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Innovators are disrupting health care and, wow! What they are doing is really really interesting.

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Almost everyone agrees that healthcare is a mess in the US. Medical training is way too long and way too expensive, making it tough for students to choose to become more poorly paid PCPs. The delivery system is antiquated, based on office visits at the convenience of the provider, not the patient. And, we put sick people in hospitals where they are exposed to nasty germs and medical errors. So, it was very exciting to listen to some amazing healthcare disruptors on Day 1 of the first ever bicoastal TedMed2014.

 

The Disruptors

Erica Frank, MD, MPH

Erica Frank, MD, MPH, Founder, President & Exec. Director, NextGenU
Erica Frank, MD, MPH, Founder, President & Exec. Director, NextGenU

Erica Frank is a Canadian physician with a specialty of Preventive Medicine. As the President and Executive Director of NextGen U, she is turning medical education upside down. How? By offering Med Ed via MOOCs (Massive Open Online Courses). What a fantastic idea!  It’s about time we democratize medical education and eliminate the perverse selection system that has pre-meds stabbing each other in the back to get the top grades in the best schools.

According to the Next GenU website, the organization:

…partners with leading universities, professional societies, and government organizations like the U.S. CDC, Grand Challenges Canada, and the World Health Organization. NextGenU.org’s accredited university partners give learners credit for this training (or institutions can adopt them and use them with their students), all for the first time ever for free (and without advertisements). All our courses are competency-based, and include a global peer community of practice, and local skills-oriented mentorships. Founded in 2001, we launched our first full course (Emergency Medicine) in March 2012, and have students registered in over 100 countries: initial data show that NextGenU’s training performs comparably to traditional American medical schooling.”

Not only can NextGen U have profound impact on the US medical education process, but it can help the developing world by training local people who otherwise might not have been able to go to medical school. During her TedMed talk, Erica described a partnership NGU has with the Sudan to train family physicians. The program expects to train 10,000 new doctors in five years time.

In another interesting twist, via another NextGenU partnership with ReelDx – a hosting platform for creating and sharing HIPAA-compliant clinical videos, the Sudanese family practice residents will begin creating video clinical case studies that can be used to further clinical training. Think about the power of this – future Sudanese residents will learn from cases of Sudanese patients in the Sudanese language.

I had a chance to video interview, ReelDx’s CEO, Bill Kelly this week, and came away quite excited about the many possibilities for enhancing healthcare in the developing world by creating and sharing clinical case videos via the ReelDx platform…but more on that in a future post.

 

Gail Reed

Gail Reed, Journalist & Medical Education Cooperation with Cuba (MEDICC)
Gail Reed, Journalist & Medical Education Cooperation with Cuba (MEDICC)

Gail Reed is an American journalist who was NBC’s first Havana-based producer since the 60’s. She has become an expert on the healthcare system in Cuba. Her TedMed talk focused on Escuela Latinoamericana de Medicina (ELAM), the Havana-based medical school that is one of largest in the world with close to 20,000 medical students from 110 countries. The students come from Latin America, the Caribbean, Africa and Asia; 91 are from the US.

But what really makes ELAM different is their focus on enrolling the students from the poorest communities who are committed to returning to practice those areas. They want women, people of color, and people who speak the language of the poor communities. Tuition, room and board are free and the students receive a small stipend.

Now there’s a concept (similar to what the Sudanese training program is doing):  Train people from communities who will stay in those communities. This is so different from our approach of having very expensive training paid for either by wealthy parents or by expensive student loans, churning out docs who want largely urban, well-paid, specialist practices so they can have a chance of paying back those loans before they retire.

 

Elizabeth Holmes

Elizabeth Holmes, Founder of Theranos
Elizabeth Holmes, Founder of Theranos

Elizabeth Holmes started her talk by saying “I can order a venomous viper or a ‘tank for any situation’, but I can’t order a blood test — because it’s too dangerous!” She dropped out of Stanford University School of Engineering at age 19 to found Theranos, a company that challenges traditional blood testing processes. Instead of the large samples of blood drawn by large needles, her CLIA-certified company has developed a process to run high quality lab tests on very tiny samples collected by a finger prick. She is working on making lab testing more accessible as well by partnering with Walgreens to bring lab testing closer to where you live. You still have to have a doctor’s order to get the lab test, but hopefully she is working on a way to disrupt this as well. If you can order a tank, shouldn’t you be able to order a CBC?

 

Jared Heyman

Jared Heyman, Founder of CrowdMed
Jared Heyman, Founder of CrowdMed

I have written about Jared and CrowdMed recently so I won’t repeat it all here. In short, his company has developed a platform that links patients with complex hard-to-diagnose conditions with online Medical Detectives. Anyone can be a Medical Detective, but many of them are retired physicians who still enjoy the challenge of solving a tough clinical problem. I joined as a Medical Detective and worked on a case. I actually figured out what the patient later had confirmed as the correct diagnosis. It was fun. Crowdsourcing medical diagnoses – what a good idea.

 

TedMed Day 1

Day 1 of TedMed was a great day – some of the ideas presented were so creative and so full of potential that it left you shaking your head and wondering why it had taken so long to get to them. We are in the middle of massive health reforms – ranging from the insurance reforms of Obamacare, to payment reform, and now to delivery system reform…and then, of course there’s the whole digital health revolution. What a great time to be in healthcare!

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