Automating Healthcare

By Wayne Caswell, Founding Editor, Modern Health Talk
Inspired by “What if AI Could Uber the Healthcare Industry?”

I loved this Forbes article because it so closely matches what I write about at Modern Health Talk … and because of the truly immense potential.

Many of my past articles are about topics like Getting the Healthcare Incentives Right and how a Hybrid Healthcare System might blend free market capitalism (to encourage innovation and risk taking) with social concepts that promote the general welfare as declared in our Constitution.

Consider what’s possible

People complain about rising healthcare costs – already $3.5 trillion/year. But at the same time, the medical industrial complex fiercely resists changes that would cut into their perverse profits. As a result, the U.S. spends almost twice as much per capita on healthcare as other advanced nations, according to the World Health Organization, yet we still live sicker and die younger.

If only we could cut our costs in half and improve our outcomes to match the others. We’d save well over $1.5 trillion every year. But I think we can do even better than that if we think creatively and beyond cost savings.

The positive effect on profits, GDP and global competitiveness could match the cost savings. And with that, public investments in health, wellness, prevention and productivity might nearly pay for themselves — potentially wiping out $3.5 trillion/year in current spending. But to do that we must first know Why American Healthcare is So Expensive in the first place.

Exponential Technologies

Exponential technologies include network and computing systems, data science, nanotech and digital fabrication, robotics, artificial intelligence (AI), augmented and virtual reality (AR, VR), autonomous vehicles, and digital biology, biotech and medicine.

Consider what’s already happening with medical devices as the power, speed or capacity of the electronic components doubles each year. The devices themselves keep getting smaller, cheaper, more accurate, and easier to use, moving down-market from doctors and specialists in hospitals and clinics, to consumers at home or on the go.

The consumerization of medical devices not only enables the Smartphone Physical but also remote telehealth monitoring services that can focus on wellness and prevention to dramatically lower overall costs. This is happening today, albeit slowly and with a lot of resistance from industry incumbents protecting their positions. Imagine the accelerated benefits if government was to encourage and even demand the use of such technologies.

As the embedded processors, sensors and actuators disappear into everyday objects like the watch on your wrist, clothing or patches you wear, or even under-skin devices, an obvious benefit is real-time monitoring. This can give you or a telehealth monitoring service context to better understand what affects the measurements. Is it a strenuous exercise, something in your diet, or maybe something in the environment? Having that knowledge facilitates taking corrective action if needed.

But is that knowledge learned, and where does it reside? Is it something you or a remote human must interpret and make decisions on, or can that be automated through machine learning and artificial intelligence? And is the data stored and processed in the sensing device itself, or is it in a connected smartphone, or computer system in some remote service? How remote is it – in another room, or across town, state lines, or even international borders? You can see why your local doctor might resist.

Technology Intersections

Solutions to the world’s most pressing problems often lie at the intersection of these exponential technologies, blending science and technology (INFO + BIO + NANO + NEURO).

Consider a healthcare solution that leverages remote sensing, machine learning, public health records, and personal genetic profiles to improve population health and help prevent disease. Or think of the potential impact of big data analytics and knowledge learned from data collected from millions of medical records, published medical journals and Internet queries, and trillions of connected smart devices. Then personalize care based on genetics and behavior.

How might politicians use the knowledge of what affects health, and insight into the economic impact, to improve regulations and legislation to promote wellness and productivity and reduce care costs? Might they finally see gun violence as a public health issue? Would doing something about toxic pollution (air/food/water) become easier to justify? Would automation and the move to universal healthcare help them prioritize good nutrition, poverty relief, safe places to play and exercise, sleep wellness programs, and other factors that benefit the general welfare?

False Predictions

Don’t summarily disregard the possibilities and potential of automating healthcare, or the impact of exponentially advancing technology. We often overestimate what can be achieved in the short-term. But we vastly underestimate what can be achieved in the long-term. We humans are just not equipped to process exponential growth. We instead think linearly, assuming a constant rate of change. But thinking exponentially is key to exploiting new opportunities.

