Perspectives on Health: Artificial Intelligence, The Internet of Things & Big Data’s Impact on Health Facility Design

By Julie Wellik

The impact artificial intelligence (AI) is already having on our health is nothing short of transformative. At Lucile Packard Children’s Hospital in Palo Alto, California, the Stanford Children’s Health CHARIOT program (Childhood Anxiety Reduction through Innovation and Technology), uses augmented and virtual reality to help kids cope with apprehension during medical procedures and physical therapy.

A Microsoft app, developed by one of its blind software engineers in 2016, verbally describes for users what they’re hearing but cannot see, including people’s facial expressions and vivid street scenes. It will even read a restaurant menu out loud.

And there’s Brooklyn-based start-up Inspiren’s in-room device, which is loaded with motion sensors to help staff keep track of their rounds for care and medication and recognizes when a patient is out of bed or falls, notifying doctors and nurses via an app.

Technology’s sweeping impact on the health industry isn’t confined to modern medical marvels: big data analytics informs clinical decision-making, drives operational efficiencies and cost reductions through more targeted care measures, while new technologies are enabling information sharing across providers and platforms – all leading to better patient care.

In a 2018 survey of 84 industry CIOs, the majority believe in the power of artificial intelligence to enable a transformative leap in health care delivery and outcomes. From AI, the Internet of Things (IoT), blockchain, AR and VR, virtual assistants and bots, 3D printing to precision medicine, understanding emerging, disruptive technologies – what they are, why they’re important and how to deploy and fund them – is the foundation for innovation, driving partnerships and fostering data-driven cultures in our health systems.

The transition from automation to digitization is a fundamental shift, requiring a health system to merge its organizational and digital strategies to take full advantage of digital technologies’ benefits and IT-related capabilities to redefine business models; rethink processes, emphasize quality outcomes in making business choices, and re-examine the organization’s cost structure – the value of technology in improving quality and lowering costs. Value-driven health care that keeps the patient and family in the forefront in the underlying goal of this transformation.

And speaking of patients, their health care preferences vary greatly driven by age. Millennials are digital natives who are ready for virtual health care and shop for good pricing, whereas Baby Boomers are loyal health care traditionalists, physician-centric and the least likely to easily adopt emerging technologies. Providers must continue to serve a diverse set of consumers, whether through digital or more 20th century-style delivery.

Yet creating a vision and organization for connected digital health is extremely complex. The big five tech companies – Apple, Amazon, Facebook, Google and Microsoft – have all launched multiple consumer-facing health care delivery channels on their platforms. Billions are being invested in health start-ups, retail and health system partnerships.

The health care industry has had an extraordinary grip on data – until now. According to Microsoft health care evangelist John Barto, that power is shifting to the consumer. “We touch our phones an average of 2,617 times a day, and the amount of digital exhaust we’re creating is an opportunity to recraft experiences in health care,” he says.

Unstructured data, estimated to be at around 80%, is generating 2.5 quintillion bytes of new data per day, which includes email, documents, images, videos, and smart device data. So while the surge of new data creates unlimited opportunities for increasing levels of engagement, the challenge requires combining all of the multiple data sources – clinical, financial, research, social determinants of health, pharmacology and patient histories, sensor and wearables data, mobile/IoT data and more – into a coherent and connected digital health strategy.

The promise lies in the ability to aggregate and analyze data from patients’ daily lives to enhance health outcomes for the individual, the general population, and reach beyond the hospital’s walls to create new and better health care delivery channels. The consensus is that health systems and companies must begin making use of this data to transform their business or risk getting left behind. 

From tele-surgical systems to iPads, computers, cameras, monitors, sensors and more, integrating advanced technologies in hospitals requires the deep engagement of IT in facility design. The aforementioned CHARIOT program’s AR/VR headsets are just a few of the more than 20,000 digital devices in use within the new 397 bed, LEED Platinum Lucile Packard Children’s Hospital. Each patient room is equipped with 20-30 connected devices, with three wireless networks operating at the same time. For research alone, the hospital is generating 20 Terabytes of digital data each month. With more than 525,000 outpatient visits and 13,000 pediatric discharges annually, strategic digital design and integration at Stanford Children’s is a major and ongoing priority.

In designing for advanced tech-integrated facilities, planning for massive device growth and data flow, on-premise and cloud data storage, security and data privacy, network density – as well as the patient and provider user experience – architects and digital strategy consultants place great emphasis on visioning workshops with all project stakeholders participating. Beginning with the end in mind and working with decision makers, staff, CTOs and CIOs to understand the overall vision, together we arrive at the right problems, and then find the solutions.

“We must fall in love with the problems, not the solutions.”

 

– Anshul Pande, Stanford Children’s Health CTO, on AI’s explainability versus its utility

Deploying AI technologies to address decreased access to quality care in rural regions shows great promise. As health facilities continue to shutter in rural areas, staff relocate, leaving communities without trained healthcare providers. Telemedicine and AI tools can offer connections to skilled clinicians, delivered through an app to providers in underserved areas, helping to close the rural/urban care divide.

A significant and immediate upside to AI: “Algorithms don’t get bored, they don’t get tired after an 18-hour shift, and they can handle repetitive tasks,” says Andrew Rebhan, health IT consultant with The Advisory Board Company. AI also helps eliminate human error, and it can make accurate diagnoses and relieve staff of administrative tasks that contribute to work-related stress. In fact, in a current Yale-led study, doctors give Electronic Health Records’ usability an “F” and cites that EHR’s may be contributing to high rates of professional burnout. So while the flood of digital health data is implicated as a source of fatigue, AI is also relieving staff of routine tasks that contribute to cognitive overload that can impact patient outcomes.

Artificial intelligence, machine learning and the Internet of Things is transforming how we deliver, access and receive care. Leveraging technology in partnership, man and machine are unlocking keys to diseases and providing more efficient, compassionate and personalized care. Digital transformation is really human transformation, and executive level buy-in and engagement helps facilitate change and signals that digital-first policies empower staff to rethink existing services, processes and care pathways. 

Microsoft can identify when someone has pancreatic cancer before they’re actually diagnosed just by examining their search queries. In this, we clearly see that the benefits and promise of AI greatly surpasses its risks.

This article is comprised of  content provided by our expert presenters and panelists at the Artificial Intelligence & the Internet of Things: Implications for the Design of Health Facilities Symposium held November 14, 2019 and planned/hosted by HKS Denver. Presenters included Andrew Rebhan, a health information technology consultant with The Advisory Board Company; John Barto, a health care evangelist with Microsoft; Michael Wang, founder and CEO of Inspiren; Anshul Pande, MS, vice president and CTO of Stanford Children’s Health; Nat Sims MD, an associate professor of anesthesia, Harvard Medical School and Massachusetts General Hospital’s physician advisor, biomedical engineering; Abraham Arakelian, associate partner with Syska Hennessy Group Los Angeles; Don Archiable, Principal and electrical engineer with Osborn Engineering Cleveland; Paul Langer, senior digital strategy consultant with ARUP San Francisco; and Rick Taylor, RCDD, principal with BR+A Engineers, Boston. The event was facilitated by HKS’ Tom Harvey, Principal; Sheila Ruder, Associate Principal; and Mackenzie McHale, Vice President and Rachel Matthews, Medical Planner.

Julie Wellik

Julie Wellik is a Senior Writer at HKS. Based in San Francisco, she writes stories about some of the world's most impactful design work coming from HKS' reach in health, hospitality, sports, education and sustainability. She is a passionate co-director of Citizen HKS, the firm's public interest and global social impact program.