“Healthcare desperately needs good design” – Bon Ku
With healthcare now accounting for a fifth of the U.S. economy, perhaps it’s not surprising that nearly every presentation I attended at SXSW18 referenced implications for healthcare. Three themes emerged to let us know healthcare is a field that is 1) ripe for disruption 2) interconnected, complex and relevant to diverse stakeholders 3) a human-centered endeavor. As we design for the future, we must ask ourselves with each decision, “does this have a net impact of health, or ill-health?” – Karen DeSalvo
1. Altering Reality around Patient Needs
Whether it is VR, AR or MR, blended realities are rapidly becoming the new norm. These technologies are showing up everywhere from surgical suites to patients’ homes, and their uses are just as varied – from narcotic-free pain treatment, to precision neurosurgery and autism-spectrum education. The brain surgery panel at SXSW 2018 shared technology that uses AI and AR to map the patient’s brain, create predictive models to decide the best location for intervention, then perform robot-assisted surgeries. These technologies are changing the way care is delivered and taught, and the start-up VerbSurgical from Google and J&J is only the latest in the transformation.
2. B(Older) Generations
By 2030, one in five US citizens will be 65 or older and a majority of these individuals want to stay engaged and in their homes. This population shift has enormous implications on everything from how we design menus, technology interfaces, transportation and cityscapes. This creates boundless economic opportunity as we strive to keep our selves and loved ones active, engaged, connected and safe. Some of the greatest technological innovations for doing this – Alexa, Uber and Seamless – are out of the reach of many without the financial means, so equitable change will require new solutions.
“You’re going to live 30% longer than you think” – James Canton, Institute for Global Futures
3. Building Healthy Infrastructure
Social determinates of health show that 60% of a person’s health is not related to medical care. This means that our built environments (e.g., housing, sidewalks, parks) impacts our behavior, connection, and environmental sensitivities are vital to healthy living. Karen DeSalvo paralleled today’s challenges to those of the Tuberculosis epidemic of the 1980s when medications failed. It was the housing changes that brought fresh air and clean water that squelched the epidemic. We need health-focused infrastructure changes to build healthy cities.
4. Default = Health
According to Nicholas Chim 80-90% of people choose the default setting when it comes to technology (and far too many other things). This means that whenever possible, the default settings have to be designed to encourage health, and it is always possible. Examples included Pokémon Go’s impact on physical activity, Apple Watch’s shift to focus on health and the rise of walking paths designated at hospitals or in large office buildings. To create solutions with universal appeal and personalized impact, it is critical to have diverse stakeholders at the table to innovate new solutions, trouble shoot and help brands reach the communities that need it the most.
5. Democratization of Medicine
Technology is becoming smaller, smarter and tailored to you. Patients are not only demanding their data – they’re creating it! With wearables and smart phones becoming ubiquitous, health systems and insurers are looking for ways to intelligently and securely integrate that data into decision making. Patients are expecting on-demand healthcare that anticipates their needs and is there for that urgent call at 2 a.m. We often think of personal health coaches as something reserved for the wealthy, but with the help of artificial intelligence and wearable technology, many more people will have the ability to have personalized encouragement to reach for the apple over the Snickers. The shrinking footprint of diagnostics and treatment is true from pocket-size, mobile ultrasounds to otoscopes, and now there are even contact lenses that can deliver slow-dose medications!
“Patients do not want Blockbuster; they want NetFlix” –Bon Ku
6. Smart Health: Making Data Hustle for the Patient
Our healthcare system generates one of the nation’s largest masses of highly confidential, unorganized and poorly utilized data. If we realize the potential for healthcare to transform this chaos into opportunity, we could see a future where patients can easily find the best medical service provider, immediately understand cost implications, do some comparison shopping and even check previous patient reviews. Extending this, after seeing one specialist people will be able to obtain seamless, interconnected treatments and access continual follow-up to track process progress towards improved health. Artificial intelligence and machine learning are being applied to healthcare for just these purposes. In the future our contact lenses, sink or even toilet may communicate with our health record and help diagnose disease before symptoms appear. These advances are being led by companies that transcend traditional boundaries. They assume integrated roles of provider, payer and sometimes lender/bank to have access to the right data, resources and patients. Amino is a great example of this.
“A one-year window for healthcare insurance incentivizes short-term thinking on long-term health challenges.” – Neel Shah
7. A Storm is Brewing
The massive changes in climate are creating more health risks. Flooding, natural disasters, sea level-rise, famine, and epidemics are all shifting due to climate change. The environments we are creating today need to be resilient to that change, and poised to grow and change with cities. These changes will have wide reaching health implications. Imagine bank lobbies becoming areas of refuge, providing power for mobile devices, (as it happened in NYC after Sandy) or pop-up infection-isolation spaces for clinics or stadiums.
8. Reach Out and Touch Someone
The health impacts of loneliness are profound and concerns grow with a rising population of people older than 65 who may experience reduced ease of movement and difficulty accessing transportation. Additionally, all generations are struggling with the growing phenomena of loneliness, something stressed by Esther Perel’s keynote. We are learning that virtual connection is not enough to combat this, and in fact, technology such as social media can have an unintended isolating effect. To address these concerns, more technologies and a larger number of companies are focusing on connecting our virtual worlds back to physical connection. MeetUp– a digital meeting platform that brings together people in person – is flourishing with this approach.
“The quality of our relationships,determines the quality of our lives” – Esther Perel
9. Outcomes that Mirror Patient Priorities
For decades, our nation has focused on healthcare treatment rather than health outcomes. This approach has helped contribute to poorer health in the United States compared to other high-income countries, but incentives are shifting from volume to value. The business case around this shift is still evolving, and what matters to patients is starting to take a front seat. Examples from Mount Sinai to Dell Medical School show that patient outcomes centered around how they feel, function and survive are becoming easier to measure with rapid diagnostics, body sensors, and a focus on patient reported outcomes. The focus on what matters to the patient – whether that being able to drive, be pain free or be more active provides much more insight to treatment and care. The Next Generation Health Clinics at Mount Sinai is a fascinating example of same day, full health evaluations that are capturing a wide range of patient outcomes. Initiatives focused on patient outcomes share a common mind-frame of building, measuring and learning in a consistent feedback loop of improvement.