Is tech’s role in healthcare a first step towards an idyllic Kurzweilian partnership between humans and machines or the beginning of an Orwellian nightmare?
As more tech companies become involved in making the American health care system more efficient, the monolith as it has existed for decades will finally be disassembled.
There are many reasons to get excited about this disruption. These new players are masters of efficiency who have looked at the costs involved with health care and understand that they can do better — much better. As Bruce Jaspen wrote in a recent Forbes article put it: “If Amazon and Buffet lift the veil on health prices, insurers are in trouble.”
However, the way they achieve these efficiencies in their warehouses and sales floors gives us a clue about how they might achieve the same effect in health care. It might just be what the doctor ordered, so to speak. Or, as American author and futurist Amy Webb predicted in her #SWX18 Tech Trends keynote, policymakers may fail to appropriately deal with the new privacy and security challenges these technologies will present, landing us in a sort of big-brother-like dystopia. In this first of two articles on the topic, I’ll explore the latter outcome.
An Introduction To The Players
Numerous shakeups in the healthcare industry have taken place in the last few months. First, CVS and Aetna announced a merger that, as Reed Abelson and Katie Thomas reported for The New York Times reported, is intended to “create a world where … getting high-quality, low-cost medical care will be as close as your corner drugstore,” which they hope to accomplish by putting their “merged data about people’s health and vast reach” to work for them. What this would look like in a nutshell is that diagnoses would increasingly be made by artificial intelligence, Internet of Things (IoT) sensors and web portals. Anything non-acute would be handled by a local health care provider, such as a clinic or community pharmacy.
Then, Amazon announced its intentions to form its own health care company with Berkshire Hathaway and JPMorgan. The details have not yet been disclosed, but we know that this company will focus on “technology solutions.” We need only to look at the technology solutions they are employing elsewhere to get an idea of their vision.
Last but not least, Apple entered the fray, announcing that it will open private medical clinics in order to offer its employees the best healthcare experience in the world. According to Christina Farr at CNBC, Apple is also looking to hire “doctors, health coaches and ‘health designers’ to create a program to promote healthy behavior.”
Variations On A Theme
All three entities will seek to achieve economies of scale by relying heavily on technology — artificial intelligence (AI), IoT sensors and telemedicine — local health care providers and preventive care. Notes Dylan Scott at Vox of the Apple plan, “Population health and preventive care will be the guiding principles, driving down costs by helping workers stay healthy rather than treating them once they get sick.”
Unfortunately, this is where things could get a little dark.
Trimming The Fat
Preventive care is wonderful, important and a critical component often omitted from the public discourse on lowering health care costs. At PrescribeWellness, we are big believers in preventive care and steadfastly encourage Americans to take control of their health by actively managing their nutrition, exercise and chronic illness.
But what happens when the entity in charge of your healthcare has the ability to not only monitor your every lifestyle decision but also reward or penalize you accordingly? Imagine if your guilty–pleasure fast food or social cigarette carried a fine that got tacked onto your health care costs. What if your Apple watch reported when you ordered that second glass of wine? What if your employer confiscated your candy?
Every Step You Take, Every Move You Make
Amazon recently caught some heat for patenting wristbands that track warehouse employees’ hands in real time to calculate their efficiency. It doesn’t take a Black Mirror episode to imagine how similar technology could track people’s health habits to keep health care costs down. Moreover, what will it mean when nine companies control the future of AI?
There is little doubt that focusing on preventive care combined with a bevy of future technologies that constantly and silently collect data on our diets, sleep patterns, alcohol consumption, stress levels and medication adherence will succeed in driving down costs and raising the quality of care. This trade-off could plunge us into a world that is uncomfortably Orwellian. In fact, it seems to already have happened with our social data.
A Surplus Of Big Data, A Lack Of ‘Live Data’
Another way this could play out badly is by landing us in a situation where devices do the lion’s share of diagnoses and treatment, with human practitioners doing very little. While devices’ abilities to quantitatively measure, interpret and store data about our health will continue to improve, devices will never be as good as humans when it comes to qualitatively measuring that data.
If humans are removed from the healthcare equation, we’ll inevitably end up with a ton of big data on the population as a whole — and on individuals — but with a dearth of what I like to call “live data” — all the information healthcare providers can gather in a face-to-face medical encounter. This information is crucial because it paints a broader portrait of a patient’s health and allows providers to administer more holistic treatment, resulting in better patient care. Indeed, an increasing body of research shows how important human interactions with health care providers are to the healing process and to a patient’s general well-being.
Orwell’s 1984 Or Kurzweil’s 2029?
Luckily, the future is not yet written.
We aren’t necessarily facing a nightmarish 1984-esque world. It may turn out to be quite the opposite: a future where preventive care, local care, IoT technologies and interoperability are fully leveraged to keep the population healthy at a fraction of the current cost, while making security of data, privacy and protection paramount.