Staring up at a team of doctors and nurses from his bed in the hospital emergency room, Bill knew he wasn’t getting back to his vacation anytime soon. That morning, Bill chose a more vigorous hike for his snowshoe outing. At 45 years old, Bill is an active man with no medical history. About half way through, Bill started feeling disoriented and faint, so he called the mountain EMTs. The EMTs conducted tests down at the base of the mountain and detected an abnormal electrocardiogram (EKG) reading that could show signs of potential heart failure. Bill was rushed in an ambulance to the nearest hospital an hour away. After spending over 6 hours in the hospital and costing the health system thousands of dollars, Bill was finally told he was just dehydrated and his heart was fine.
Bill’s history of EKG readings show the potential abnormalities in his heart beat are actually normal for him, but his care providers did not have access to these records. Imagine that hospitals had the digital infrastructure in place to see any patient’s record at any care location. In this case, the EMTs would have seen that Bill had always had an irregular EKG reading, and a trip to the ER would not have been necessary. Taking this vision a step further, imagine if Bill wore a wearable device that constantly monitored his vitals. Had Bill looked down at his device and seen low levels of hydration, he could have simply grabbed some water. The whole ordeal would have been avoided.
The opportunity for technology in healthcare is monumental – from simple instances like Bill’s story to changing the lives of people who suffer from chronic conditions and life-threatening diseases. And it’s no surprise that change is needed. Healthcare is a cumbersome, $3 trillion industry bloated with high costs, inefficiencies, and information asymmetries. Today, the wealth of data being created in medical settings is often not archived, shared, or utilized. But tech companies are working to change this.New technologies like wearable devices and cloud-connected applications will provide streams of personalized medical data to doctors and patients. These technologies together create greater access to medical data, which can improve efficiency for healthcare providers and create better health outcomes for doctors and their patients. But making this data readily available and able to be leveraged is still a pertinent challenge. Unleashing medical data will not just require technical developments but regulatory focus as well.Change in healthcare is in progress, but it will depend on the success of three forces. It is only the confluence of consumer technology products from companies like Apple, healthcare cloud services from companies like Qualcomm, and the enforcement from lawyers and legislative bodies that can successfully replace our system of care with one that leverages 21st century technology.
Consumer Technology Will Capture and Share More Medical Data
The first step to change is enabling constant, objective monitoring of personalized medical data. This will come through the advancement of wearable devices and sensors. In care settings today, outmoded technologies make it practically impossible to capture data in a way that can be utilized in the future. But new wearable devices promise a live feed of biometric vitals that will give doctors greater longitudinal insight. These metrics include simple things like steps taken, heart rate, and blood pressure and extend to more complex vitals like O2 saturation, EKG activity, and glucose levels.Apple could provide the tipping point for the adoption of consumer technology in healthcare with the release of its own wearable device, the Apple Watch. Samsung, Nike, and Jawbone have been early big-name leaders in the category of wearables, but their efforts have not extended far past fitness monitoring.Apple, on the other hand, has shown real commitment to healthcare, reflected in their HealthKit and ResearchKit announcements. These products show that wearables are ready to become an integral part of healthcare, not just fitness monitors. Apple is also a known category maker. It has the scale and influence to legitimize mobile health. It also has the motive and potential to disrupt the healthcare industry, similar to the fundamental changes it brought to the mobile phone and music industries.The Apple Watch promises to not only collect torrents of medical information but also to share it between the patient, doctor, and payer. These useful data streams will chip away at the iron walls existing today between a patient and their care providers. Better-informed patients are more likely to take care of themselves, comply with prescription drug schedules and detect early signs of sickness. Armed with data, patients of the future will be able to take greater accountability over their health.Steven Keating’s story exemplifies the importance of not only capturing but also sharing data. In 2007, Keating was diagnosed with a small brain tumor and was informed by his doctor that it was “nothing to worry about”. He spent the next eight years conducting his own research and sharing his medical data. Upon experiencing symptoms that he knew from sharing and discussing his data indicated a severe problem, Keating urged his care team to conduct an M.R.I. Three weeks later, surgeons removed a cancerous tumor the size of a tennis ball from his brain.
Access to data saved Keating’s life, but the broader challenge is how to make data access and sharing a more common expectation. Even if the Apple Watch and other personal devices provide a flood of important and timely data, we’ll need a stronger digital infrastructure to enable the access that is critical to realizing the data’s value.
