Government-run, single-payer health programs, on the other hand, compensate physicians with fixed annual salaries and all-in-one fees based on a patient’s health problem. This structure encourages physicians to order more tests and treatments than may be necessary because there is no penalty, only additional profit, in adding extra charges. health-care system largely operates on a fee-per-service model, in which health-care providers receive payments for each service, test or procedure performed. “The problem is that the current system only reimburses physicians after someone has heart problems.” “Eighty percent of heart disease, particularly coronary artery disease, is preventable through diet and exercise,” he says. In his roles as director of cardiovascular health innovation and co-director of the preventive cardiology clinic, he tries to figure out how to get more of his heart patients to use wearable fitness devices, to encourage them to exercise more and eat right. “It represents the best of engineering - fluids, electrical and mechanical - all in one organ.” “I knew I wanted to study the heart before I knew I wanted to go to medical school,” says McConnell. So the heart gadgeteers are working overtime to address the regulatory hurdles, funding issues and institutional inertia keeping these devices out of mainstream medical use. Yet the medical establishment isn’t quite ready for them. Looking more like fashion accessories than medical equipment, these gadgets leverage advances in smartphones, sensors and digital video, and, in many cases, perform their functions better and faster than the old equipment - for a fraction of the price. A new generation of portable heart gadgets has the potential to leapfrog these old approaches. The equipment is utilitarian, safe and ugly, hooked up to wires, electrodes and monitors. Traditional heart-monitoring equipment lives in hospitals. This year, in addition to caring for heart patients, McConnell is trying to figure out how to integrate a new wave of heart- and fitness-monitoring devices into the medical system. Dressed in black from head to foot, he is among a new breed of physician-engineers, fluent in both medicine and technology. McConnell, tall and fit with laser-blue eyes, isn’t wearing a physician’s white coat on the day he escorts two young Silicon Valley fitness app developers out of his office. Supposing Stanford were to name a chief heart gadgeteer, it might be Michael McConnell, MD, a cardiologist with degrees from MIT in electrical engineering and bioengineering.
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