Their research challenges a basic tenet of the U.S. health-care system: that patients should be treated primarily by doctors in hospitals, typically when they become acutely ill. Yet chronic conditions, such as diabetes, Alzheimer’s, Parkinson’s, and obesity, afflict growing numbers of Americans and “are things you don’t really need hospitals and doctors for,” says Lansky at the Markle Foundation. Instead, such conditions rely primarily on people managing their daily lives.
Lansky says Dishman’s work is radical because it assumes that patients will be cared for at home. “He starts in people’s living rooms, which we almost never do [in health care],” Lansky says. “The marriage between social science and technology is unusual.” Lansky adds that, by applying intelligence to data and giving control over it to family members, Dishman could reshape our health-care system.
But there are huge obstacles. A fundamental one: the health-care system is not set up to pay for technologies that manage care outside of hospitals and other medical institutions. “The financing system doesn’t reward me for using technology,” says Lansky. “If I want to put my mom in my house and take care of her, doctors and hospitals won’t get paid for putting the devices in the home…Even if Dishman’s approach is wildly successful, there’s a barrier there.”
With its deep pockets, though, Intel might just be able to breach that barrier. Its reward: a healthy chunk of the world’s largest economic sector. “There’s a tremendous market there, but it’s going to be a long time coming,” says Craig Lehmann, dean of the School of Health Technology and Management at SUNY Stony Brook in Stony Brook, NY. He researches the use of telehealth systems to manage chronic-care patients; his work has contributed to systems development at Panasonic and Bayer (now a joint venture between Bayer Healthcare LLC’s Diagnostics Division and Matsushita Electric Industrial, which owns the Panasonic brand).
Notwithstanding its new focus on research into health-care technology, Intel’s business strategy for the sector remains fuzzy. It hopes to sell components to makers of traditional medical systems, much like it does with PC makers. But if the sector does not change its model, Intel may have to build and sell the health-care systems itself. “We didn’t invent the baby boom, but it’s going to be really profitable for some of us,” says Dishman. And Intel’s joining the battle may mean better care for all.