More than 1,000 hospitals have closed in 35 years. Ezekiel Emanuel says that’s a good thing.

More than 1,000 hospitals have closed in 35 years. Ezekiel Emanuel says that’s a good thing.

In the past 35 years, hospitalizations have declined by more than 10% as more patients migrate to urgent-care centers, physicians’ offices, and at-home care—and the disappearance of hospitals is “inevitable and good,” Ezekiel Emanuel writes in a provocative op-ed for the New York Times.

Emanuel, a prominent physician and vice provost at the University of Pennsylvania, writes that U.S. hospitalizations reached their peak more than 35 years ago, in 1981. There are now fewer hospitalizations than in 1946.

Due to this decline, the number of hospitals has fallen as well, from 6,933 in 1981 to 5,534 this year.


Why hospitals are disappearing

One reason hospitals are disappearing, according to Emanuel, is that patients increasingly view hospitals as potentially dangerous places to be—”less therapeutic,” he writes, “and more life-threatening.”

In 2002, there were 1.7 million cases of hospital-acquired infections, resulting in nearly 100,000 deaths, according to CDC research. Plus, hospitalizations create risks of medical errors and falls—and constant interruptions in the middle of the night “are not conducive to recovery,” Emanuel writes.

Further, providers increasingly can provide complex care outside of the hospital, Emanuel writes. For example, anti-nausea medications and new forms of treatment mean that many cancer patients no longer have to receive their chemotherapy at hospitals. Similarly, hip and knee replacements are often performed at ambulatory surgical centers rather than at the hospital. Births frequently happen either at home or at birthing centers.

These trends will continue, Emanuel contends, and as they do, more hospitals will downsize, merge, close, or turn into doctors’ offices or outpatient clinics. The hospitals that remain, he writes, will focus on their ED, complex procedures like organ transplantation or brain surgery, and similarly urgent and high-complexity services.

Emanuel’s provocative argument about how hospitals will respond

Emanuel writes that, while he believes the shift away from hospitals will benefit patients, special interest groups within the hospital business may find it threatening. As such, he argues that hospitals are likely to lobby for higher payments from the government and insurers “to retain the ‘good’ jobs hospitals offer.”

But Emanuel argues that “the shift of medical services out of hospitals will create other good jobs—for home nurses, community health care workers and staff at outpatient centers.”

Further, revenue pressures will lead even more hospitals to consolidate and merge into massive health systems. Emanuel writes that the hospitals will claim that these mergers will create cost savings for the consumer, but he argues that these “mergers create local monopolies that raise prices to counter the decreased revenue from fewer occupied beds.” Federal antitrust regulators, he argues, should oppose these mergers.

“Instead of trying to forestall the inevitable, we should welcome the advances that are making hospitals less important,” Emanuel writes. “Any change in the healthcare system that saves money and makes patients healthier deserves to be celebrated” (Emanuel, New York Times, 2/25).

Source: More than 1,000 hospitals have closed in 35 years. Ezekiel Emanuel says that’s a good thing. | Advisory Board Daily Briefing


Flex Expands Digital Health Capabilities, Launches BrightInsight Connected Health Solution on Google Cloud Platform

Advanced medical-grade managed services solution analyzes connected medical device data and therapies, delivering real-time insights within a regulatory-compliant environment

SAN JOSE, Calif., March 1, 2018 /PRNewswire/ — Flex (FLEX), the Sketch-to-Scale™ solutions provider that designs and builds intelligent products for a connected world, has expanded its service offerings for the healthcare industry with a new digital health offering. BrightInsight is a secure, managed services solution built on Google Cloud Platform that can aggregate data and deliver real-time insights to optimize the value of connected drug, device or combination products. The company made the announcement ahead of the annual Healthcare Information and Management Systems Society (HIMSS) conference, taking place March 5-9 in Las Vegas, Nevada.

The  McKinsey Global Institute estimates that applying big-data strategies to better inform healthcare-related decision making could generate up to $100 billion in value annually across the U.S. healthcare system. Medical devices today collect massive amounts of data, which creates enormous potential for a rapid feedback loop that can help improve patient care and enhance drug therapy delivery and management. In order to make an impact, the data needs to be aggregated from a myriad of apps and stand-alone devices, as well as analyzed to provide actionable insights. BrightInsight solves these challenges and helps patients and health care professionals, from physicians to medical device and pharmaceutical manufacturers, to better understand medical device usage and medication adherence, and streamline the product development and certification process.

“We saw the need for a secure cloud platform designed to support highly-regulated connected drug delivery and medical devices, going beyond simple connectivity to deliver real-time intelligence and actionable insights,” said Kal Patel, MD, senior vice president of Digital Health for Flex. “With our 20 years of experience operating in global regulated medical environments, and having deployed more than 75 regulated hardware and software medical products, Flex can combine our cross-industry capabilities to simplify our customers’ digital transformation.”

Flex is partnering with Google Cloud to deliver insights through customizable analytics dashboards fueled by Google Cloud’s advanced machine learning and artificial intelligence (AI) capabilities. Google Cloud Platform enables BrightInsight to securely store, analyze and gain insights from health information, without pharmaceutical and medical technology customers having to manage the underlying infrastructure. Advanced use cases for BrightInsight may include controlling connected devices, drug dosing, decision support, personalized patient interventions, trend analysis and AI-driven insights.

“Google Cloud is committed to leveraging our deep engineering expertise to accelerate innovation in digital healthcare,” said Gregory Moore, MD, PhD, vice president, Healthcare, Google Cloud. “With a partner like Flex, we will enable our customers to develop innovative solutions and leverage machine learning-based analytics that can turn new data sets from wearables, medical devices, therapies and apps into actionable information for patients and providers.”

BrightInsight is designed to support CE-marked and FDA-regulated Class I, II and III medical devices, combination products and Software as a Medical Device requirements, enabling automated interventions. Deployed as a managed service, the BrightInsight platform allows pharmaceutical and medical technology companies to accelerate their time to market, reduce the cost of implementation and maintenance across multiple products, and scale for global markets.

BrightInsight features foundational capabilities for rapid development and a modular platform architecture to support customization and worldwide implementation. It is built from the ground up to securely manage highly regulated medical device data and personal health information, and Flex has put the people, technology and processes in place to monitor security and threat prevention to meet global compliance standards.

BrightInsight eliminates regulatory bottlenecks that can lead to costly delays by offering turnkey regulatory design control and file management of master files with the FDA. This service enables pharmaceutical and medical technology companies to focus on their drug, device or combination product submissions without the burden of documenting the software platform.

Source: Flex Expands Digital Health Capabilities, Launches BrightInsight Connected Health Solution on Google Cloud Platform

Top 5 free apps to keep you healthy in 2018

The most-downloaded health apps on iPhone and Android app stores reveal where Americans are turning to take control of health issues.

A new year means it’s time to comply with new resolutions for many people. Most often, that means targeting health and wellness. A Google search analysis conducted last January showed that getting healthy was the most popular resolution, with more than 62 million searches, almost double the second-most-searched New Year’s resolution: getting organized.

The ubiquity of smartphones in daily life makes it easier than ever to make a resolution related to health — sticking to it is something else. App tracker App Annie provided CNBC with data on the most popular free versions of health and wellness apps from 2017 based on both the Apple and Android app-store downloads. The data was through Dec. 28, 2017.

As technology giants such as Apple, Amazon and Google get serious about remaking the health-care sector, these results show how Americans are using their phones to take more control of their health, and the specific health issues that are proving to be most app-friendly.

Source: Top 5 free apps to keep you healthy in 2018