Daniel Kraft is the Exec. Director of FutureMed and on the scientific Advisory Board for the Nokia Sensing XCHALLENGE which will be judged and have its award ceremony at the Health 2.0 Annual Fall Conference next Wednesday, October 2nd.
It sometimes seems that the world is speeding up, and it’s often hard to remember how quickly things are changing in our everyday lives. The relatively slow, expensive technologies of the 1970s and 80s are now essentially ‘free’ features that have dissolved into our exponentially more powerful devices. GPS with navigation directions, video and still cameras, online encyclopedias and the like would have separately cost over $500K 20-30 years ago. As inventor, futurist and Singularity University co-founder Ray Kurzweil likes to point out, a kid in Africa with a smartphone today has more access to information than the U.S. president did 15 years ago.
I recently found (via Twitter) this delightful and insightful story about a couple, both born in 1986, who have two young children. The couple, inspired by their son’s propensity to play on an iPad instead of outside on a nice day, have chosen to revert their life to 1986 levels of technology. No cell phones, no Google, no email, no tweets, no SMS…. So now they read books, develop rolls of film, and look things up in Encyclopedia Britannica. Watching this family, we might wonder how we got through the day and communicated and coordinated with our friends and family.
But we don’t need to go back 27 years; even the changes in the last decade have been breathtaking, and have disrupted many businesses and ways of life (for better or worse). When was the last time you went to a travel agent, visited a physical bank, drove to pick up a VHS or DVD rental?
While much of our world has changed, many elements of our healthcare system seem stuck in the 1980s or before. Most important medical information is sent by FAX machine. Data is often siloed between clinics and hospitals down the street from each other. Blood pressures and blood glucose values are scribbled down in notebooks and rarely if it all shared with the patient’s clinicians. Appointments are often difficulty to obtain, and sourced through multiple choice phone systems. And hard to decipher prescriptions are hand carried to pharmacies. Waiting rooms are still, well, waiting rooms, replete with old magazines and #2 pencil forms asking the same questions about allergies and addresses to be filled out ad infinitum.
But all of this – how we define and experience healthcare and the practice of medicine – is on the cusp of major change. In a decade from now it will look as quaint as the family living with 1986 technology. Indeed, this year, Electronic Medical Records finally surpassed the 50% mark in hospitals and many clinics…. Increasingly, physicians are able to email their patients, which can often help avoid problems or clarify treatment paths…. Walk into an Apple Store or a Best Buy and you will find 25+ ‘connected health’ type devices, which can measure everything from how many steps you take and stairs you climb to your weight, blood pressure, and even blood sugar and posture…. Smart phones (especially with the new capabilities in the iPhone 5S) are the supercomputers in our pockets (or increasingly on our wrists) with a billion times the performance/price ratio of an early 1970s machine. Smart mobile devices are increasingly becoming a dashboard for our health, whether that means tracking our exercise, diet, or medicine compliance, or phone cases that can capture and transmit your critical bio-data.
At FutureMed, a program I run out of Singularity University, we look at the trajectory of fast-moving technologies and how they can be leveraged, especially at their convergence to improve health and medicine. Health data companies like those vying for the Qualcomm Tricorder XPRIZE have emerged out of FutureMed, and are creating connected, smart and networked devices that will change how we manage home diagnosis, triage, and communications with our clinicians. Smart, cheaper and point-of-care sensors, such as those being developed for the Nokia Sensing XCHALLENGE, will further enable the ‘Digital Checkup’ from anywhere. The world of ‘Quantified Self’ and ‘Quantified Health’ will lead to a new generation of wearable technologies partnered with Artificial Intelligence that will help decipher and make this information actionable.
And this ‘actionability’ is key. We hear the term Big Data used in various contexts; when applied to health information it will likely be the smart integration of massive data sets from the ‘Internet of things’ with the small data about your activity, mood, and other information. When properly filtered, this data set can give insights on a macro level – population health – and micro – ‘OnStar for the Body‘ with a personalized ‘check engine light’ to help identify individual problems before they further develop into expensive, difficult-to-treat or fatal conditions.
