America’s healthcare system has a human problem. Actually, there are several problems — but here is the central one: patients and providers are both suffering from the way that things are right now. Is it possible for technology like artificial intelligence (AI) to solve such a uniquely human problem? I’m not a scientist, but I work in biotechnology — a business that designs products and platforms out of the raw materials of life. As an art school graduate with a BFA in Poetry from Pratt Institute, I am an unlikely authority on this, but I know we can’t trust AI alone to make healthcare more human.
Proponents of AI like Jean Nehme (also a physician, co-founder of Digital Surgery and AI healthcare investor) who insist that “digitizing healthcare is a moral imperative” believe that artificial intelligence can make healthcare more human by enabling providers to spend more time with patients. The healthcare system on the other hand? Evidently, it’s widely known that this industry is slow to adopt technology, and at this point, healthcare itself is seen as a barrier to its own improvement.
What will it take to make this sector less of a hard sell on digital health technologies? Do medical professionals see artificial intelligence as a threat? Not too long ago, the industry was skeptical of electronic medical records (EMR), but over the last decade there has been near-universal adoption of them. I’m optimistic that we can expect the same evolution of opinion over time for other AI solutions, but first there are three key areas that the industry must nurture in order for us to expect a good prognosis for the future of American healthcare: ingenuity, wisdom, and trust.
Ingenuity — creative problem solving will make healthcare more human.
I never imagined that in my lifetime I would see a pandemic like COVID-19. I also never thought I’d see the greatest scientific accomplishment in history that was triggered by it. Two mRNA vaccines that were proven to demonstrate clinical safety and efficacy were developed in the record-breaking time of less than a year. The United States was well-equipped to pull off a feat like this because we have been a global leader in health technology and development for decades.
Our innovations in biotechnology are absolutely worth bragging about. But when it comes to our healthcare system’s performance, it’s obvious why we’re too humble to mention it. The United States spends the most on healthcare than other high-income nations, yet Americans have the lowest life expectancy, highest chronic disease burden, and the highest number of hospitalizations from preventable causes. As the SARS-CoV-2 virus took wrecking ball blows to the United States in 2020, it exposed how our healthcare system wasn’t built to withstand such a merciless force of nature.
It seems miraculous that humanity has made it through such devastation, but this is not the first time we’ve done it, and if we’re smart enough, it won’t be the last. We owe our long history of survival to a power that is innately human — our ingenuity. Before we get back to innovating away with technology, we need to understand what saved us from this pandemic. Who were our heroes? What did they do to save us? Science didn’t make live-saving breakthroughs by itself, and even though our healthcare system is in shambles, the backbone of it is still intact thanks to the divergent thinking of medical professionals and scientists.
Wisdom — rebuilding value in the ability of medical professionals to use knowledge in a profound way.
The human interaction that takes place for a physician to deliver healthcare to a patient is unique to the medical profession. Years of medical training are dedicated to developing clinical expertise yet the modern-day physician spends more time charting and documenting clinical visits than they do with patients.
Physicians are aware of AI’s potential to be an empowering tool that could help them improve the quality of care they give to patients. Administrative inefficiency is one of the many factors that contribute to our healthcare system’s dysfunction. In a Harvard Business Review piece by Christopher Kerns and Dave Willis, it is estimated that “20% to 30% or more of a physician’s available capacity is absorbed by clinical documentation, electronic medical record (EMR) inputs, and other compliance-related work.” AI automation could alleviate this incredibly time-consuming burden. However, physicians have so little control over the administrative requirements for them to practice their profession that they have no incentive to demand it.
Over 100 years ago, the Flexner report drove American healthcare to place an emphasis on training medical professionals to use scientific reasoning to make medical advancements. As a result of embracing a “hyper-rational” system of education, the role of physicians as healers has been deprioritized to the profession’s own detriment. The high costs of a medically advanced system have turned patients into consumer who shop around for the best deal to suit their individual budget and needs. It’s safe to say that the individualized healthcare model is here to stay, and this is perhaps the greatest opportunity for digital health to take root, but it’s also undeniable that this consumer-health dynamic is one of the factors that has eroded trust between patients and providers, thereby causing a rift between them.
Poorly designed people-system interactions like ours in America have made burnout rampant in the healthcare field. The value of wisdom in medicine has declined. A profession that was once defined by its compassion has lost agency within our healthcare system.
Trust — the assured reliance on the ability of healthcare to do something.
Remember the central problem of American healthcare? Patients and providers are both suffering from the way that things are right now. Trust is a two-way street. Understanding healthcare at this juncture in time is to know that the pavement on this street has been eroded so badly that people in both rural and urban communities are stranded and left to their own devices. By that, I mean that many patients are left to literally rely on their computers, smartphones and wearable devices as resources to obtain information about medical conditions and treatments to make healthcare decisions for themselves.
It may seem preposterous to imagine that American healthcare has reached such an irretrievable breakdown that patients are turning to the internet instead of directly to professionals, but this was an inevitability in the design of our system. The same Flexner report that influenced American healthcare to invest in an expensive acute-care model is also responsible for diverting the focus of medicine away from individualized health prevention. This is the same system that marched medical professionals to the frontlines in March 2020 when COVID-19 first attacked. The same doctors and nurses who we should only rely on as our last line of defense were drafted by our system to fight in a war that they never signed up for.
Did the groundbreaking outcome of America’s fast and ambitious vaccine development initiative come at the expense of half a million lives and counting? Of course not. But this is the defining example of how trust in healthcare has been betrayed in the United States. It is also the defining opportunity for digital health to take stock of what needs to be reconciled.
Ingenuity is the human power to think differently. Innovation is to introduce something new. I have a challenge in mind for the founders of digital health companies and the VC’s who will back them.
1. Examine each of the critical events that have taken place in the U.S. and abroad from January 2020 (when the World Health Organization first sounded the alarm about the novel coronavirus) up until the present day.
2. Study the cause and effect of each critical event in the pandemic.
3. Imagine how digital health technologies could have been used strategically in each critical event to steer the U.S. down a different path.
4. Learn from the past and aspire to change the course of history with your ideas.
5. Set goals now for the digital health revolution to achieve in the next century.
There will always be room for technology, but to start, let’s look around at how we can work with what we have. The most prominent goal for digital health shouldn’t be to simply invest in innovative technology, it should be to bridge the gaps between patients and providers to build an ecosystem of solutions that all of us can rely on.
In part two of my series, “Debiasing Healthcare With Digital Technology”, I will take on another challenge that digital health must contend with: racial, gender, and economic disparities.
“Artificial Intelligence Won’t Make Healthcare More Human” is part one of my original series: Digital Health’s Connection Problem
About my series:
The digital health revolution is upon us. It promises to introduce disruptive technologies that will drive innovation and transform our broken healthcare system to meet the demands of a post-COVID19 world. Will this revolution be high-impact and sustainable or an expensive fad that dies out fast? At this new crossroads where healthcare innovation meets technology, I am asking digital health companies and the VC’s who back them one question before they proceed: is disruptive technology a solution in a system that is so deeply disturbed?