Roughly every half century, there’s an innovation that drives a revolution in healthcare, according to Murray Brozinsky.
In the 1840s it was the use of anaesthesia in surgery; in the 1870s, germ theory. Then in the 1920s penicillin was discovered, and in the 1970s evidence-based medicine emerged on the back of the use of randomised clinical trials.
“We are at the dawn of the next revolution,” Brozinsky — the chief strategy officer of health technology firm Conversa — yesterday told Commonwealth Bank’s Future of Health conference. More than 100 of the bank’s corporate clients attended the conference, held at Telstra’s Customer Insight Centre in Sydney.
That revolution is the emergence of digital healthcare: Personalised healthcare driven by the availability of an enormous amounts data and the technology to leverage it. In 2020, there will be 25,000 petabytes of health-related data, Brozinsky said — “that’s roughly 500 billion four-drawer filing cabinets that would contain 500 times all of the written words since the dawn of human history”.
“We’re starting to get a glimpse of what that revolution is,” he told the conference. Evidence-based medicine draws on data but treats the “average” patient, Brozinsky said.
“We’re driven by clinical trials, which uses a set of patients to provide a standard of care or a guideline for the rest of the population — many of whom don’t look like those patients. And now we’re moving to a world where instead of treating the average patient, we’ll treat the individual person.”
That shift will be enabled by drawing on a vast array of data — including clinical data, genomic and other omics data, demographic data, data collected from sensors and patient-reported outcome data.
“In oncology we have treatments today that we know don’t work in 70 per cent of cancer patients,” Brozinsky said. “We need to move to a world where we know that the treatment will work 100 per cent of the time in the right 30 per cent of cancer patients. That’s personalised health.”
Artificial intelligence, blockchain, telehealth, virtual and augmented reality, sensors, 3D printing and, further down the track, CRISPR and SENS, are all set to change the face of healthcare, Brozinsky told the conference.
In particular, in the 13 years to 2030, Brozinsky expects AI, augmented reality and sensors to have a huge impact both individually and in combination, he said.
PwC has forecast that that by 2030 AI will be contributing US$15.7 trillion to the global economy. “Every major technology company in the US and around the world are re-architecting their whole platforms to take advantage of AI going forward,” Brozinsky said.
AI won’t replace doctors and other healthcare professionals, but help augment them, he suggested. It will “do things humans can’t do” and allow healthcare workers to “practice at the top of their licences and do things that humans can uniquely do”.
Gartner has forecast that by 2020, customers will manage 85 per cent of their relationship with enterprises without interacting with a human, he noted.
Patient demand means that in the US it takes 25 days to see a primary care physician and it’s longer for specialists, Brozinsky said. “Patients are raising their hand and saying access is way more important than actually having a physical contact with a human doctor,” he said.
At the same time, doctors and healthcare systems are recognising the value of patient-generated health data (PGHD), he added.
“They want to get information from patients in between visits; they are just looking for scalable solutions to do it,” Brozinsky said.
AI will help open the path to “mass personalisation”, shared decision making that involves the patient, and conversational interactions. ‘Digital checkups’ will enable personalised care between visits to a doctor using automated digital conversations, Brozinsky believes.
The average car has 60-100 sensors and produces gigabytes of data every day. By comparison, the average human collects 12 bits of data a day. More data is starting to be generated and collected with the growth of the wearables market. However, “wearables and active tracking” are not the future for personal health data, Brozinsky argued.
Instead, more important will be sensors embedded in devices people already use every day, products that can be improved with sensors and then as a by-product create data that can be analysed, and “data exhaust” from devices such as smartphones.
On the augmented reality front, Brozinsky expects the technology to rapidly outstrip the virtual reality market. He cited two examples of existing healthcare applications employing AR — Augmedics X-Vision, which can be used to aid spine surgery, and Evena’s Eyes-On Glasses for vascular imaging — as well as AR’s use in training.
AI, AR, and sensors will each “be major on their own”, Brozinsky. “But if you think about a future in 2030 where we have passive invisible sensors tracking everything that’s relevant biologically on our bodies and all that information then goes to our electronic health records... imagine that richness feeding the artificial intelligent driven conversations.”
“We’ll be able to move from descriptive, to predictive to preventative care very, very quickly,” Brozinsky said.
Today’s patient experience is “episodic, in person, using snapshots of very thin data, it’s very inconvenient, it’s rushed and ultimately you feel like you’re in a cattle car,” he said.
“I think we’re going to move to an experience in the future where it’s going to be continuous conversation, it’s going to be relaxed, it’s going to be informative, it’s going to leverage longitudinal, very rich data, and ultimately personalised health will feel empathetic.”