Health care: Information tech must catch up to medical marvels
Michael Dowling, Northwell Health's CEO, believes we're entering the age of smart medicine.
- The United States health care system has much room for improvement, and big tech may be laying the foundation for those improvements.
- Technological progress in medicine is coming from two fronts: medical technology and information technology.
- As information technology develops, patients will become active participants in their health care, and value-based care may become a reality.
In his book Health Care Reboot, Michael Dowling, Northwell Health's CEO, argues that "[the United States] is constructing a solid foundation upon which the new American health care is being erected." To those steeped in news of health care's administrative bloat, under-performing primary care, and low levels of insurance coverage, such a thesis may seem bold, wishful, or downright delusional.
But Dowling does not ignore the health care system's need for improvement. Rather, he believes that contemporary trends can foster such improvement if we recognize their value. He cites advances and disruptions in areas such as consolidation, education, payment reform, and mental health to support his progressive view that "better, safer, and more accessible care" is coming.
Among those trends is big tech's move into health care, or as Dowling puts it, technology may soon move us into the age of smart medicine.
Medical tech marvels
Dowling sees big tech's stride into health care as coming from two fronts: medical technology and information technology. On the medical technology front, the technology available to doctors has accelerated at an unprecedented pace, resulting in tools and techniques that are "the stuff of Star Wars."
"Some of the most advanced technology tools ever developed in any field are in use to care for patients. Look at any modern operating room or intensive care unit, and the technology to treat patients and keep them alive is remarkable," writes Dowling.
To pick one of many examples, Northwell Health's Cohen Children's Medical Center was the first pediatric program on Long Island to institute ROSA, a "robotic operating surgical assistant." Before ROSA, children suffering epilepsy would have to undergo a full craniotomy to target and monitor areas of seizure activity. With ROSA's assistance, surgeons can get the same results through a minimally invasive procedure, reducing the risk of infection and strain on the patient.
Even technology not designed for therapy has been co-opted to play small, yet supportive, roles in quotidian treatment. A study out of the Children's Hospital Los Angeles found that virtual reality can help reduce a child's anxiety and stress during basic procedures such as a blood draw.
Information tech plays catch up
Photo: Sisacorn / Shutterstock
Dowling characterizes the information technology front as "less impressive," pointing to the well-known difficulties of onboarding electronic health records. Beyond concerns of cybersecurity and interoperability, such systems have caused widespread burnout and dissatisfaction among practitioners thanks to their time consumption and complicated workflows.
But progress is being made. Apple recently added a Health Records app to its iPhone, giving patients from 39 health systems access to their medical records.
"This existing new reality is that a fat file, that until recently was stored away unavailable to the patient, now sits in its entirety on the patient's phone," writes Dowling. "For patients with chronic conditions who make frequent use of medical services, this leap forward enables them, whether a mile from their doctor's office or a thousand miles, to track and share with their doctor essential data on blood pressure, heart rate, glucose levels, and scores of other important clinical markers."
But to succeed, this information must be gatherable, accessible, and understandable to any patient. Big tech will need to streamline such systems for maximum user-friendliness, all while keeping operations on a device with which patients and practitioners are intimately familiar.
That device will be the smartphone and tablet. 77 percent of Americans own smartphones. Among Americans over 65 years of age — the demographic most in need of such advancements — 46 percent own a smartphone, a number that is likely to climb.
Big tech's vision of integrating information technology with health care is some ways off. Much experimenting must be done, and big tech needs to better collaborate with traditional health care stakeholders. Even so, these incipient steps may lead to a framework where practitioners can gather more data more quickly and with greater ease, while patients become partners, not passive recipients, of their health care team.
Accelerating value-based care
In the United States, value-based health care exists today as a should-we, could-we debate topic. Big tech's entry into the field could push value-based care closer to practice. As noted on the health care blog Tech Prescribed, integrating improved data acquisition with AI-powered platforms could turn value-based care into a manageable venture.