Bringing these disparate, fast-moving and often convergent technologies together to reshape the future of healthcare certainly has challenges, not the least of which are those from the regulatory and reimbursement worlds. But with some imagination and the desire to address challenges with many of the seemingly magical technologies increasingly at our disposal, we have the opportunity to dramatically shift healthcare from the VHS tape era into the 21st century.
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Great comments!
Well, from the perspective of trying to take care of older adults with lots of chronic illnesses, I would say that yes, I could use some help from technology. (It’s not yet very helpful, for various reasons)
But I agree with Bird that all the tech is not enough if clinicians don’t have time to sit, focus, connect with patients, and help them with their health problems.
Vik is on top of it, great post. Healthy 30 year old computer geeks dont know what it is like to come face to face with real diseases, I am getting ready to tell a 70 yo that we found mets in his liver, i might refer him to an app that will help him deal with the fact that he has less then 6 months to live. They say that having an emr is like having all the information right at your fingertips, that is like taking a harrisons textbook of medicine and tearing it page by page and throwing it in the exam room and says “there you go, you have the medical text right at your fingertips”
Oh yes, I almost forgot. At the very end of the essay, the author sneaks in the concept that is every health-app developer’s and schemer’s dream: reimbursement. Of course, we don’t want to do things that help keep people well and out of the system because that’s not reimbursable, and why miss an opportunity to feed at the taxpayer’s trough?
Bravo!
I am with bird. So much of the “big data will solve it all” is big hooey. People knew before the advent of eHealth whether they were well or sick, and that continues to be true today and most of them knew what do about their ailment, whether it was self-care or visiting a PCP.
Most of what’s described in this post and countless others like it are bells, whistles, trinkets, and toys that are supposed to produce a gusher of information that will drive/change behavior. Who are we trying to kid?
The average American household does not have a college graduate in it, has a lower income now than it did in 2007, and is increasingly likely to have someone living in it with multiple stressors that leave them either emotionally or physically unable to live full lives. Their problems are education, economic opportunity, and disintegrating communities and families. There are no apps for those. There problem is not insufficient access to information. Access to information does not heal broken spirits.
As for people like me…yeah, apps are cool, and I use Strava with a heart rate monitor when I run and cycle, but I have run and cycled (and lifted) for longer than the people who invented Strava have been alive. If Strava fell off the face of the earth today, it would mean nothing to me other than I would want a pro-rated refund for my annual fee. I am driven to stay out of the medical care system and keep as of my personal information as far away from it as possible. The notion that I need an app to tell me how I feel defies the boundaries of both logic and good sense.
Like all app-related cheerleading, not a single word is focused on helping people fix their lives, stay well (truly well) and (mostly) stay out of the health care system. That’s the cost control and utilization answer. Where’s that app?
Being one of those physicians that has all the technology available and has had the state of the are emr for 12 years now, has email capabilities with patients, able to monitor blood pressures and sugars via computer all i can say is this is load of crap. All of the above have cost so much that I now have no time to spend with the patient or incorporate the data into any logical thought. I would say that most true grunts on the front line like myself would aggree with me. Medicine is still and always has been a social discipline that involves a hurting person having time to tell his story to a caring listening physician who can then come up with a plan will work for the patient. And unfortunately many of us have come face to face with the new system and it is not a comfort to us.
Daniel excellent post. I’m curious to know: were you taken aback at all by how quickly medicine at Singularity took off? I think we all guessed there was a market for this kind of smart, well produced video content – the success of youtube and other video channels certainly suggested there was something there – but I don’t think that anybody really guessed that things would take off as quickly as they did. What factors do you think are behind the explosion?
Trailing thought. If you have a second – can you tell us a little bit about what the process is to get involved with the Singularity University curriculum? I know a lot of our contributors and readers are very excited about what you’re doing and would kill to get involved.