What Role Will Hospitals Play in Health Care's Future?

A recently released online study conducted in 8 countries suggests that patient attitudes about privacy in health care may be changing. More than 70% of the respondents said they are receptive to using toilet sensors, prescription bottle sensors, or swallowed monitors to collect personal health data. A personalized health care regimen based on a genetic profile was preferred by 66% of the respondents. Trusting the results of personally administered tests as much as or more than if they came from a doctor was accepted by 53% of respondents to this study, “Intel Healthcare Innovation Barometer,” conducted by Penn Schoen Berland for Intel.

Another interesting result was that 57% of the respondents believe traditional hospitals will be obsolete in the future. Although I have been suggesting this will occur as we watch hospitals morphing into health systems in our local communities, such a suggestion might seem out of step with our observed reality. Commenting on the survey results, Eric Dishman, Intel Fellow and general manager of the company’s Health and Life Sciences Group, stated “Most people appear to embrace a future of health care that allows them to get care outside hospital walls, lets them anonymously share their information for better outcomes, and personalizes care all the way down to an individual’s specific genetic makeup.” He went on to say that “Care must occur at home as the default model, not in a hospital or clinic.”

Although we are not there yet, my recent experience with the health care system suggests that hospitals are not necessary in most situations for good health care to be delivered.

Here’s my story. I woke up on a Sunday evening with the worst upper gastrointestinal (GI) pain I have ever experienced and had some vomiting. The pain subsided as it seemed to progress down my GI tract. Although I felt lethargic that week, I was able to work, thinking I had a viral GI event given to me by my grandchildren. However, by the next Saturday evening, I felt some pain and thought it might be a kidney stone.

That Sunday afternoon, I visited my family physician’s urgent care facility, where the physician assistant diagnosed a possible kidney infection and prescribed an antibiotic. I thought I was starting to feel better but got a call from my doctor’s office informing me that my pancreatic enzymes were elevated and I needed to have an ultrasound performed. That revealed gallstones in my bile duct.

The next day, I had an appointment with a surgeon who ordered a magnetic resonance cholangiopancreatography (MRCP), which occurred the next morning. Before my surgeon could remove my gallbladder, she needed me to have an endoscopic retrograde cholangiopancreatography to remove the stones in my bile duct. Because it wasn’t an emergency, that procedure did not get done until the following Monday morning.

Three days later, I had my gallbladder removal, and I was able to teach my Sunday school class 3 days later. I was back at work that Monday, 3 weeks after my initial bout with pancreatitis. Through all those events, I was treated as an outpatient. Although my MRCP was done in a hospital outpatient department and my surgery was done in a facility that could have kept me overnight, I had no need for a hospital to receive any of the care I received.

The survey respondents suggested that hospitals will be obsolete in the future, and my own recent health care experience validates this observation. As I lecture on the future of health care, I suggest that hospitals will become a place you go to die because they will only be needed for trauma care after a severe injury when the patient’s situation is life threatening.

I learned a few other things through this episode. There are a lot of very caring health professionals who do their jobs very well. When you are hurting, you care more about your provider’s bedside manner than the credentials they possess. There may be a lot of problems with the US health care system, but when it works well, it is the best.

When I came back to work after my health care experience, I felt as if I had been given a new beginning. May you view 2014 as an opportunity for your own new beginning.