AI, 5G and IoT in Health Care: Evolution or Revolution?
We all know of technology’s transformative power, but how often does the marketing hype surrounding new technologies correctly predict how it will be implemented?
This question is particularly relevant in the health care sector. In the United States, health care spending accounts for 17.9% of the nation’s gross domestic product. In 1970, Medicare spending was $7.1 billion. By 2017, it was 100 times greater. Yet though the U.S. spends the most in the world on health care, outcomes here generally trail those of other industrialized nations, and life expectancy here ranks 31st in the world — lower than in Costa Rica, Slovenia, Cyprus and Chile, while scoring one notch higher than Cuba.
Electronic health records, which were incentivized under the Affordable Care Act, arguably haven’t had a significant role in helping to improve the efficiency of health care spending, but have improved physician–patient communication, record keeping and likely patient outcomes.
Technologists have promised broad technology trends such as AI, IoT and, more recently, 5G could lead to a new era of health care. AI could for instance, help drive more accurate diagnoses and manage patient workflows. The use of 5G and IoT in health care, in conjunction with AI, could transform remote patient management. “From my perspective, I think it’s completely possible,” said Christopher McCann, chief executive officer at Current Health, referring to the promise of such technologies to transform the health care paradigm.
But McCann is quick to point out that technologies like IoT in health care must be linked to a health care delivery model to succeed. “And that model will require more policy changes and more alignment between the community interests and the payers’ interests,” he added. Currently, an insurance company is disincentivized to improve long-term outcomes for a given patient provided they change insurance companies every few years. But with more patients in the United States becoming covered under Medicare and Medicare Advantage, McCann is optimistic about the prospects of an improved alignment between patients’ and payers’ long-term interests. “That needs to happen first. Then technology can be part of how that solution is actually delivered,” he said.
Current Health is working along those lines to identify high-risk patients in their homes — much earlier than is common today, enabling early treatment to help slow or stop the disease progression. “The best way of taking costs out of a health care system is to create a healthier society,” McCann said. “I know that sounds a bit clichéd, but ultimately, that’s saying: ‘Let’s treat our populations more proactively and preventively, and less reactively and acutely.’”
It’s ultimately in employers’ best interest to help optimize their employees’ health and productivity as well, which aligns their interests with those of insurers and providers, said Nancy Reardon, chief strategy and product officer at Maestro Health. Reardon sees biometric screenings as a strategy to improve care delivery. “Employers should be looking more closely at employees’ biometric screenings and use those results throughout the employee life cycle,” she said. “For instance, staff-wide screenings that provide detailed information on blood pressure, height, weight, waist circumference, body mass index, cholesterol, glucose and more, help employers and their health plan administrators develop individualized care management plans and identify conditions that may otherwise go unnoticed.”
A gradual increase in chronic conditions in the United States and throughout the world threatens to have a significantly negative effect on productivity levels. According to the CDC, some 84 million American adults have prediabetes, and 90% of those people are unaware of that fact, even though the condition leaves them at risk for developing full-blown Type-2 diabetes as well as heart disease and strokes. “Employers can help correct that trend in their population via biometric screenings,” Reardon said.
The similarly-minded connected health company GreatCall leverages passive remote monitoring and predictive analytics to help detect and ultimately prevent adverse health events in seniors. GreatCall deploys passive remote monitoring sensors throughout the home to understand what the firm refers to as “activities of daily living.” From there, the company’s analytics can spot anomalies potentially indicating a change in an individual’s health. Again, the company is operating under the assumption that earlier detection of potential problems can reduce the costs of health intervention in the long run.
GreatCall also addresses another challenge: patient adherence. Medication adherence alone is responsible for “50% of treatment failures, around 125,000 deaths, and up to 25% of hospitalizations each year in the United States,” according to an article from U.S. Pharmacist. Although it is more difficult to gauge, many physicians who instruct patients to, say, keep a log of blood pressure readings or other health metrics struggle to have their patients comply.
GreatCall sidesteps this challenge after sensors are installed in patients’ homes by enabling users to live their normal lives without requiring behavioral change like journaling medical information or logging how they spent their day.
In one case, GreatCall technology identified a user suddenly made fewer trips to the kitchen. One of the company’s employees called the customer and asked open-ended questions such as: “How are you feeling?” This led the company’s employee to confirm the patient had a decrease in appetite and recommend that a care manager intervene.
5G may be “a bit hyped at the moment,” according to McCann, but the technology potentially offers a wave of similar advances related to remotely monitoring patients. Wi-Fi saturation in rural areas trails urban areas in countries such as the United States and the United Kingdom. And for people with Wi-Fi in rural areas, their connection speeds tends to be slower as well. 5G could thus support video chat between patients and doctors, and support data transfer from clinical-grade wearables and medical devices. It is a “fundamentally revolutionary technology,” McCann said. It just may not be as transformative as quickly as some marketers hint.
The rise of 5G though could also extend the influence of technology-oriented companies in the health care market. Already, companies ranging from Alphabet health care subsidiaries Verily and Calico to IBM’s Watson subsidiary have made health care a central focus. 5G could boost the influence of telecom firms on the industry.
The alliance of such firms could converge around artificial intelligence, which could serve as umbrella technology. “Physicians don’t have the time to sift through massive amounts of data,” McCann said. And AI can broadly help to address the current shortage of doctors and caregivers while helping streamline and inform medical decision-making, flagging anomalous health care, potentially fraudulent patient data or sift through large troves of research data or genomic information. But again, in order for AI to live up to its promise, the technologists developing it must work closely across the health care ecosystem.
While Walter Cronkite once said: “America’s health care system is neither healthy, caring, nor a system,” with the right blend of policy and technology, it could be all of those things.