Healthcare: Transition refining quality care
San Diego’s healthcare providers are focusing increasingly on giving treatments at locations other than hospitals to suit patients’ needs, a trend that seems likely to continue. Helping patients improve their quality of life, rather than the length of the time they have left, is also a new priority for providers. In future, individualized medicine that is specifically created to suit patients’ genomics will revolutionize the healthcare system, much as the use of data is changing the sector now. Jobs in the healthcare sector will begin to shift towards outpatient and ambulatory care, as well as more specialized care practitioners such as ED nurses and lab workers. Information technology professionals will be in greater demand because of the growing reliance on technology for healthcare provision. The Trump administration’s intention to repeal the Affordable Care Act has created doubt as to the future of healthcare, but there is hope that the replacement plans will be made available ahead of the repeal and that health coverage is maintained for the millions that gained it under the ACA.

Where do you see San Diego’s health care sector headed in 2017?

Along with the trend nationally, I see a continued shift in San Diego to treating patients not in hospitals, but in other locations that provide the right level of care in the right place at the right time. Patients will benefit by getting the care they need in a setting that’s more convenient for them, with easier access to appointments and with an integrated approach to care among all of their care providers. We need to be where patients need us when they need us.

I also see a growing emphasis not just on prolonging a patient’s life — which medicine is good at doing — but improving the quality of that life, as well. End-of-life care should be what the patient wants it to be, where they want it to be.

Scientific advances will continue to transform medicine and the delivery of health care through this year and years to come. There will be more advances in individualized medicine that tailors treatment to patients based on genomics, which will continue to affect everything from which drugs are right for each patient to understanding the best way to treat different cancers. At the same time, there will be advances in helping whole populations of patients as health care’s ability to use data changes the research landscape and helps translate findings to the patient bedside faster. Other technological advances will help perform seeming miracles, like detecting potential heart attacks before they happen.

Where do you see the biggest growth?

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The shift from inpatient/hospital care to outpatient/ambulatory care is one of the largest areas of expansion. Moving care out of hospitals and closer to the patient, whether that is in a doctor’s office, outpatient surgery center, urgent care or telemedicine.

The other big growth area for health care will be in the use of data to support population health. As providers more and more are compensated for value instead of volume, we will have to provide better wellness and prevention care. This will involve the use of data to identify patients at risk for disease and providing them with the health education, monitoring and early diagnosis to avoid costly interventions later.

What types of jobs will be in demand? (Conversely, are there any jobs that are not as hot?)

Areas where there will be high demand in health care include specialty nursing areas such as the intensive care unit, operating room and emergency department. There also will be continued demand for specialty imaging and lab positions. And to support the shift to ambulatory care and population health, physician extenders such as physician assistants and nurse practitioners will be high demand.

The demand is also driven by current market forces and the aging population of workers in these fields. We will also need information technology professionals who can help us maintain and evolve our information systems and leverage our data to keep pace with the shift to population health. On the physician front, primary care physicians, hospitalists, intensivists, post-acute care specialists will be in high demand. And of course, their comfort with using data and technology in providing care will be critically important.

Is there anything the Trump administration is doing or contemplating that is cause for excitement or concern in this sector?

First, I want to say that I trust the checks and balances system of this country and its strength no matter what president is in office. Under this administration, the future of the Affordable Care Act (ACA) is in question, new regulations are being proposed and debated and there is considerable anxiety being created as people wonder about the impacts of these changes on our patients and our workforce. As health care providers, we have to put our anxiety aside and keep focused on our mission of improving the health and well-being of everyone who comes to us for care, and we must preserve the peace and quiet of a healing environment.

If the ACA is to be repealed, I hope whatever the replacement plans are will be shared ahead of time so that health care providers have time to respond. We will do what we need to adapt to any reforms that come, but every time we have to change, it incurs an administrative cost, which takes time and money away from patient care. I also hope that whatever is put in place makes available good health care coverage for everyone. The ACA expanded health care coverage for millions and millions of people; going back to fewer people with insurance is the wrong direction. But the quality of that insurance is important. Under the ACA, much of that expanded coverage comes with high deductibles people cannot afford, which does not work either.

Having said this, I am cautious about not engaging too much in all the speculation that’s happening now regarding what the Trump administration may or may not do. That can be distracting and nonproductive. There simply are not enough facts available yet. Instead, we need to continue to monitor the situation and develop plans to address the challenges that lie ahead.

Anything else you’d like to add?

This industry is undergoing the biggest transformation in its history, and I’m excited to be part of that. The scientific advances happening coupled with the focus on making health care truly focused on the needs of the patient is the best of both worlds.

There are great challenges that must be met to ensure everyone can get high quality care, and it is unclear what the new administration will do to advance that cause. We will continue to focus on driving down costs, improving the quality of our care and making it more convenient to come here. We have been working toward these goals before the ACA and will continue to do so no matter what happens now because it’s the right thing to do. Scripps has been here for more than 125 years and has survived a lot. We will adapt so we are here well into future for our patients and our community.