Last week, hundreds of healthcare start-ups and active investors gathered in Chicago, IL for the annual MedCity INVEST conference. ExplORer Surgical joined to learn from our peers and funders as well as add to the conversation about the newest, most innovative happenings in the MedTech space. Over the course of the conference, several questions were raised pertaining to the impact of voice technology, how to maintain privacy and security in the age of connectivity, and how current healthcare structures will need to change in response to these disruptive technologies.
AI and voice applications in healthcare
For quite some time, tech companies have been betting on artificial intelligence (AI) as the primary way we will interact with software, and eventually technology as a whole. Nearly all of the major tech players are actively designing and tweaking their technology to be the smartest AI available, but how are they betting we’ll be able control this AI? Voice. Apple has Siri, Google has Google Assistant, Microsoft has Cortana, and, arguably the most accepted in the market so far, Amazon has Alexa.
Despite how novel each of these digital assistants appear to be, part of the underlying technology they’re currently using, voice recognition, has been in circulation of decades. For instance, Dragon Dictate, a speech recognition product that integrated with Epic in 2018, initially launched in 1990 and has been making advancements ever since.
Voice technologies such as Dragon have evolved significantly over the past 30 years, which brings us to April 4th, 2019, when Amazon introduced six new skills for Alexa that are HIPAA compliant. Alexa, accessed via the Amazon Echo and associated hardware, entered the health tech arena as a top player due to Amazons ability to get their hardware into homes all across America. Users range from children to octogenarians, and they are now capable of giving voice commands that directly impact their personal patient care regimens. In light of this shift towards HIPAA compliance, there are many questions surrounding whether or not Alexa can and should be used as a diagnostic tool.
What's next for AI and voice applications in healthcare?
There is natural hesitation among healthcare professionals who are concerned about the security, reliability, and overall efficiency of this type of technology being used as a diagnostic tool. At this point, the leading voice recognition technologies are well above 90% accuracy, but in healthcare, where people’s lives are on the line, the standard is 100% accuracy. The counter response to these concerns is that voice tech will be utilized as a 1st layer of triage. According to Kristi Ebong from Orbita, when used in this capacity, voice tech does not need to be 100% accurate. Additionally, the more it is used in low risk situations, the more it can improve over time.
Thought leaders do not currently see technologies such as Alexa acting as stand-alone tools, but rather as a push towards total system integration. For example, Boston Children’s Hospital is demonstrating what total system integration can look like through the development of apps such as KidsMD, which brings medical knowledge surround fevers and medication into the home via the voice-powered Alexa appliance.
Privacy and security
In the age of connectivity, there is an increasing demand for bilateral flow of information between the patient and the provider. Real-time data exchange facilitates improved patient outcomes by increasing access to medical intervention and allowing providers to view the full patient story like never before. This data exchange is largely accomplished via connected medical devices that provide remote patient monitoring (RPM), such as pacemakers, continuous glucose monitors, and CPAP machines, to name a few. Additionally, we have seen an insurgence of start-ups that have focused on direct, and secure, patient-to-provider or vice versa communication. Some start-ups like HealthCrowd and OhMD have focused specifically on direct patient-to-provider text messaging.
What's next for privacy and security in healthcare?
Despite the obvious benefits to real-time monitoring, direct communication, and data storage, there is a delicate balance between sharing information and maintaining appropriate privacy and security. *For the purpose of this discussion, privacy will refer to what companies and providers do with generated patient data, while security will refer to how companies and providers protect patient data from cyber attackers and system hackers. With increased use of Internet connection, cloud storage, and platform integration, comes increased risk of security threats and cyberattacks. There are several guiding principles for both the safe keeping of personal patient information, as well as the utilization of digital health records, but the ultimate responsibility for privacy is a shared burden between the medical device companies developing the framework, and the patients agreeing to enter the network.
Although patient privacy is of upmost importance, there may come a time when privacy negatively impacts the opportunity for information dissemination. When more privacy measures are in place, fewer insights can be derived from large patient data sets collected via connected devices. Consequently, if patients are asked to give up privacy in the future, they will need to feel value in return for their contribution. Since patient data is currently in silos, there will need to be an educational push moving forward to normalize that data so physicians can make better decisions that improve patient outcomes and drive industry change.
Structural changes via telehealth
Healthcare is one of the largest industries in the United States, with spending accounting for 17.9% of the annual GDP. Nevertheless, as former President and CEO of Cleveland Clinic Toby Cosgrove points out, the industry has been one of the slowest to undergo structural adaptations that could improve its day-to-day efficiency. Part of this slow adaptation is because healthcare providers have traditionally been skeptical of new technologies and viewed them as a risk, largely because of their reliance on the scientific method and their vow to do no harm. There needs to be an industry-wide shift from viewing technology as a disruption to seeing it as a means to an end that strives to improve patient outcomes, slow down chronic disease, and reduce the overall cost of healthcare.
Could telehealth be the beachhead for structural changes?
A nuanced approach to structural change could start with the widespread adoption of telehealth. Due to patients’ growing ability to manage their own healthcare via computers and mobile devices, telehealth may be able to provide better access to higher quality care for rural communities and individuals with limited mobility. Additionally, shifting to a self-management healthcare model could help providers be more proactive rather than reactive. If physicians can utilize the wide array of medical technologies available today, they may be able to keep more patients out of hospitals, which ultimately cuts costs, reduces strain on staff, and improves quality of patient care.
The transition to telehealth may be smoother than anticipated, with adoption already increasing more than three-fold over the past four years, which Dr. Sylvia Romm of American Well notes is a faster rate than the adoption of EHRs when they were at a similar stage of development. This is key, considering a crucial first step in the adoption off healthcare technology is physician buy-in. At this point, physicians refer to improved patient access to care and more efficient use of time for both parties as the main benefits of telehealth.
Currently valued at $38.3 billion with a projected valuation of $130 billion by 2025, telemedicine is ripe with hundreds of companies competing for market share. Some of the major players currently winning in the telemedicine space include Amwell, Doctor on Demand, and 2nd.MD. Once telehealth strengthens its reimbursement structure, it has the potential to serve as the pivotal technology that alters the structure of healthcare as we know it.