Current health care system cannot survive aging population

The U.S. has the second largest oldest population in the world. By 2050, 21.4 percent of our population will be 65 years or older. Heart disease and stroke are the leading causes of death in the U.S. population accounting for one-third of the deaths in the U.S. every year. The cost is staggering, with direct costs of 214 billion dollars and a further cost of 138 billion dollars due to lost job productivity.

Cancer is the second leading cause of death in the U.S., costing the healthcare system of approximately 174 billion dollars. Diabetes, obesity and Alzheimer’s disease are endemic and will continue to rise with an aging population. The anticipated rise in healthcare costs due to the aging population is simply not sustainable.

A new approach to care delivery is required. We’re saddled with expensive, inefficient healthcare IT (HIT) that has severed the personal connection between doctors and patients as well as between nurses and patients. If we don’t change how care is delivered in this country, the healthcare system will collapse into a sea of red ink.

The move to value-based care is sometimes cited as a way to prepare for an aging population. But value-based models depend on enough patient volume to make the model work. Doctors and nurses are stressed enough due to inefficient HIT like EHRs, which were designed as billing systems that don’t accommodate healthcare workflows. HIT needs to make the transition from data collection to supporting higher levels of productivity.

Appropriate strategies to decrease the incidence of chronic diseases and the associated costs to the healthcare system are critical if all Americans are to have appropriate access to healthcare. Even a decrease of chronic diseases by 10 percent would result in savings of greater than 100 billion dollars to the health care system. Using primary and secondary prevention strategies that rely upon lifestyle changes are extremely cost-effective and will improve the quality of life for the aging population. Inparticular, improved education to the at-risk population will further enhance the positive impact to cost upon the health care system.

The 21st Century Cures Act mandates that patients have unfettered access to their medical records.Navigating through the maze of lab and imaging reports and physician notes with current technology is a daunting task for patients. We need to provide an organized approach to this information, with patient approved secure access to medical records to all providers involved in the care of the patient. Utilizing Artificial Intelligence (AI) to improve patient medical literacy with be a critical piece of cost-effective management.

Better technology will also support remote patient monitoring of patients with chronic diseases. This will enable the development of Virtual Care paradigms which will further enhance the ability of health care providers to extend and improve care to the at-risk population, concentrating efforts to the high-cost patient using Population Health powered by better data and analysis.

The Healthy Lifestyle Program I oversaw at Roper St. Francis is an example of a kind of program needed to prepare for the aging tsunami. It’s a cardiometabolic program aimed at reducing risk of chronic disease, normalizing metabolic abnormalities, decreasing the need for medications and improving overall fitness and functionality of the patient.

Fine tuning the diet and setting goals for fitness are essential to this approach. Patients meet with a dietician regularly and adjust diet to a more balanced and healthy plan. Regularly scheduled small group exercise sessions with “homework” assignments on non-gym days improve fitness. This reduces overall metabolic abnormalities and improves functionality, particularly in those patients previously limited by orthopedic issues. Programs such as these need to multiply many times over and eventually become standard for care.

It’s past time for technology to create efficiencies and boost performance as it has done in other industries. Despite its failings to date, improved HIT is the only way the current system can handle our nation’s aging population. Technology designed by clinicians for clinicians can restore the doctor patient connection, empower remote care and make population health more efficient. Only then will the current healthcare system be able to accommodate our aging population.

Dr. John M. Ciccone is the Chief Medical Officer of DSS, Inc. A practicing cardiologist since 1982 and leading advocate for better health IT, Dr. Ciccone started his career in New Jersey and moved to South Carolina in 2012. He is Board Certified in Internal Medicine, Cardiovascular Disease and has additional Board Certification in Integrative and Holistic Medicine.