Healthcare in the USA and across the globe is in crisis! We are plagued with erratic quality, unequal access, and sky-high costs. The good news is that we are on the cusp of radical change – we’ re in the midst of an avalanche of converging technologies in medical science, software, hardware and communications and this perfect storm is transforming medicine and healthcare in ways that sounded like science fiction a mere decade ago. This is giving medical professionals, patients and key industry players the unprecedented ability to make appropriate healthcare more accessible, affordable and humanistic.
Patients, physicians, pharma and regulators would do well to face these profound changes, as their lives and their industries will not look the same after they have transpired. Those who aren’t prepared when the waves of change reach the majority of healthcare will be swept aside.
As a trained physician, academic, innovator, and medical futurist, I examine the most important developments. My job is to assess how the hand of technology can continue to provide the dose of humanity that is crucial to effective healthcare. By preparing for the inevitable waves of change, you can make informed decisions about how technology will shape your well-being or company, and stay healthy and afloat amidst the waves of change.
The convergence of exponential technologies is propelling three major trends that will see healthcare flipped on its head: the transformation from patient to pro-sumer, the move from a pipeline based approach to sick care delivery to a platform based approach and a shift from insurance based payer approach to an out-surance based approach.
Patient to Prosumer
For two millennia since Hippocrates, only physicians were able to acquire and access medical data and make medical decisions. This model of medicine trains physicians to think they know best what’s good for the patient. Patients are subjects of healthcare, not partners! However technology is democratizing the access to knowledge as well as the ability to deliver care. The convergence of smartphone, sensor and AI technologies, notwithstanding the exponential advances in others now enables patients to not only contribute to health decisions for better outcome but actively engage in the care delivery process – a move from passive recipient of care to active producer (pro-sumer) of their own health.
An array of wearable skin and edible sensors (about 300 currently commercially available and several in development) is now able to give you thousands of data points that range from activity, to emotional status to vital signs to continuous blood labs. The combination of these sensors with smartphone technology and built in artificial intelligence – or machine learning which is the ability of computers to reason the way humans – is resulting in a flood of point of care diagnostics –medical testing and monitoring devices that come to patients as opposed to them going to a health center.
Pipeline to Platform
Uber, Airbnb, Amazon and Apple. All of these companies disrupted their markets when they launched and today they are industry leaders. What’s the secret of their success?
These cutting edge companies are built on platforms: two sided markets that are revolutionizing way we do business. As digital networks become more ubiquitous, providers that do a better job of harnessing the power of the platform will win. This approach has significant potential to address many of the challenges that have historically been experienced domestically and globally in terms of the provision of safe, accessible, affordable, cost-effective, and convenient health care. The application of Telemedicine and Telehealth technologies are principle examples of how platforms can be used to strengthen healthcare services by overcoming many of the barriers to healthcare (ex. geographical, technological, access, and cost) and provide quality diagnostics and treatment that improve patient well-being among all demographics — particularly traditionally disadvantaged groups and underserved communities.
Telemedicine is transforming how healthcare is being delivered and there are a number of design (and patient) centric companies and organizations who are re-imagining how medicine can be practiced and are driving the industry forward with innovative technologies and solutions. According to some market reports, this industry has the potential to realize a growth of 20.8% by 2020 with a market of $86.6 billion. This market is huge and to discuss it in its entirety would be a little ambitious for the scope of this blog but suffice to say that companies like American Well and Doctors on Demand that never existed a few years ago are set to become the largest provider groups…and off course that’s not factoring in the entrance of giants like Apple and Amazon into healthcare delivery.
New technology is already on its way and augmented reality, virtual medicine advances, biotech, and wearables will be integrated into this landscape to provide additional methods for the provision of care, patient monitoring, diagnosis, and treatment. All of this will increase the level of physician-patient interaction that leveraged and facilitated by technology and will require new ways of thinking about healthcare, tech, and medicine as well a signifiant amounts of user-centric and human orientated design thinking.
Insurance to Out-surance
Massive reductions in insurance costs are coming, along with a wave of disruption.Traditionally, insurance premiums are determined by actuaries… a function of big numbers, statistics and probabilities. That’s what you have to do when you don’t know what’s really going on. You hope that the pool of insured individuals is big enough to account for the variation in your predictive model.
But exponential technologies — namely computation/digitization, artificial intelligence, machine learning, sensors, networks (especially social networks), and genomics — will change all of that.
Social networks will allow us to create true peer-to-peer insurance models.Imagine finding a group of peers, who you trust and can vouch for, and coming together as a group to self-insure.You skip the centralized, expensive middleman insurance carrier – instead, a technology stack (app, database, AI-bot) manages a decentralized network of people who pay premiums and file claims that the group approves.
This takes out an enormous percentage of the cost structure of traditional insurance. Instead of paying fees and insurance company salaries, your peer group can opt to distribute the extra cash that wasn’t paid out…..out-surance!
When talking about insurance, it’s going to be difficult to ignore genomic data. Your DNA is your medical future. It’s predictive of what’s likely to inflict or kill you. And although the Genetic Information Nondiscrimination Act (GINA) was passed to protect people from genetic discrimination in health insurance and I imagine that, soon, groups with great genes will coalesce and self-insure.
It’s in their best interest to do so. You’ll be able to upload your genomics data and find others in your peer group that have similar or better risk profiles than you do…
For life insurance companies, I believe there is a beautiful alignment of incentives coming soon. These life insurance companies will use genomics information to help their clients stay alive longer.
Why? Because the longer they are alive, the more premiums they can pay…
Sensors will allow insurance policies to be based on actual data (e.g. usage, health), rather than general heuristics and rules. Sensors will have the biggest impact on health insurance, as hundreds of new health sensors are coming to market in the next 5-10 years.Sensors tracking healthy behavior such as how much you exercise and what you eat, will get you low insurance costs. A number of health insurance companies are already using health sensors in their policies.
Technology is reshaping healthcare. Understand what’s happening, and why. Prepare so your well-being, company and industry make it through the coming tsunami unscathed.
Dr. Rubin Pillay is our featured blogger and a high performance healthcare executive offering a twenty eight year career of impressive successes as a clinician, academic, leader and innovator/entrepreneur. A medical futurist and Professor of Healthcare Innovation, he is currently the Assistant Dean for Global Health Innovation at the School of Medicine, and the Chief Innovation Officer of the Health System at the University of Alabama in Birmingham. Invite him to deliver a keynote on how the smartphone revolution and it’s increasingly powerful new set of tools, from attachments that can diagnose an ear infection or track heart rhythms to an app that can monitor mental health, can reduce our use of doctors, cut costs, speed up the pace of care and give more power to patients!