The Handheld Hospital

Instead of using technology as part of a medical “arms race,” Dr. Jason Hwang believes the goal of new technology should be to lower health care costs while delivering higher quality and more convenient care.

The co-author of “The Innovator’s Prescription: A Disruptive Solution for Health Care,” Dr. Hwang contends that health care too often uses technology in a way that is akin to “business model malpractice.”

That is what he told an audience of NorthBay Healthcare managers, board members and physicians last week in our Green Valley Conference Center. He was part of our semi-annual systemwide speaker series.

Dr. Hwang is co-founder of Icebreaker Health, a telemedicine company that delivers highly affordable primary care via smart phone apps.

As an example of his premise, he cited the evolution of the computing industry — from mainframes to mini-computers to personal computers to smart phones. That is how “disrupters” move the needle from a highly centralized model to a less centralized one, and then finally, to very decentralized.

The typical smart phone is much more powerful than the mainframe of 40 years ago. That much power now resides in a person’s pocket and is much cheaper than the computer mainframes of yesteryear.

So, he said, health care’s mainframe is the centralization of services. Disruption in health care comes when services are more decentralized, like when banks moved to ATMs to improve accessibility to service and increase convenience. That kind of model of accessibility and convenience is still rare in health care.

But when it comes, the impact will be profound.

Simplifying technologies enables disruption by making work less dependent on trial-and-error experimentation. An example of this kind of disruption in health care is the retail clinic located in a grocery store or drug store. It is staffed with a nurse practitioner and offers a limited array of services. So far retail clinics have met with failure in Solano County, but have been a great success and a significant disrupting influence elsewhere.

The ultimate in disruption in health care would be patient self-diagnosis and treatment for many conditions that lend themselves to this approach. Much of diabetes care is already being done this way. Why not other conditions? It will happen.

Other examples include the use of smart phone apps in rural areas where medical resources are scarce. For instance, why not allow a patient to phone in an EKG for interpretation? Another use under development is using the smart phone to do ultrasound procedures and then call in the results for review and interpretation by medical professionals.

All of this Dr. Hwang calls, “The Handheld Hospital — Health Care in the Palm of Your Hand.” It is a brave new world in health care and one I find very exciting.