Digital Transformation of Healthcare
Until 2019, in the pre-Covid era, Healthcare was lagging behind several other sectors in terms of Digital Transformation. The music sector as well the travel sector were well ahead, and even the manufacturing sector was considered to be much more advanced than healthcare.
The pandemic did not change the situation at a snap of a finger but raised the awareness that healthcare cannot scale in the physical space and we need to move to the cyberspace whatever can be moved and the sooner the better. Indeed prescriptions, tele-consultation, tele-monitoring, as pointed out in the previous posts, have increased dramatically and have changed the perception of both doctors and people that:
- it can be done
- there is a value in doing it
- technologies can help a lot
Hence, even when the pandemic will be over it is most likely that this type of “healthcare through the cyberspace” will remain. An indication is also in the expected growth of technology investment expected in the healthcare area, as shown in the graphic.
This is just a tiny fragment of what DX should be, the massive leverage of data to deliver healthcare, a first step.
However small, this first step is important, I feel, because it has set the transformation in motion. This is clearly addressed in the FTI’s report. According to the report in the third quarter of 2020 investors poured 8.4 B$ into US global health, a good portion of those aimed at accelerating the DX into the whole healthcare value chain, including insurers and Government Agencies. The goal is to leverage data to make home care possible, with remote assistance supported by software (AI).
We can expect data to take the lead in the coming years:
> personal data containing
- the genome sequence;
- the metabolome and proteome (these are further down the lane in terms of massive availability);
- the record of exams, diagnoses and prescription (these are already available, in most Countries, in digital form but are difficult to access and are often contained in different non-communicating silos);
- physiological data resulting from real time monitoring through wearable – contextualised in terms of stress, emotion, activity, ambient temperature, umidity;
- behavioural data resulting from ambient sensors, including food intake.
> community data containing
- presence of abnormal incidence of pathologies
- global environmental factors
- emergence of specific symptoms
- usage of medicines
- proximity and contacts
- comparison with other communities with similarities or differences
The intelligence derived from the data analytics applied to the above data (notice the importance of both personal and community data) will become important both in the identification of potential problems and in the monitoring of the impact of decisions taken at personal and community level.
We are going to have an immediate feedback from the personal level to the community level and the other way round. This is bound to lead to better curing protocols, better proactive healthcare and to a decrease in healthcare cost.
Most of the issues are not technological. We could say that the required technology is already available (in many Countries at least), although it is obvious that technology will progress significantly leading to the harvesting or more data with higher sensitivity. The real issues are of organisational and regulatory types. Privacy is clearly a potential stumbling block, particularly in Western Countries.
In Europe, the interoperability among data spaces -preserving data sovereignty and privacy- is now being addressed by the Gaia-X initiative. The pandemic is also pushing towards transnational data sharing at community level (and in a much more limited way at personal level, as an example for health passport and at a more specific level for vaccine effectiveness and side effect). Notice that the shift towards federated Clouds and in perspectives towards “fog” to include data spaces located under people’s control (like in smartphones, in vehicles, in home’s hubs) requires both interoperability (and standards) as well as a regulatory framework.
The FTI’s report indicate as emerging players in the Healthcare Digital Transformation companies like General Catalyst, Geisinger, Epic, Accenture, Alibaba, Qualcomm and Nokia; none of them would have rung a bell just 2 years ago when discussing the healthcare sector.
The focus on data is clearly bringing the big data companies to the fore, from Amazon to Google (Google Health) to Apple (Apple’s Health Records) to Microsoft and Salesforce, particularly when considering personal data and enterprise community data (Salesforce).
In 2018 Amazon acquired PillPack, a mail-order pharmacy, and rebranded it into Amazon Pharmacy in 2019. Patients in the US can ask their doctor to send the prescription directly to Amazon for prompt home delivery. In parallel Amazon launched Health-lake, an AWS healthcare analytic platform that is HIPAA compliant (the Health Information Privacy Application Rules in the US), capable of converting unstructured healthcare data into structured ones, in practice simplifying third party access to data to enable new services. Part of these services are in the area of drugs creation (in partnership with Accenture and Merck). Additionally Amazon has created Amazon Care, a telemedicine program designed for its employees, but obviously expandable well beyond that.
Amazon Transcribe Medical provides doctors with an automatic speech recognition to support dictation of prescriptions and exams, Amazon Care Hub supports caregivers in senior homes and Alexa is now able to recognise changes in a person’s voice detecting emotional status and in perspective some tell-tale signs of an incipient health issue.
Last year Amazon launched Halo, a wristband harvesting several wellbeing parameters. These data can be automatically uploaded to their physician (most likely to one of their physician software assistant) to facilitate consultations and proactive prescriptions.
At Amazon Go -shopping stores- shoppers select food and pay using biometric data that can be correlated to that shopper health record.
Put all of that together and the trend is clear. Amazon, as several other big data players, are looking at the healthcare arena as their new marketplace and this is bound to disrupt the whole healthcare system.