Updated: Apr 28
Healthcare has made great strides over the past two centuries, Life expectancy has almost doubled and has grown for 5 years over the past 10 years, Child mortality has dropped 10 times, more people have access to healthcare than ever. This is mainly because of countless scientific advancements and medical inventions that have changed the way we approach disease. We have gone from only being able to give the patient comfort while the body and the disease battled to actually have a curing mentality and aiming at giving patients a full recovery.
But not all is beautiful in this story, while technology has been a means of reducing cost in almost every industry, it hasn’t been the case in healthcare. While computers and cell phones tend follow Moore’s law and double their price/performance ratio every 2-5 years, healthcare has actually been getting more and more expensive over time.
This is one of the greatest challenges facing us today, we need to find a way to use technology to change that trend and to make healthcare more affordable. I am convinced that technology holds the key to this.
I will try to briefly overview the main trends that can change this alarming tendency to increase costs:
Big Data: It is estimated that in 2020 the average person will generate 1.7MB of data per second. A lot of this data is healthcare data that can come from many sources like electronic health records, wearables, etc. This data can be used for two very important things. The first one is value-based healthcare, if we can actually measure with good accuracy what the actual outcomes of medical procedures are, then we can compare to published data and understand how well a specific drug, device or hospital is doing with a specific patient group. It can align all incentives from a fee for service model to an outcome-based model. Where payment is proportional to the clinical results. The second thing it can do is to better assign risk to insurance payment. It can help nudge people to conducting a healthy lifestyle by making their insurance price lower if they have healthy habits and increase if they don’t.
Artificial Intelligence: A lot of this data that is generated needs to be processed and this task will be beyond human’s capacity to do so. The amount of medical knowledge generated doubles every two months. No human specialist, no matter how smart can keep up with this. Machines can come to the rescue. Algorithms can study every clinical trial ever published and provide specific insights to the physician on which drug to use. Algorithms can help radiologists identify disease earlier. Algorithms can detect fraud in insurance claims and they can help develop ideal treatment plans. What algorithms won’t do is replace the physician as many people have speculated. Several studies conducted have shown that the physician, working with a machine will always outperform a machine and a physician by themselves.
The Social Communication Revolution: The need for physical infrastructure is being reduced exponentially. This is also becoming true for healthcare, almost every patient has a mobile device that is capable of videoconferencing, more and more medical devices are being connected to mobile devices and simple exams can now be carried out remotely. Without the patient using hospital real estate. Surgeons like Shafi Ahmed have used digital like AR o VR technologies to broadcast live surgeries, these can be used for teaching as well as for interconsult, physicians anywhere in the world who specialize in a specific disease can digitally oversee many cases even if they are not present.
3D printing: The first thing 3D printing will bring healthcare is that it gives us the ability to manufacture very complex parts at an affordable price. Human tissue is incredibly complex and printing will give us an unprecedented ability to mimic it. Today this means we can make porous surfaces on hip replacements so they can have bony ingrowth. It means that we can make guides to make surgeries more precise and that we can have bio-similar models that training physicians can use to practice before the actual surgery. Tomorrow it will mean no need for product stock or logistics as devices will be made at the point of care. It will probably also mean that we can make organs and tissue that can be used on patients.
Genomics and all the omics: The more we understand how our body works and behaves, the better we can manipulate it. This means that chronic diseases and diseases like cancer will probably have many new treatment options.
The future is bright, we have never had so many educated people or technologies that can help tackle the challenges of healthcare! But we need to organize, like all changes there will be inertia. We need to create an academic community that evaluates the use if these technologies in healthcare and can orchestrate a data centered discussion around what works and what doesn’t. This data needs to provide feedback to the system so the positive aspects can be reinforced and the negatives reduced. We need to create spaces where the limits and challenges of technology are shared openly and the results are scientifically analyzed. This community has to include patients, physicians, engineers, scientists, nurses, and everybody who can play a part in allowing technology to transform healthcare.
I couldn’t let this time go by without mentioning that on October 11th and 12th in Lake Nona, Florida we will be hosting the 5th annual Digital Surgery congress by Techfit. We want to orchestrate a community around the use of these technologies and Orthopedic and Maxillofacial surgery and will have respected surgeons, engineers and researchers from around the globe. If you’re curious visit www.dsmeeting.com