The future of U.S. health care already has begun

Imagine this future for our health care system:

You are a patient with a chronic disease. You wear a washable, stylish shirt that contains sensors that continuously monitor eight parameters, including heart rate, blood pressure and body mass index. Your shirt submits that information to an algorithm in your personal database, which provides real-time advice on activities to improve your long-term health and functionality. You still consult with your primary care physician, but predominantly through telemedicine.

Occasionally, you need to see your doctor in person. As you enter the clinic, an automated voice directs you to the exam room and asks if you have any health updates. When the nurse and doctor come in, they maintain eye contact and never touch a computer — the whole visit is documented by voice recognition and advanced artificial intelligence. The doctor's recommendations appear on your personal electronic health record; any prescription immediately transmits to your pharmacy and is available within two hours. All of the financial transactions execute in the background, with a summary text sent to your phone.

These concepts are not as far away as they might seem, as all of our major health systems have some components already under development. Visionary leaders in the business of health care discussed providing the infrastructure for these advances at last month's University of St. Thomas Executive Conference on the Future of Health Care.

These top minds would tell you that just focusing on repealing, replacing or fixing the Affordable Care Act obscures the tectonic shifts now underway. These shifts are quietly changing the structure, financing and operations of the health care system in Minnesota and across the nation.

For instance, chronic disease may be addressed by initiatives such as those of the Cleveland Clinic's "functional medicine" approach. This program uses precision medicine by treating root causes of chronic illnesses, not just symptoms. What may be the most telling thing about this clinic is the waiting list of 2,000 patients.

It's not just new approaches inside the walls of clinics and hospitals that make a difference to patients. Changes in Minnesota law have opened doors for for-profit insurers. This certainly will lead to insurers being more organized and more corporate in managing the entire process. For example, Allina and Aetna have entered a joint venture in which the insurance product brings together payer and provider under a common umbrella. In theory, this type of partnership improves patient outcomes and reduces headaches caused by the somewhat adversarial relationships that once existed between the insurer and provider. Many experts forecast a future of mergers and partnerships to achieve greater economy of scale and cost savings.

HealthPartners has done well as both payer and provider, operating a sound business and providing quality care to patients, something that Allina with Aetna is looking to replicate. Wheeler spoke to Minnesota being a leader in this area, saying, "We do things uniquely here they don't do elsewhere. … I'll get told 'You can do that in Minnesota.' No, you can do that elsewhere, too; we just choose to."

Remember that futuristic idea about a sophisticated shirt that monitors your health? At the conference, Myant presented its washable clothing that contains multiple physiological sensors — wearables that make the Fitbit look old-fashioned. Similarly, Mayo's Chief Information Officer Cris Ross reviewed its $1.5 billion investment in new data systems that bring meaningful patient information to doctors more quickly. He said that artificial intelligence might be overhyped, but augmented intelligence is not. The doctor-computer combination will be powerful in the future.

Although the public's focus on health policy will persist, real change will come from the energy and innovation of health care leaders in Minnesota — as it has for decades. They will be leading the way into a healthier future for us all.