Future Health 5/11/18

Delivering care in the new virtual world… 

Dr. Mom & Dr. Dad As Second Assists – It’s only a matter of time before the baton is passed and we get consumers more involved as “partners” in care delivery.  In a study recently report in JAMA Dermatology, pictures taken by parents of a child’s skin conditions via a smartphone camera and forwarded to a dermatologist for diagnosis were of high enough quality to allow for reliable pediatric dermatology care.  The result is that teledermatology involving parents as partners makes for better access at lower cost with comparable results. The study was completed at Children’s Hospital of Pennsylvania (CHOP).  The study involved 20 families who were given photography instructions and 20 families who were not given instructions.  The researchers then compared diagnoses made during in-person visits with photograph-based diagnoses made by a separate clinician.  The photograph-based diagnosis matched the in-person diagnosis 83% of the time with only three of the 87 images not allowing for a conclusive remote diagnosis due to poor photographic quality. In a similar study released in January from researchers at Stanford University, a computer assisted model had an accuracy level of 95+%.  So, the advent of Dr. Mom and Dr. Dad is on the horizon.  It’s an important shift especially in shortage specialties like pediatric dermatology. 

Artificial Intelligence On The Rise – For those of you who are trying to keep up with all of the changes in technology and the implications for health care, it’s rather difficult given the plethora of studies and information.  If you’re trying to understand the implications of artificial intelligence, check out the 2017 Artificial Intelligence Index completed by a multi-institutional, multi-disciplinary group of experts. At 101 pages, it is ripe with information on the future of AI.  Check it out!  The reason this is important relates to another survey study of 20+ healthcare organizations released in December 2017 by the Center for Connected Medicine.  That survey found that the healthcare organizations were marking artificial intelligence deployments as a “low” or “very low” priority in 2018.  Rather than focusing on AI, the systems are leaning towards initiatives in cybersecurity defenses, consumer-facing technologies, and leveraging predictive analytics for precision medicine.  While these areas are very important and there are only so many resources available – AI should be moving further up the technology list.  From my perspective, leaders in the use of AI as an “adjunct to care delivery” will be the successful health systems of the future.  Just watch in the coming years as the nimble AI adjudicated care delivery systems outpace the traditional care delivery organizations.  It’s going to happen – and, happen quickly.  Stay tuned!!

Then, Consider The Impact Of Artificial Intelligence On Work – As if you don’t have enough to do already, you may want to consider reading (browsing) the 20 most insightful books recommended by Upwork – an organization that monitors the impact of technology on work.  It’s very clear that technology is changing the way work gets done from manufacturing cars to mining coal.  And, if we think it will not impact healthcare we will be wrong, wrong, wrong.  In fact, the industry is at the forefront of change.  Why – because historically we’ve solved our delivery problems by throwing people at the problem.  But, that’s costly and part of the underlying problem with costs in healthcare delivery.  Couple that problem with the fact that over the next decade large numbers of our workforce will be retiring, becoming disabled or dying as the Boomers move into their last quarter – and, the industry is set for dramatic, rapid change in how work gets done!!  Here are some thoughts from Stephane Kasriel, CEO of Upwork as recently presented at the 2018 World Economic Forum

  1. AI and robotics will create more jobs, not mass unemployment — as long as we responsibly guide innovation – There have been several doomsday scenarios presented including Entrepreneur Elon Musk’s notation that artificial intelligence is “our biggest existential threat” to mankind. I’m not sure that’s going to happen.  In fact, it may be the biggest leap forward for mankind – depending on how it is used!  As Kasriel noted in his WEF presentation, society needs to “guide innovation responsibly [by] opening up new windows of opportunity, not eliminating them.”  AI requires new skills and capabilities.  Simply doing work the way we’ve done work for the last 150+ years will create job loss.  However, adaptation of the professions to these new capabilities will actually enhance our capability rather than diminish our presence and opportunities.
  1. Cities will compete against other cities in the war for top talent – we are seeing this one play out real-time as Amazon strings many cities across the USA along with the opportunity to be the “second Amazon headquarters city”. The Metropoles across the US cities are competing aggressively for Amazon’s attention which will invest over $5 billion in building a second headquarter.  
  1. The majority of the US workforce will freelance by 2027 – In today’s world, about 36% of the US workforce (= 57 million workers) work in freelance situations. It is projected that over the next decade, the majority of USA workers will become freelancers according to the report Freelancing in America: 2017.
  1. Education breaks out of the silo – I sit on the board of a major distributed graduate university and it is safe to say that we are reassessing the future of higher education.  We are coming to the recognition that the approach we’ve taken toward education is no long sufficient in preparing the workforce for the challenges they will face.  Something needs to be done.  I personally believe that education will no longer be an “dedicated, time-focused experience” but rather will require that the workforce engage in an “ongoing, continuous learning environment”.  The approach to such a situation requires vastly different models, processes and business models from the tradition of higher education.  

Managing 23, Me, Myself and I – Several weeks ago, the genetic testing company, 23andMe, announced that the FDA had finally given the go-ahead for launching a direct-to-consumer (D2C) testing kit for cancer. Consumers will be able to pick up the kit without a prescription for tests like BRCA1 and BRCA2, which have been genetically linked to a higher risk of ovarian, break and prostate cancer. The only problem is that the results of the test will provide data and the value of the data is in the interpretation.  Managing that piece of the equation is where the challenges will no doubt arise.  Keep your eyes on this one for it is the future but the path is unclear…

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