"As a result, we will see the move to VBC accelerate even further as more firms turn a profit through this business model. Good news for docs — this will make you the primary customer for provider technology and really improve your user experience as a side effect," writes Colton Ortolf of Tech Prescribed.
The Northwell Health entity Pharma Ventures was created both in response to collaborating with big pharma and as a means to promote value-based care. Pharma Ventures was designed "to link drug prices to drug performance" and "to serve as a super-site for clinical trials." The goal is to drive down costs while simultaneously improving patient experience. Such an initiative is only possible due to Northwell's integrated systems and system-wide electronic health records.
Entering the smart age of medicine
For Dowling, health care in the United States is laying an important foundation for the medicine of tomorrow. We're moving away from the view that health care is something the patient receives at a medical facility. Soon, health care will see the patient take an active role alongside a team of health care providers.
"The new American medicine is proactive and has physicians working in teams with nurses and other caregivers to reach out to patients and guide them along a pathway to health and wellbeing," writes Dowling.
By creating new machines, proliferating information, and making that information easier to obtain, big tech's dive into health care will be a fundamental element in this upcoming paradigm shift.
Erin Meyer explains the keeper test and how it can make or break a team.
- There are numerous strategies for building and maintaining a high-performing team, but unfortunately they are not plug-and-play. What works for some companies will not necessarily work for others. Erin Meyer, co-author of No Rules Rules: Netflix and the Culture of Reinvention, shares one alternative employed by one of the largest tech and media services companies in the world.
- Instead of the 'Rank and Yank' method once used by GE, Meyer explains how Netflix managers use the 'keeper test' to determine if employees are crucial pieces of the larger team and are worth fighting to keep.
- "An individual performance problem is a systemic problem that impacts the entire team," she says. This is a valuable lesson that could determine whether the team fails or whether an organization advances to the next level.
Water may be far more abundant on the lunar surface than previously thought.
- Scientists have long thought that water exists on the lunar surface, but it wasn't until 2018 that ice was first discovered on the moon.
- A study published Monday used NASA's Stratospheric Observatory for Infrared Astronomy to confirm the presence of molecular water..
- A second study suggests that shadowy regions on the lunar surface may also contain more ice than previously thought.
Credits: NASA/Daniel Rutter<p>Still, it's not as if the moon is dripping wet. The observations suggest that a cubic meter of the lunar surface (in the Clavius crater site, at least) contains water in concentrations of 100 to 412 parts per million. That's roughly equivalent to a 12-ounce bottle of water. In comparison, the same plot of land in the Sahara desert contains about 100 times more water.</p><p>But a second study suggests other parts of the lunar surface also contain water — and potentially lots of it. Also publishing their findings in <a href="https://www.nature.com/articles/s41550-020-1198-9#_blank" target="_blank">Nature Astronomy</a> on Monday, the researchers used the Lunar Reconnaissance Orbiter to study "cold traps" near the moon's polar regions. These areas of the lunar surface are permanently covered in shadows. In fact, about 0.15 percent of the lunar surface is permanently shadowed, and it's here that water could remain frozen for millions of years.</p><p>Some of these permanently shadowed regions are huge, extending more than a kilometer wide. But others span just 1 cm. These smaller "micro cold traps" are much more abundant than previously thought, and they're spread out across more regions of the lunar surface, according to the new research.</p>
Credit: dottedyeti via AdobeStock<p>Still, the second study didn't confirm that ice is embedded in micro cold traps. But if there is, it would mean that water would be much more accessible to astronauts, considering they wouldn't have to travel into deep, shadowy craters to extract water.</p><p>Greater accessibility to water would not only make it easier for astronauts to get drinking water, but could also enable them to generate rocket fuel and power.</p><p style="margin-left: 20px;">"Water is a valuable resource, for both scientific purposes and for use by our explorers," said Jacob Bleacher, chief exploration scientist in the advanced exploration systems division for NASA's Human Exploration and Operations Mission Directorate, in a statement. "If we can use the resources at the Moon, then we can carry less water and more equipment to help enable new scientific discoveries."</p>
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