ACA architect is skeptical about healthcare tech revolution

Man using a smartphone
ACA architect Ezekiel Emanuel believes tech will play more of a supportive role in healthcare going forward.

One of the key architects of the Affordable Care Act isn’t buying the idea that Silicon Valley will lead the healthcare revolution.

It’s not that innovative technology won’t play a role in transforming healthcare delivery, but the tech industry is more likely to be in the passenger’s seat than holding the steering wheel as the country moves forward post-ACA, Ezekiel Emanuel, M.D., a senior fellow for the Center for American Progress and a professor at the University of Pennsylvania, told KQED.  He acknowledged that his views are more subdued than those of the “tech-utopians” in California who see new technology as a cure-all.

“I do think the role is a much more supportive role that augments what the doctor can do for patients,” he said. “Getting them better data about the patient, getting them to understand where the funds are flowing so that they can understand where the waste is in the system.

“I am much more skeptical that the computer is going to replace a doctor,” he added. “Not going to happen.”

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Emanuel also expressed skepticism over the infiltration of wearable technology for continuous monitoring. The problem, he said, is not getting that kind of information, but what healthcare providers do with it—which requires some level of human interaction.

Even those that have emerged as proponents of health technology have asked for more validity when it comes to new technology. Recent studies have shown that mHealth apps aren’t effective for managing chronic conditions or vulnerable patient populations, and are unlikely to increase physical activity.

Still, given the market growth of wearables, American Medical Association CEO James Madara, M.D., has urged physicians to get more involved with mHealth app development following the organization’s adoption of mHealth guidelines.  

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Despite the likelihood of an ACA repeal, Emanuel added that there needs to be “some mechanism to get people coverage,” whether that’s a tax credit or a voucher. He noted that California’s exchange success offers some quantifiable data tied to cost and quality.