A lack of sustainability and exclusion seem to be 2 of the main problems in healthcare faced by today’s society, and these are expected to worsen in the generation to come.
A recent document published by the World Economic Forum(1) involving a broad vision looks for new models in healthcare, because we have learned that current models will not be sustainable over time with health care expenditures growing 2% faster than income, as documented in the United States(2) and most developed countries.
The crisis involves economics and the exclusion of large segments of people because of poverty, ignorance, lack of communication, and distance. The world’s population has tripled in less than a century, and life expectancy has doubled in the same period of time. Many countries report a reduction in the number of primary care physicians and specialists, so an imbalance of supply and demand is already evident.
An increasing number of previously excluded patients are becoming new customers of health maintenance and care programs through the explosion of communication and information technologies. Nevertheless, less than 10% of the world’s population can afford any major intervention on the heart, brain, kidney, or joints.
Although changes have occurred with respect to the control and prevalence of communicable diseases, the world’s population is still far from seeing control of malaria, human immunodeficiency virus, and many other diseases. In addition, there are large numbers of patients who have diseases related to lifestyle, such as obesity, diabetes, and hypertension. Prevention and innovation seem to be the way to face the new trends, but these cannot become widespread unless we use novel communication and information technologies, such as telemedicine.
Innovation has been poorly oriented because of the use of older models of healthcare instead of looking outside the traditional institutions and approaches. More problems could be solved without developing new drugs, vaccines, or faster scanners by more widespread use of methods already available for prevention and cure. One example is the “Million Hearts Initiative,” which could save 1 million lives over 5 years with simple measures, such as adequate use of aspirin, blood pressure and cholesterol control, and smoking cessation.(3)
Other basic initiatives have been successfully implemented, such as the Sesame Workshop school program in Colombia, led by Valentin Fuster, using healthy dietary initiatives in partnership with gastronomy celebrities and the media,(4) and the empowerment of patients for self-control of diabetes, hypertension, and obesity with the use of new electronic sensors.(5)
Another potentially important venue for disease prevention and control is the new digital world where telemedicine is part of the solution. In Venezuela, we have initiated an expanding telemedicine program with considerable success. This system could be easily implemented in other developing countries and societies.
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– Tomás Sanabria, MD
This article originally appeared in the January 2014 issue of The American Journal of Medicine.
