We've all heard the election post-mortem by now. President Obama's surprisingly comfortable re-election — along with the continued split control of Congress — means that the Patient Protection and Affordable Care Act, a.k.a., Obamacare, is here to stay, although some Republican governors are deciding to let the federal government run their states' health insurance exchanges and are opting out of the law's Medicaid expansion.
The "meaningful use" EHR incentive program isn't going anywhere either. Just before the election, several GOP members of the House and Senate had questioned the appropriateness of the net $27 billion effort.
Yes, the group, which included Sen. Tom Coburn (R-Okla.), a physician, was right in that the more than $8 billion paid out so far have not reduced Medicare expenditures and may have even increased utilization of diagnostic testing, but we are still in Stage 1 of meaningful use. The real savings will not show up until Stage 3, when EHRs, if properly implemented, are supposed to increase efficiency and patient safety.
What never was an issue during the numbingly contentious election season was whether innovation in mobile, wireless and other forms of digital health would slow down. It continues full speed ahead, and would have done so even if Mitt Romney had won or if one party had seized control of both houses of Congress. That is a testament to how much our bloated, expensive and downright dangerous healthcare industry needs fresh ideas.
Sure, there is concern that forthcoming regulations from the Food and Drug Administration might stifle innovation, but the FDA's job is to protect the health and safety of the public. Those that don't pass the smell test need to go away, as the Washington Post examined in an investigative piece this week, partially inspired by the work of MobiHealthNews.
Seriously, nobody has devised a cure to tinnitus yet, but a $2.99 app made by someone with no medical background claimed to be "an easy and inexpensive way to cure your tinnitus"?
And good ideas? They will always find a lucrative market.
In fact, digital health should become more important as the Affordable Care Act phases in. A 2.3 percent excise tax on the sale of medical devices takes effect Jan. 1, an effort to rein in what former Sen. Dave Durenburger (R-Minn.) has dubbed the "medical arms race syndrome," one of many reasons why healthcare costs have soared. Hospitals will have to consider whether a mobile app or a compact yet effective device like the pocket ultrasound might be a better alternative to an expensive, full-sized machine.
And while politicians and pundits were distracting the public with their high-profile arguments over insurance coverage, they forgot to mention one other important provisions of the ACA: accountable care. As I have argued before, healthcare provider organizations will have more incentive to invest in wireless and mobile technologies to keep people out of the hospital as incentives shift from volume to quality.
As a result of the ACA, Medicare no longer reimburses for preventable readmissions within 30 days of discharge for treatment of heart attacks, heart failure and pneumonia. CMS may add joint replacements, stroke care, stenting, and coronary artery bypass grafts to that list as early as next year.
If you're in digital health, keep innovating. With healthcare in dire need of reform, there is more demand than ever for new ideas that save lives and money.
