The Most Pressing Need is Not New Meds or Devices: It is Scaling the Proven Solutions that Already Exist
Our medical industry is great at developing new drugs and devices, but that is not the most pressing need. Most premature death, disability, and medical costs come from chronic conditions. Among the most damaging and costly are diabetes and cardiovascular disease. We already have protocols and systems combining lifestyle and medical interventions that have been proven to dramatically improve health and reduce costs in these conditions. They interfere with the biology that causes these chronic diseases.
Lisinopril, losartan, eplerenone and spironolactone for high blood pressure; statins for high cholesterol; metformin and empagliflozin are precision medications that interfere with the biology that causes chronic disease. Intermittent fasting, carb restriction, and exercise impact the same biology. Two landmark studies have proven protocols combining these medications and achieving aggressive risk factor control provide dramatically better outcomes than usual care. Patients with type 2 diabetes and chronic kidney disease treated with these optimal medical therapy protocols (OMT) have one fourth as many heart attacks, one fifth as many strokes and they live eight years longer compared with patients receiving usual care. Patients receiving OMT for heart artery disease have a reduction of mortality as high as 89% and healthcare cost reduction of $21,900 per patient per year compared with patient receiving usual care. The most pressing need in our system is to translate and scale these proven interventions. That should be an urgent national priority.
The greatest opportunity to realize these benefits will come from advanced primary care medical home teams in the outpatient setting. There are already primary care provider teams focused on urgent care and the unique needs of hospitalized patients. The greatest gains will come from primary care teams and providers focused on chronic cardiometabolic conditions. That is the low hanging fruit. The highest risk, highest cost conditions offer the greatest opportunity to improve health and reduce cost. We have the codes to identify those patients from claims data, the protocols to manage them, the educational content to train the teams, the triggers to alert the team to gaps, the analytics to measure baseline and quarterly financial and clinical outcomes, and the systems to bring it all together. The new science and systems make a shift to this kind of care inevitable. The highest level of success requires a comprehensive solution. The big question is how long it will take to get there? This area of medicine is the most pressing need for translational research. If you understand the need and want to be part of getting there, let me know who you are. I will keep that information confidential unless you post it yourself. If you would like assistance in providing this type of support for your patients more quickly, please contact us. We all depend on this broken system. Let’s fix it! wbestermann@congruityhealth.com
Further more, the entire industry has been focusing on high end costly multimillion dollar imaging machines, cathlabs, surgical robots, Stents, etc for hyper-specialized care to deliver late stage sickness seeking profiteering delivery system; it ignores and completely negelects the development of the technologies urgently needed to enable the primary care team to initiate effective prevention measures. We have been attacked by the ndictry insiders trying to prevent our technology from entering the markets taking its right full position in the mainstream. What is the real reason behind all these actions or non-actions? Early detection and early warning for primary secondary prevention do not pay well to the specialists, the hospitals, and the entire medical industry.
We are here to fundamentally fix this injustice! Bill, join us, please!
The industry has not paid attention to building devices that support primary care physicians to make better and more accurate and timely early detection and early warning for diagnostic decision making at their bedside. The traditional ECG has not advanced since it was invented 130 years ago with a poor diagnostic accuracy of 12%! Stress imaging tests deliver an accuracy of only 38-40%, Bill. This is was why I embarked on the journey to rectify this chronic lack of a better tool at bedside for the primary care team to save lives and lower costs simultaneously!