Friday 3 January 2014

Four Shifts in Healthcare Delivery

2013 has been a very interesting year for healthcare technology - we may even look back and say this was around when healthcare delivery changed for good. As part of my work at NextServices and even as a patient, I track various developments (some hands-on) through the year.

Here are four shifts that I would like to highlight:

1. Medicine becomes a data science
Medical diagnosis is becoming less of an art and more of a science because of increasing availability of data from inside and outside the body. DNA tests, microbiome tests, imaging studies provide clues to lurking problems. Further, data from sleep, activity, stress, changing weight, heart rate and so on provide indications of overall well-being. What isn’t happening however is our ability to interconnect these different sources of data to form a cohesive story. But we will soon be able to. With doctors and patients changing the way they deliver and receive care, we will be to unearth diseases before they manifest as symptoms. IBM predicts that in five years, doctors will routinely use DNA in care. Interesting companies like Theranos are changing how lab tests are done - by precise data analysis through micro samples.

When we think about medicine evolving as a data science, three shifts in healthcare become apparent. One, monitoring ailments becomes a longitudinal statistical analysis and not based on disparate episodes of care. Two, doctors need not be in the same location as their patients. Three, a single diagnosis could involve comparisons across patient populations.

2. Human body as an ecosystem of a billion data points
The human body is expected to have a billion-plus data points. Blood biomarkers provide data points in the hundreds of thousands, DNA in the millions and the microbiome in the trillions. Sensors (via chips) will soon be able to conduct lab tests and provide instant results. Upcoming tricorder-like device Scanadu(about 2 inches wide) is attempting to measure oxygen intake, temperature, heart rate, blood pressure and possibly test for urine and saliva. A survey even suggests that 70% of the people will be willing to share their healthcare data via a smart toilet (yes!).

These data points will find their way through the cloud onto the smartphone. There are already several biosensors on the smartphone - apps such as Cardiio measure heart rate by sensing blood flushing into the face. Apple recently filed a patent for an invention that relates to “sensing and reporting events associated with movement, environmental factors such as temperature, health functions...”. See Smartphone Physical that interconnects various smart devices and applications to provide a patient physical exam via a phone. It may not be much longer before sensors are often found inside the body than outside.

3. Complex Data. Simple Interface.
Generating data is of limited use if we can’t find easy ways to interpret them. IBM’s Watson, which is now more capable than human doctors in diagnosing cancer, provides some insight into how to analyze a lot of data. IBM is also making Watson available as an API to allow programmers tinker with it and build apps.

At NextServices, we got early access to Google Glass as part of its Explorer program and succeeded in porting EHR functions (such as imaging, medications and vital signs) onto the head-up display (we also demoed it at FutureMed). We foresee physicians using Glass at the point of care just as they use our iPad app today. In fact, Wired says that wearable tech will be as big as the smartphone. As devices evolve, we will see increasing underlying complexity that enables simpler interfaces.

4. EHRs as building blocks of healthcare delivery
Much of the industry’s focus has been dedicated to implementing electronic health records (EHRs) that are merely building blocks for digital healthcare. EHRs must be viewed as hubs that interconnect patients and doctors where medical information flows back and forth. Coupled with devices that capture data digitally, EHRs will make the need of a physical visit optional (dare I say, redundant half of the time). According to Fast Company, visiting a doctor would even be as alien as going to a video store.

EHRs will possibly cease to be called so (think how absurd an ‘electronic credit card account’ sounds). Doctors and patients will routinely engage over a digital healthcare delivery platform without realizing that they are on one.

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Wish you a fantastic 2014!