Nick Webb

[spacer height=”40px”]So here’s when you think about the trajectory. we went from being good at first aid you know fixing broken bones and keeping people from bleeding to death. Then we got really good at infectious disease we invented penicillin. We started to create things like polio vaccines. It was really cool we were able to do some amazing things during this period time. And we were emboldened by our genius. We’re able to do such crazy cool stuff that we entered into modern medicine. And modern medicine was all about testing for everything and intervening for everything we can so we could really broaden the scope of the diseases that we could treat and diagnose. It was a great time. A lot of people were served during modern medicine. But where we are today is the manifestation of an ecosystem that’s driven by third party reimbursement. It’s driven by a dysfunctional health care system. I was working for a drug client of mine in New Jersey and the goal there was how can we charge more money for drugs. That was their goal and then I get in an airplane and I go to one of my third party provider clients insurance companies and their goal was how do we pay less money for drugs. Right. So we had this dysfunctional Crips and Bloods thing going on right now.

And it’s not serving our patients…but the good news is it’s not sustainable and it will be fixed. But unfortunately I believe we’re here. I believe we’re in a time right now of hyper interventional health care where if it can be diagnosed or if you know one of the big things that a lot of my drug clients look for is what kind of cross indication or usage can we find and now look what’s happened with predicate devices and so on. We have an explosion of interventions. And remember that these interventions reward interventions the system the ecosystem we reward companies to intervene. We reward companies to intervene. And you would think that’s a good thing we’re delivering more health care. This is the future of the DO. You guys have been here for a long time. You’ve been here…the health market is going to catch up with you eventually but they will never ultimately do it because I believe their philosophy has failed. Anticipatory health care and prevention is the only way we get through this. I mean what happens is people start this disease process and it’s asymptomatic. And then it starts to have symptoms and then after the symptoms start to get pesky enough to where they go in by then their clinical options have fallen away. Now it’s real expensive to serve them.

And unfortunately we can’t care for that patient had we got involved with them early on. But anticipatory health care will look at 67 different data signals across the patient to be able to identify things through the learning machine. So essentially you are constantly being diagnosed so that we can get patients. This is not replacing care providers. This is about providing a tool that goes beyond the stethoscope and the OTA scope. We are moving towards Dashboard Medicine. Think about how powerful it would be. Think about this having a patient present to you with six months of daily continuous blood pressure and heart rate and blood sugar…that’s crazy. And it’s happening. I get to participate in dozens and dozens of hackathons and digital hackathons. This isn’t a fantasy. Everything Apple is doing everything Google is doing. They’re all doing it to be able to provide. They want to own the patient data. And I think that ultimately Apple’s got a little bit of a head start. There is a Harvard medical student developed Buoy health care. Think about buoy. It uses the learning machine to be able to diagnose you just by putting your symptoms into the computer online. You get a chance try it. It’s amazing. Think about what we’ve always tried to do that movement towards the tricorder. That’s incredible. And we’re actually there.

But what’s more interesting is when you measure miniaturized that to the point where it’s invisible and ultimately we’re diagnosing continuously. This is really where I think when we talk about connection architecture this is where we’re going. Now for the last 10 years there has been a very very big push about access to health care. Everybody’s talking about access to health care access to health care. But wait a minute I thought I just said that from the data it says that it’s not so much an access of health care although we know that underserved populations are not getting the care they need and deserve. But we can’t really do that unless we look at the real causality and forget the political dynamics and just think about it from the math. Think about this now you guys are probably already know the answer…what percentage of type 2 diabetes cases are caused from self-inflicted chronic disease what we now call lifestyle disease. Is it 50 percent…is it more than 70 percent… more than 70…90 percent. So if you go through these numbers look at this. Type 2 diabetes. Stroke caused by what we now call lifestyle disease, 70 percent. Take a look at stuff like cardiovascular disease obviously big number 80 percent. Even things that maybe are less obvious to me but obvious to you, things like colon cancer look at that, 70 percent. It turns out that a lot of experts are suggesting right now that as much as 80 percent of every dime we spent in health care today 80 percent is self inflicted chronic disease.

If we want to serve the underserved we can’t waste money on self-inflicted chronic disease. You guys know that…you get it. You make those personal connections and we know that’s what’s required to be able to drive the engagement but we also have to change the game. If our discussion is always about more access more interventions I can tell you the drug industry and the device industry loves that dialogue. We need more access. You’ve got the AARP talking about we demand more hips, knees, and viagra for our seniors. Right. So if that’s the dialogue the bottom line it doesn’t scale. Eighty percent of all health care costs are self-inflicted. It’s gratuitous utilization. Now combine that with the fact that by the year 2020 one third of Americans will be over 65 years of age. So you’ve got the silver tsunami combined with the epidemiology of chronic disease that is almost exclusively driven by self-inflicted gratuitous utilization. That’s not good. And that’s going to change we’re going to change the games. We’re gonna change the economic ecosystem that surrounds it.

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