Thoughts on Healthcare Structure

Some random thoughts that have accumulated over the last few months. Apologies if they seem raw. Please feel free to discuss, write responses, and otherwise engage.

• Emergency services should be a utility on par with fire, police, etc. Patients in emergency situations are operating in an inelastic market and should be brought to the closest, most effective facility that would stabilize them until they (or appropriate parties) are able to make decisions about their care.
• Once a patient is stabilized, data should reside outside of hospitals and decisions should be made based on wide-scale epidemiology and pricing. There is a need for a player to support this.
• Providers should have a market to offer/bid on services with transparency into outcomes they are able to deliver based on cohorts. This should lead to increased medical tourism, acceleration of adoption of telesales, etc.
• Patient record / EHR should start at birth, not at the time of an acute intervention. This should lead to a number of things: 1) by the time a patient has to undergo care, there should already be a lot of data about them to cohort them, and 2) there will be growth in quantified life improvement industry. For example, we would see an explosion of services that would offer to improve life in a specific way with far lower friction for development of such surfaces. This means there is a need for a platform akin to App stores.

If any of this is of interest to the reader, let me know and I could write out some thoughts on a topic in greater depth. Also, if am planning on putting together teams to tackle some of these, so please let me know if you are interested in being involved at nikitab@jomi.com.