My Review on Amazon.com --->
The Adoption Curve's Economic Dilemma, April 16, 2009
4.0 out of 5 stars
The Edge of Medicine employs a rich symphony of details only a medical school professor could author. This is a great book for medical professional and lay-person alike. The concepts featured, from personal diagnostics to regenerative medicine, are introduced in a way for the reader to understand current clinical context and the vision of future healthcare delivery.
However, the technologies reported on are not new. These innovations have been in practice, albeit under the radar, for the last 3-5 years. In the coming years, they will form a new layer of "standard of care" demand. For instance, an Army Medical Hospital that treats soldier wounds with a regenerative medicine resolution will do the same for a civilian auto accident survivor. Little by little, what is offered as cutting edge to one group will soon be offered to another. Yet, hospital system economics will dictate care delivery based on ability to pay. More and more, we will see standard of care and affordability barrier trajectories go up in a direct relationship. Those who want to read more about the upcoming disparities in futuristic medicine should read Joel Garreau's book, *Radical Evolution.
The adoption curve's economic dilemma is examined further.
The author accurately portrays stakeholder intent in the cost of healthcare: the provider and insurer want to maximize revenues. This means costs are maximized for payers. The payer is the only stakeholder that wants to reduce their costs. What does this mean for the adoption of life saving and cost saving products and services? Providers employ a competitive advantage by advertising a - high quality, low error, reduced pain, and reduced time of stay - patient solution. They are delivering better technologies to stay out in front of patient demand. They don't do so because it's a cheaper way to go in terms of investment dollars. Take robotic surgery, for example. It is not less expensive to deliver this type of care. However, hospital systems advertise client testimonials telling of the satisfaction of quick recovery and painless intervention. They bank on higher utilization of the services rendered. This provides cost justification for the technological implementation.
In the last few years, business model innovation in healthcare has moved to target the payers - those who will pay out-of-pocket for premium or simplified services. From elective surgery providers to online health communities and retail care clinics, these offerings bypass the hospital provider and insurer financial model. The one exception is retail care clinics, wherein, some insurers cover most costs of a visit (<$100). These companies get it. They reject the inelastic economics of delivering innovative care through the hospital system and insurance conundrum, replete with regulatory, reimbursement, and policy challenges. Jeff C. Goldsmith's, **Digital Medicine: Implications for Healthcare Leaders, examines payer-centric business models of the future and how they will become commonplace.
The Edge of Medicine induces hope for recipients of life saving and enhancing technologies. However, this is a standard that not all American's will realize, except for what is delivered in emergency rooms of the nation.
*Radical Evolution: The Promise and Peril of Enhancing Our Minds, Our Bodies -- and What It Means to Be Human
**Digital Medicine: Implications for Healthcare Leaders (Management Series (Ann Arbor, Mich.).)