Benefiting from More Medical Data Requires Cloud Connectivity
The infrastructure necessary to store a mass amount of data, make it readily available on any device, and enable analytics on that data simply does not exist in hospital networks today. The amazing digital infrastructure of connectivity we’ve built in other industries has yet to fully enable the healthcare world. As new technologies create more ways to capture data in abundance, building a web of intelligent connectivity and decision support systems becomes even more critical.The impact this web of connectivity can have in healthcare is robust. Recent investor appetite in healthcare mirrors that potential. In 2014, private equity and venture capital invested over $4B in healthcare technology companies – double the total healthcare investments made in 2013. Investors are supporting companies who see the next step for patient care. They envision a future where your vitals, medication history, doctor’s notes, lab results, and any data collected in the hospital will all be stored in the cloud. Where both you and your doctor would have full-time access to the data anytime and anywhere. And where both you and your doctor would use the same analytics and systems to help diagnose you, treat you, and recommend preventative measures.Companies, new and incumbent, are strengthening their efforts to enable this data-driven vision. They are building the necessary pipelines to bring more data to our fingertips. Qualcomm is an established healthcare technology leader working toward this vision, but cloud-enabled Big Data companies like Cloudera could be equally as influential if their focus turned to healthcare. Similarly, many companies with cloud capabilities are redefining analytics for medical data. IBM is developing analytics solutions across the spectrum of healthcare. Big Blue is creating a cloud-based service using its Watson technology to conduct predictive analytics on the stores of health data. This service will deliver tailored insights to hospitals, physicians, insurers, researchers and potentially even individual patients.
In addition, healthcare analytics startups are emerging at a fast rate. Flatiron Health, a Google Ventures-backed startup, is building software and infrastructure to provide intelligence to cancer centers and patients with oncology data intelligence. Their solution enables analytics on the 96% of patient data not captured in clinical trials; data that has been never been utilized until now.Paving the mass transit system necessary for medical data to flow and be analyzed is a large undertaking. While technology companies are ready to instigate change, hospitals and healthcare providers are less primed. Long entrenched in the ‘gatekeeper’ role, hospitals have not been incentivized to share information or invest the big dollars in the technology needed for storage and connectivity. Hospitals are ‘black holes’ for data. The impact companies like Qualcomm, IBM, and agile startups like Flatiron Health can have is contingent on realigning incentives in hospital networks. This realignment will need to affect funding, standards, and behavioral and procedural change. The only way to tackle change at that scale is through the government and external stakeholders.
Institutionalizing Change Will Take More Than New Technology
Re-calibrating incentive structures and changing behavior requires influence, especially in this regulatory-laden industry. Part of this influence will be sourced by data-driven stakeholders holding care providers accountable in a new way. Suppose your doctor didn’t use all of the new data and tools available to you and others. Your insurance providers and possibly your lawyers would hold him accountable for damages that could’ve been avoided. The threat of legal accountability will make the use of data a priority. But will this be enough motivation for providers to open the spigots and make sure the data they collect is available and shared in a quick, efficient, and secure manner? This is where government regulation will play a role.
Electronic issues in malpractice claims.
The government, whether it be Congress, the Department of Health and Human Services (DHHS) or both, needs to provide real financial incentives for healthcare providers to increase the connectivity of data. While meaningful use requirements have spurred widespread adoption of electronic medical records (EMRs), there has been little action to address the information silos that have resulted. Regulating incentive structures and behaviors is critical to clearing a path for technological advancements in hospitals to be successfully adopted and implemented.
Although digital healthcare is still a vision of the future, the promise is real. Access to information is the crux of the solution. Everyday patients like Bill will reap the benefits of a wearable device or connectivity across care settings to avoid potentially time-consuming, cost-intensive treatments. They will also have insight into their own health for the first time. Doctors will be able to make data-driven decisions and propel the quality of their care. The potential efficiency ripple effects are vast, but we must continue investing in healthcare-focused consumer technology and cloud communications to release the medical data that’s inaccessible today. More data will open opportunities for stakeholders to re-write how care is delivered and will in turn solidify change in our system of care. It starts and ends with data. It’s time to democratize this $3 trillion industry and truly bring our system of care into the digital age. [Contributed by Kathleen Collins, Jeffrey Vogel and David Wong]