The Changing Face of Healthcare

Several significant forces in the last several years have been changing the way healthcare has and will continue to be delivered. The emergence of more unique ways to deliver care such as clinics incorporated into businesses and factories, the increased use of mid-level providers (nurse practitioners & physician assistants), the increase integration of technologies such as telemedicine and robotics and the shift from interventional reimbursement to outcomes reimbursement are just a few examples.

Compounding these are the ever-increasing costs of healthcare, the strain of funding Medicare on the U.S. economy, and the complications of insurance and healthcare payments under the affordable care act, ACA.

This has led to changes in how businesses intend to interface with the healthcare system going forward. CVS’s acquisition of Aetna will try to leverage healthcare delivery through their pharmacy structure. United Healthcare’s acquisition of DaVita hopes to leverage cost containment and resource control by directly controlling physicians. And the recently announced collaboration among Berkshire Hathaway, Amazon and J.P. Morgan Chase presents a yet unknown structure whose stated goals is improved quality and less cost. How they will implement their strategy is yet to emerge.

The decline in hospital admission over the last several decades has further led to restructuring by hospital corporations such as Tenet. Premise Health has emerged as a company placing physicians and other healthcare providers directly in corporate/business offices.

The big question then with these new ventures are how do organizations know what works financially and how do they track performance… In other words, how do you track, measure and value the relationships between cost and outcomes?

How can the analyst measure which methods(s) may generate better or best outcomes?

A simple return on investment, ROI, calculation will not provide needed nor valid insights. However, the use of cost-effectiveness analysis (CEA) would provide quite useful, valid and actionable information. CEA uses decision tree models to compare not only cost outcomes but effectiveness outcomes of various treatments on patient health and even on future healthcare usage based on various current actions. It can further be used to determine how effective a set amount of money spent on a particular treatment or method will impact outcomes (i.e. willingness to pay calculation). CEA models are flexible and can incorporate a wide variety of scenarios. As opposed to Big Data, CEA makes use of Broad Data so that comparisons of treatment modalities can be evaluated using real life outcomes. It can compare effects on a discrete problem such as a cancer tumor, or on chronic ongoing diseases such as COPD or CHF.

As the delivery of effective yet profitable, or at least cost effective, healthcare becomes more challenging, methods for evaluating treatments and programs become more necessary if not essential. Methods must be implemented to evaluate these new treatments and programs once they are in place so adjustments can be made. CEA enable organizations to both initially evaluate and subsequently monitor new methods and programs in a meaningful way.

The Present and Future of Radiotherapy

The radiotherapy market is growing due to several factors, such as an increase in the number of new cancer cases and technological advancement in the hardware and software used in radiotherapy. The current international markets are underequipped to address new cases of cancer. In low- and middle-income countries, only 10% of the population has access to radiotherapy. Therefore, there exists a wide gap between the demand and the installed base of equipment, which offers a huge opportunity for the companies to grow in the radiotherapy market. Expansion of the radiotherapy market can be both lifesaving and profitable.

Effective planning for the treatment

It is necessary, and continuous technological developments are taking place to minimize the exposure to radiation of healthy tissue, in order to avoid any side effect. This goal is a driving force of R&D for radiotherapy. Software plays an increasingly significant role in cancer care. Population growth and increased life expectancy are adding to the incidences of cancer. The software & services segment includes software, which is used for treatment planning, analysis, and services, which are needed for the maintenance and efficient use of radiotherapy devices. The software & services segment of the companies are expected to grow, as software products help improve physician engagement and clinical knowledge-sharing, patient care management, and the management of cancer clinics, radiotherapy centers, and oncology practices for better performance. Companies like Varian are continuously increasing their software portfolio. Software plays an increasingly significant role in cancer care. At the same time, healthcare systems are subject to harsh budgetary constraints in nearly every country. As a result, healthcare providers face the challenge of achieving more while using fewer resources. To achieve this goal, hospitals have a strong need for software platforms that make radiotherapy treatment cost-effective. The development of effective software will improve the delivery of advanced radiotherapy in the future.

Introduction of new technology
Technology is another salient feature. Radiation therapy remains a significant modality for cancer treatment, which is the primary driving factor for the designing of new techniques to improve the survival rate of cancer patients. New technologies, like proton beam therapy, are available in developed countries like the United States, Germany, and United Kingdom, due to well-established reimbursement policies. Proton therapy can be used on tissues that are highly sensitive, like brain, spine, and eye tumors. It is more accurate, as compared to other X-ray radiation therapies.

Advancement in the technology is also helping to execute the planning of the radiation therapy.

