As a world, we are caught up in an exciting period of rapid technological advances and innovations. And healthcare is similarly in a period of rapid innovation and technological advances. So how do these two trends merge or connect? Does every technological advance or tool have application in healthcare? How do we decide what technologies will add value to our healthcare organization and to the patients we serve? This creates a need for staying knowledgeable about technology developments and trends outside of healthcare, as well as prudent decision making, along with alignment and execution on the part of healthcare organizations.
Let’s look at some of the current “critical” technologies in healthcare. Electronic Health Records (EHRs) have been around now for decades, yet they continue to evolve and need additional optimization and interoperability. But why? In 2009, only 16 percent of hospitals were using an EHR. By 2013, this number had risen to around 80 percent, based on CMS meaningful use criteria. But with the rush to implement, came a lack of diligence to detail, related to workflow integration and interoperability. But it seems clear that these systems are becoming platforms for workflows, data analysis and delivery and clinical collaboration. While this might not be happening fast enough to meet the needs of all users, this is related to a continual expansion of scope, which is common in healthcare technology execution. Even now, clinicians want more and more clinical functions rolled into EHR platforms.
In the midst of the work to optimize legacy platforms, we all want to embrace and get on board with the next big thing or the “killer app”. You see this with Artificial Intelligence (AI), Machine learning, SMART on FHIR, and any number of emerging technologies. Let’s focus on the cognitive technologies such as AI and Machine Learning, driven by voice and natural language processing (NLP). The broad promise of AI is to liberate people from repetitive, non-value-added mental tasks, in the same way the industrial revolution liberated people from repetitive, physical tasks. Which will be embraced, or who might be the big winners? We now see tech giants Amazon, Google, Apple and others entering the healthcare market. Which of these technologies will be broadly embraced, or which of these players will be the big winners? These are players without experience or expertise in healthcare. So, who do you think will win; and maybe more importantly, who will lose? We will see once the dust settles, but I do think that in the end, the health care consumer will win.
“If AI can help humans become better chess players, it stands to reason that it can help us become better pilots, better doctors, better judges, better teachers.” Kevin Kelly.
If this is true, when will the premise come to be realized? We are at a point in healthcare where benefits are measured from a value perspective, but value to whom? I believe that value delivered to the system accrues to patients, initially as a whole, but ultimately to individuals. I think Mr. Kelly’s premise points to this.
"The broad promise of AI is to liberate people from repetitive, non-value-added mental tasks, in the same way the industrial revolution liberated people from repetitive, physical tasks"
What we are seeing is an era of large-scale “experiments” in healthcare to test what works and what doesn’t. Healthcare delivery organizations need to be selective in where they make their investments in these technologies. Most of them aren’t playing in the “gold rush” that all the new entrants to the market are playing in. So, the playing field is asymmetric right now. The traditional players are looking for sustainable growth and measurable value. The tech firms and bigger players with venture arms are seduced by the size and scope of the healthcare market, and are better equipped to take bigger risks. But the rules of the game are changing, so agility is equally valuable. How do we, and how will we, deliver or add value to the system of healthcare delivery, now and into the future?
I think we need to look towards macro trends in the consumer markets, such as voice-driven cognitive technologies, the use of the Internet of Things (IoT), wearables and look for specific and transferable or adjacent-use cases focused on creating efficiencies and enhancing the user experience. In the case of the consumer, for example, look at virtual encounters all completed with no direct provider inputs but with equal or even greater consumer satisfaction and no perceptible quality difference. From the perspective of providers, Informatics developers are still trying to figure out how AI will fit into existing workflows in a way that is intuitive and not disruptive. There have been some recent surveys of physicians that show that physicians are actually optimistic and enthusiastic about the potential impact of digital technologies. The use of AI assistants may necessitate changes in EHR-user interface design and more seamless ways of integrating outside agents into native EHR processes to enhance the end-user experience and to offload cognitive burden around review of larger amounts of patient data. Certainly, with the focus and concern around physician burnout connected to EHR dissatisfaction, this is an area worthy of research and investment.
This is an exciting time for the consumer of healthcare, and either a time of anxiety or excitement for healthcare providers and organizations. Stay tuned.