Stanford Medicine 2018
Health Trends Report

The Democratization of Health Care

A Message from Dean Lloyd Minor

In last year's inaugural Health Trends Report, we discussed the explosion of data in medicine and what it meant for patients, researchers, and physicians. This year, what we’ve found by drilling down into operation and implementation has vast implications for medicine writ large as all early signs point toward the democratization of health care.

For our second annual report, we again interviewed industry experts and comprehensively reviewed publicly available data from a variety of media, analyst, and academic sources. We also gathered insights from our own faculty about the trends influencing their work and the issues driving the future of health care.

In short, individuals and organizations hold more data than ever before, and the pace at which these groups exchange data is accelerating. At the same time, new tools are rapidly and accurately interpreting medical data — from radiology imaging to genomics — and pushing insights directly to the point of care, which is less and less defined by physical location.

Despite all of this, we haven’t reached the promised land of digitally enabled health care and open access to data. Health care lags other industries when it comes to data sharing and interoperability. It’s clear that we have work to do when fewer than one in three hospitals can electronically find, send, receive, and integrate patient information from another provider.

But we are undoubtedly on our way to a future of care that is more preventive, predictive, and personalized.

I hope this report begins a conversation about how we can best realize the promise data offers our patients and those who care for them. I hope you find the report valuable, and I look forward to hearing your thoughts in the coming year.

Lloyd B. Minor, MD
Dean, Stanford University School of Medicine

Executive Summary

The Road Ahead

As the trend of democratization continues to develop, traditional health care entities will need to make adjustments to account for new technologies, new ways in which patients will experience health care, and new kinds of partnerships. Perhaps, most of all, health care democratization has the potential to recast the patient-doctor relationship, giving patients an opportunity to play a much more prominent role than they have before. If we get this right, it could be a very positive development, for both sides

Over the past year, we've seen the future of a democratized health care ecosystem move closer to reality. But there is a long road ahead. Below is a summary of the key issues that are likely to influence the course and speed at which we arrive at a more open, innovative, and equitable health care system.

Key enablers of democratization:

  • Taking advantage of innovations: AI and machine learning have proven benefits in health care; these and other innovations will not only help the industry progress, but also ensure data is appropriately cleaned, managed, and shared.
  • Collaboration: Working together with tech companies and other health care entities will preempt knowledge sharing and strategic partnerships. 
  • Building trust with patients:  Adequate data sharing requires that the proper rules and guidelines be put into place to ensure the needs and privacy of the patient come first.

At the same time, the obstacles to data sharing in health care are numerous and include:

  • Accessibility: Consumers and health care providers are reluctant to share data with tech companies and non-traditional health care sectors.
  • Data quality: Most data requires thorough cleaning and structure alignment in order to be referenced and shared between systems; there are not enough processes to ensure cleaning gets done.
  • Physician burnout: Doctors are becoming increasingly frustrated with inputting data into EHR systems and find themselves with less time with their patients.
  • Privacy and ethics: Patients are largely uncomfortable with their data being used for research and other purposes; the industry lacks any explicit permissions or anonymization processes.

If these issues can be successfully addressed, the road to democratization will achieve substantial benefits for patients, providers, and the system as a whole.

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