Technological advancement in existing technologies, such as CT imaging, is making imaging more accurate and consistent. This can give a better representation of a tumor and help in better planning. Already-existing technology, such as IMRT, SBRT, IGRT, conformal 3D, VMAT, and others that are used for radiation therapy treatment is undergoing various advancements. For example, Varian is developing a software, which can be used to develop better planning tools, in which statistical models can be used to calculate the quality of an IMRT treatment for a patient. This is expected to increase the usage of IMRT for treating cancer. IGRT is the type of radiotherapy. Research is more focused on IGRT, in order to prove its fewer side-effects. IGRT may include electronic portal imaging, fluoroscopy, ultrasound, CT scan reconstruction, and respiratory gating technology. SBRT is also growing as an option for treating cancer. SBRT is used to escalate the dose to the targeted tumor, which can increase local control while limiting the dose to nearby critical structures and normal tissues. This will cause minimum damage to the surrounding tissues and hence, will experience strong growth in the forecast period.

Internal radiation therapy holds a low share in the radiotherapy market. Containing Yttrium 90, a radioactive substance, this is also an emerging technology. There are only two manufacturers that provide commercialized forms of SIRT, as of April 2015. SIRT is becoming more of a mainstream treatment; other manufacturers are actively looking toward its marketing, resulting in the growth of the internal radiation therapy segment. However, SIRT is not yet widely available in the United Kingdom.

Internal radiation therapy is more precise in targeting cancerous cells because it is placed near a tumor, which reduces the risk of damaging healthy tissues and organs, thereby contributing to the growth of the internal radiation therapy market segment.

To increase the market share, companies are constantly investing in R&D. The positive results of this extensive R&D and strategic partnerships can help the companies gain a significant boost in the emerging field of radiotherapy.

Learn to Relax and Have Fun Playtime Outdoors

Connect with nature and get your regular dose of natural stress relief while you’re at it! This we should memorize as a daily mantra.

I talk a lot about getting outdoors to move, do your exercise and have fun while you are at it. Most of us don’t follow my advice, sometimes (because of work); I don’t follow my own advice. But I try damn hard to, because I know how much better it makes me feel.

Leading a healthy lifestyle is not just about eating healthy food (if you know what that is) and working out all the time. It’s about being aware of your life and moments throughout your day, and it’s about taking time for you, relaxing, doing fun things alone or with family and friends. The more time you spend focusing on your inner well being and the more you look after you, the better you are going to feel. This will result in a more “productive you” at work and a more “fun you” to be around. People who don’t get out, just stare at a screen all day and night, nor make an effort on weekends to break the mould and do something different, are mostly bitter people who think they have all the cards stacked against them and things are unfair. Well, they don’t at all; they stack them that way with their own self-destructive behaviour. Get out and make an effort!

As a Health Coach with my own story of recovery from depression and being overweight, I can really attest to this being a major factor in the process of getting well again and finding that healthy lifestyle, for real.

Many of us think we are healthy, maybe because you hit the gym every day, or think you eat loads of salad. Not so fast, too much hard exercise actually harms your overall health and well being. What we need is a good dose of balance with everything we do.

But first we need to draw up a menu of everything we “should” be doing and check it daily and weekly to make sure are doing it right.

That menu should include:

Eat well (and I mean follow the keto diet to become ketogenic). This will in itself become a lifestyle habit for you that you will not want to break. Once you learn how to achieve this and get there, it’s the most amazing feeling.
Workouts and Fitness Routines need to be carefully coordinated so that you do not over exercise, as so many people do everyday worldwide. Your whole body fitness program may need a total adjustment.
Set up an “efficient” cardio and weight training program, but do not over exercise.
Schedule alone time in your calendar for reading and meditating.
Schedule Play and Fun time alone or with friends and family.
Make sure you breath take note of what’s going on during your day while you are living it, or you may just miss it and become automated. This is MINDFULNESS; we need to adopt a mindful mind. This will help you take more enjoyment out of any given situation and deal with difficult ones more effectively.

That said, as a Health and Fitness Coach this is how I spend my weekend beach time, because I just don’t like to sit still for too long. After 30 minutes of sunbathing and reading I get antsy, so I decided to have some fun and create a simple and fun beach workout. Nothing much to it, but it will keep you true to your primal health coaching program movement plan for the day and you will have fun while at it. You could just go for a swim, but that would be boring…

Move intuitively and be creative. Take any and every opportunity you come across for this type of thing. Believe me, these moments happen a lot but are often lost as we are too busy thinking about what’s next.