The following quotes show that it’s risky to say that something can’t or won’t be done, especially when technology is concerned and it’s the right thing to do. I hope the list inspires you and others to do the right thing.

• PHONOGRAPH – “The phonograph has no commercial value at all.” (Thomas Edison)

• TELEPHONE – “Well-informed people know it is impossible to transmit the voice over wires and that were it possible to do so, the thing would be of no practical value.” (Boston Post, on the telephone, 1865)

• TELEPHONE – “This telephone has too many shortcomings to be seriously considered as a means of communication. The device is inherently of no value to us.” (Western Union internal memo, 1876)

• ELECTRICITY – “Fooling around with alternating current is just a waste of time. Nobody will use it, ever.” (Thomas Edison, 1889)

• CARS – “The horse is here to stay, but the automobile is only a novelty–a fad.” (President of the Michigan Savings Bank, speaking to Henry Ford’s lawyer, Horace Rackham. Rackham ignored the advice, invested $5000 in Ford stock, and sold it later for $12.5 million.)

• PLANES – “Heavier-than-air flying machines are fantasy. Simple laws of physics make them impossible.” (Lord Kelvin, president, British Royal Society, 1895)

• INVENTION – “Everything that can be invented has been invented.” (Charles H. Duell, commissioner of the US Patent Office, recommending that his office should be abolished, 1899)

• PLANES – “Man will not fly for 50 years.” (Wilbur Wright, to brother Orville after a disappointing flying experiment in 1901. Their first successful flight was in 1903.)

• RADIO – “The wireless music box has no imaginable commercial value. Who would pay for a message sent to nobody in particular?” (David Sarnoff’s associates responding to his urgings for investment in radio, 1912)

• TANKS – “The idea that cavalry will be replaced by these iron coaches is absurd. It is little short of treasonous.” (ADC to Field Marshal Haig, at tank demonstration, 1916)

• MOVIES – “Who the hell wants to hear actors talk?” (H. M. Warner, Warner Brothers, 1927)

• NUCLEAR – “There is not the slightest indication that nuclear energy will ever be obtainable. It would mean that the atom would have to be shattered at will.” (Albert Einstein, 1932)

• TELEVISION – “Television won’t last because people will soon get tired of staring at a plywood box every night.” (Darryl Zanuck, Movie Producer, 20th Century Fox, 1946)

• SPACE – “Space travel is bunk.” (Sir Harold Spencer Jones, Astronomer Royal of the UK, 1957, two weeks before Sputnik orbited the Earth)

• COPIERS – “The world potential market for copying machines is 5000 at most.” (IBM to the founders of Xerox as it turned down their proposal, 1959)

• MUSIC – “Guitar music is on the way out.” (Decca Records, declining to record a new group called The Beatles, 1962)
• COMPUTERS – “I think there is a world market for about five computers.” (Thomas J. Watson Jr., chairman of IBM, 1943)

• COMPUTERS – “So we went to Atari and said, ‘Hey, we’ve got this amazing thing, even built with some of your parts, and what do you think about funding us? Or we’ll give it to you. We just want to do it. Pay our salary, we’ll come work for you.’ And they said, ‘No.’ So then we went to Hewlett-Packard, and they said, ‘Hey, we don’t need you. You haven’t gone through college yet.‘” (Steve Jobs, founder of Apple)

• COMPUTERS – “640 K [of computer memory] ought to be enough for anybody.” (Bill Gates, founder and CEO of Microsoft, 1981)

• INTERNET – “I predict the Internet will soon go spectacularly supernova and in 1996 catastrophically collapse.” (Robert Metcalfe, founder of 3Com and inventor of Ethernet, 1995)

• NEW BUSINESSES – “The concept is interesting and well-informed, but in order to earn better than a ‘C’ the idea must be feasible.” (Yale professor’s comments on a term paper submitted by Fred Smith for an overnight delivery system. Two years later, Smith founded Federal Express.)