to further accelerate the culture and commitment to improving the transition to technology-mediated care by delivery of healthcare. Potential members U.S. health systems in the global landscape. go through a thorough evaluation, including Historically, these providers have primarily been Jarrett Fowler a review process that includes overview and destinations that patients needed to travel site visits. In addition to American Hospital to in order to receive care and that clinicians Dubai, other international members of the needed to travel to in order