In the U.S. there is one cardiologist for every 14,000 people. In Indonesia, it’s one for every 500,000. That’s the kind of fact that a group of health care leaders and thinkers from both the private sector and governments tackled at a fascinating dinner in Davos at the World Economic Forum, which I had the privilege of moderating. The landscape of modern healthcare is frustrating because so much remains to be done to insure the world’s population has access to the healthcare they need. But the deeply-informed group was optimistic that huge progress is possible, and soon. The dinner, organized by healthcare technology giant Philips, focused on how technology can empower both patients and caregivers.
One conclusion I came to, listening to the passion and knowledge about this topic around the Davos table: The digital revolution that has so thoroughly transformed our lives is finally beginning to transform health care. While the movement towards digitally-driven care is still in its early stages, the room of CEOs, doctors, ministers of health, NGO leaders, hospital operators, and businesspeople were in wide agreement that it means more people can become and stay healthier.
What Philips and many in the room are working for is something I like to think of as a web of care, a supportive infrastructure the weaves together doctors, people, and the institutions of health. The Internet of Things will play a huge role in this transformation, as a more interconnected world gathers signals from patient monitors, the environment, and hospital and clinic systems and puts it all in the cloud. Then we can apply analytics on the ensuing databases, both to insure better care for individuals and to come to research conclusions that will help all of us going forward.
Jeroen Tas, who heads Philips’ Healthcare Informatics group, kicked off the dinner by explaining the company view–that the role of tech is to “augment us.” He continued: “With data and data analytics we can personalize care and bring human intervention and interaction where it’s needed and where today it’s lacking.” Tas explained, as an example, that Philips has recently launched a major program in Indonesia to use tech to address an acute shortage of midwives and gynecologists. “We can hook people up using a tablet and give the doctor an obstetric monitoring app,” he said. The community nurse hits a triage button and connects online so a gynecologist can look at pregnant women remotely. As the Indonesian program takes off, Tas says, it will become much easier to get the right care to the right people at the right time, despite the shortage of specialists.
But one theme that emerged over and over during the discussions is that tech is no replacement for the human touch. A need for the soothing and personal care of the professional will never go away. Nobody in the room wanted to head into a world of robotic care with no doctors or nurses. As Philips CEO Frans van Houten said, “We should not make technology the center point. It is an enabler. We’re here to celebrate health, not technology.”
Nonetheless, as systems become more refined and building and implementing them becomes cheaper, it will be tempting to rely on them more and more for things that formerly were the province of doctors and other healthcare workers. As tech moves with headlong speed and enables seeming digital miracles, it will take decades to learn where the proper lines are between human and machine-driven care.
One of the stars of the discussion was Bernard J. Tyson, Chairman and CEO of the Kaiser Permanente health system. Kaiser has pioneered numerous healthcare innovations in its 38 hospitals and more than 600 outpatient facilities in eight U.S. states and Washington, D.C. Tyson spoke eloquently about the increasingly tight digital connection between Kaiser’s 18,000 doctors and its 10.2 million members. Members routinely email their doctors, and get extensive consultation online and by phone, even while continuing roughly the same number of in-person visits to their doctors as before. The key differentiator for Kaiser is that it serves as both the health insurer and the healthcare provider. So unlike the adversarial and fractured nature of much of the rest of American healthcare, at Kaiser the company’s primary interest is in keeping its members healthy. In doing so, it has been aggressive about implementing digital tools like apps for members, online information, and 24X7 personal online interaction.
Another of the dinner’s stars was Zeke Emanuel, Chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania and an advisor on healthcare to President Obama. Emanuel is a huge fan of Kaiser Permanente and spoke at the dinner about what he considers the inevitable “Kaiserization” of American healthcare. The consolidation of insurers and caregivers–the routine structure of healthcare in most countries around the world–is inevitable in the U.S. as well, Emanual believes. He thinks it’s not that far off, either. “There’s simply no choice,” he told the group.
For all the virtues of a more connected system, many in the room worry about doctors feeling overwhelmed with the growing demands of a connected system. Emails come in around the clock. That poses big challenges, but it also means that doctors become more connected to their patients. That has proven hugely important at Kaiser, Tyson said. Its members have become more engaged with their own healthcare, staying more informed.
Another speaker at the dinner was Ron Gutman, CEO of HealthTap, which has assembled a network of 85,000 doctors who help it assemble a vast database of information about health and wellness, and can consult directly with members via video, voice or chat. Members of its HealthTap Concierge service get direct private voice consultations with a personal doctor. But for all his digital assets, even Gutman said what what his service aims for is “compassion, not just recommendation.”
One of the evening’s most memorable moments came when someone mentioned that even obvious interventions that cost little are not widely understood. He mentioned as an example that older adults should take one baby aspirin every day. Many in the room expressed surprise that this was something everyone should do. As moderator, I surveyed the room. Only three people turned out to take baby aspirin every day, but they were Emanuel, Tyson, and one of the other most eminent health leaders in the room. Everyone turned to one another and said, “OK, now I’m going to start doing it.” While that revelation was not a digital one, it underscored how valuable will be systems that efficiently explain how people can prevent disease and take better care of their health.