Theranos for President?

November 17, 2015
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In the health tech universe, function lags hype by a huge margin.

That seems to be the lesson being taught over and over again, as the promised benefits and game-changing impact of new technologies, systems, and capabilities remain as elusive as ever, even while the crowd of innovators continues to grow.

In the health tech universe, function lags hype by a huge margin.

That seems to be the lesson being taught over and over again, as the promised benefits and game-changing impact of new technologies, systems, and capabilities remain as elusive as ever, even while the crowd of innovators continues to grow.

Theranos (and it’s CEO Elizabeth Holmes) is, if not the latest, then certainly the largest single hype machine to slowly dissolve under scrutiny.

It is hard not to notice, in an election year, the similarities of Theranos’ trajectory and that of the typical presidential candidate. Much as America’s executive hopefuls make the usual gestures of guaranteeing change, progress, prosperity, and security, Theranos has joined the crowd of health technology innovators heralding its proprietary vision of the future as the surest way forward for everyone.

But while an overhyped presidential candidate can, at worst, be censured by the four-year term limits and election cycle, there may be no coming back from an errant diagnosis or the expense of unnecessary care. That is why it is so destructive to see that although Theranos promised to turn the blood-testing industry on its head, a series of investigative reports have shown the hype to be mostly just that: hype.

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Theranos may yet prove its methods and devices and justify the great acclaim and wealth it has thus far attracted. The more important outcome in the shorter term is that compelling stories not be allowed to substitute for diligent scrutiny. Presidential elections are taxing enough; we don’t need the same sort of cult-like phenomenon driving the advance of medical science.

To a disheartening extent, a similar approach was taken—and federally endorsed—with respect to Electronic Health Records (EHR). The heralded benefit to doctors and patients, personalized care and population health, accountable care and quality tracking, all came well in advance of broadly demonstrated and duplicable outcomes. Interoperability standards came too late (in fact, they are still en route) relative to the mandated adoption of EHR platforms.

The net result is that stakeholders are both bullish and bearish when it comes to measuring progress and navigating disruption.

“It is coming faster than some people thought it would come, and slower and on a more complicated basis than others have also predicted,” explained Professor Carl Nelson in a presentation on the future of healthcare at Northeastern University.

When expectations are set according to the loudest fanfare, rather than carefully aligned with transparent, studied outcomes, the state of the industry will, paradoxically, end up showing us as being both ahead, and behind.

The spectacular potential of new technology—presented by the HITECH reforms and driving adoption alongside innovation in the HIT field—deserves continued emphasis; but it also warrants cautious skepticism.

“It’s something we may have to just live with,” Nelson concludes. “The benefits may outweigh these costs. But the trend to focus on EMRs and interoperability will continue, and should continue cautiously.”

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Many an individual is crippled by healthcare costs, insurance or no. That the public, the media, and professionals across a spectrum of stakeholder industries (finance, commercial, and yes, even medical) are so readily enraptured by a good story without demanding hard data to back it up is alarming, disquieting, and ultimately, expensive both in dollars and in credibility. Populism and cults of personality may be dominant forces in American politics, but American healthcare is in the midst of a critical transition: expectations and accountability deserve to be higher.

As with Theranos, the promise of EHRs may well be delivered upon in the future; now, however, trial and error rules the day. The potential of technology must still be buttressed by the human-based systems of the past, before it can be fulfilled.