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Emerging technology has long been a driver of change in health care, and the pace of technological change has accelerated dramatically in the past decade. Physicians are being challenged to incorporate blockchain technology, virtual health care, artificial intelligence, gamification of learning, and the rapidly developing Internet of Things into their work and into their interactions with patients.
Blockchain in health care
Blockchain is a log of activity that is time stamped, tamper proof, and shared across a network of computers. Each transaction that goes into the log of activity is enclosed in a block and linked together in chronological order to form a chain, now called blockchain.
The potential applications of this emerging technology in health-care delivery are almost limitless.1 Shared, secure, and linked data that can be accessed by all can give rise to the automation of complex problems, community-generated solutions to problems that empower patients, and an increase in trust, transparency, and incentive alignment. Currently, insurance claims, prescriptions, and payments mostly reside in sequestered computer systems, but a blockchain of the transactions among them would open up a wealth of learning and efficiency possibilities.2 Hospitals, medical centers, insurance companies, clinical trials, and large practices can collaborate to create a blockchain of transactions in which all members can view access, share, and analyze the data.
Burton Lesnick, MD, FCCP, has given the topic of technology change and the practice of medicine some thought. He is a member of the CHEST Board of Regents and the former founding medical director of The Children’s Care Network, a pediatric accountable care organization of 1,800 providers in metro Atlanta area. Dr. Lesnick notes that blockchain is still in its early phases, partly because it is expensive in terms of computing power and electricity to adequately maintain a distributed ledger.
“I would see it being used in the next decade for high-value public registries, especially where the authenticity of data is critical. For instance, in Europe, we are already seeing a lot of effort to prevent counterfeit drugs from entering the pharmacy chain. We may soon see blockchain being used to track expensive drugs in our health-care system, thus ensuring chain of possession and preventing fraud,” he said.
Virtual care
Some traditional face-to-face encounters between doctor and patient will be replaced by virtual care of different types. Telemedicine is growing, thanks in part to advocacy from Medicare and Medicaid, although the lack of federal guidance on coverage and reimbursement could be a barrier.3 mHealth, the delivery of care via mobile devices, is being utilized for preventive services, appointment confirmation, and follow-up information, but the future of this technology will probably expand into transmission of data from patients and health devices, as well as health alerts.
According to a report by the World Health Organization, an increasing proportion of the population is accessing health information and services through mobile phones.4 According to the Physicians Practice 2018 Mobile Health Survey, a majority of practices that participated in the study stated they use mobile health in their practice on a weekly basis.5 Those still not using mHealth cite concerns over HIPAA compliance. Dr. Lesnick offers some cautionary perspectives.
“Many of us can already download data from medical devices such as CPAP machines and home ventilators. A prominent pharmaceutical company has recently gained FDA approval for an inhaler that date and time stamps when and how the inhaler has been used. Wearable health devices, such as fitness monitors and watches that can alert users about life-threatening arrhythmias are wonderful. But the potential for physicians being overwhelmed by the incoming data flow is concerning. This is especially true when physicians are already reporting high levels of burnout associated with frustration using electronic medical record systems. We can only hope that algorithms will be developed to sift the precious stones from the digital effluent.”
Despite the security concerns, health-care providers, along with the Centers for Medicare & Medicaid Services and the insurance industry, are planning to address the projected shortages in the health-care workforce with virtual care.3
Dr. Lesnick added, “Doctors need to be engaged at the level of their health-care systems and national organizations. Providers are needed to provide context and balance to ensure that new technology utilizes appropriate scope of practice, optimizes care, and reduces costs, while reducing burdens on caregivers.”
Artificial intelligence and the Internet of Things
Artificial intelligence (AI) in health care is the use of complex algorithms and software to approximate human analysis of complicated medical data. The applications in medicine are potentially limitless given the rapid accumulation of data related to health care.
According to Forbes, AI for health-care IT application will cross $1.7 billion by 2019.2 By operationalizing AI platforms across select health-care workflows, organizations could see significant productivity gains during the next few years. Forbes also predicts more AI solutions will be used in imaging diagnostics, drug discovery, and risk-analytics applications.2
At the Icahn School of Medicine at Mount Sinai, New York, researchers use an in-house AI system known as Deep Patient, to predict risk factors for 78 different diseases. Doctors use the system to aid in diagnoses.9 AI is being used to diagnose patient wounds via smartphones, remotely monitor the elderly, and help health systems to digitally verify a patient’s insurance information.
Dr. Lesnick observed that chess computers started beating grand masters more than 20 years ago. However, the best chess players, in combination with a computer, can still reliably beat a computer alone. We need organizations like CHEST to help us become more adept at using technology. AI is a powerful tool but just another instrument to be employed in care of patients.
Big data and AI will combine to create a new ways of practicing medicine in the coming years, but what this trend will mean to individual clinicians remains to seen.
An area of rapid development is the Internet of Things, the extension of internet connectivity into everyday objects and devices designed to monitor and send information. Health-care devices now incorporate AI, real-time analytics, machine learning, physiologic sensors, and embedded systems.10 Physicians will increasingly have access to real-time data on individual patients. For physicians, managing, storing, and analyzing data from the personalized health-care devices of their patients will be a major challenge as the Internet of Things continues to expand into health care.
Dr. Lesnick noted, “In my collaboration with Georgia Tech [in Atlanta], one area I’m really excited about is process mining. Instead of sorting individual data points for statistical correlation, process mining looks at groups of actions and decisions. We’ve applied this to our local emergency room. I’m hoping we can find the most efficient processes and hardwire them in order sets. If we can eventually apply process mining to the health-care system as a whole, we might start to see gains in efficiencies.”
Gamification
Gamification is the term used to describe any tool or platform that applies game mechanics to nongame initiatives in order to encourage and increase engagement. Elements of gamification often include the use of badges, reward points, prizes, social interaction, and leaderboards. Gamification is frequently used by sales teams, marketers, employee training and performance management, onboarding, learning management, and health and wellness.11
The rise in smartphone ownership and wearable technology will likely increase the adoption of gamification technologies to manage health-related concerns and issues. Patient education via gamification is a potentially powerful tool to enhance engagement around disease management. Maintenance of certification and CME are also growth areas for gamification.
Cybersecurity and data breaches
The rapid development of mobile devices and the Internet of Things, in addition to the transmission of health data on a massive scale, will mean more health data will be stolen for a variety of illegal purposes. Hacking and unauthorized access are now common occurrences. Privacy breaches, potential HIPAA violations, and financial damage to patients and institutions are all areas of concern that accompany technological changes.12
Dr. Lesnick stressed that all health-care professionals must be accountable for safeguarding patient information and using the latest security software. “Physicians can be advocates for their patients by cautioning them about the risks of placing their private medical information into public spaces, such as social media. Patients should also know that they may be waiving their privacy rights when they utilize commercial entities that collect and store DNA analyses for purposes of ancestry tracking or medical screening,” he concluded.
References
1. Dhillon V et al. “Blockchain in healthcare: Innovations that empower patients, connect professionals and improve care.” (New York: CRC Press, 2019).
2. Das R. Top 8 healthcare predictions for 2019. Forbes. 2018 Nov 13.
3. 2019 Predictions. Teladoc Health. 2019. http://go.teladochealth.com/predictions/3/.
4. Director-General. “mHealth: Use of appropriate digital technologies for public health.” World Health Organization. 2018 Mar 26.
5. Physicians Practice Staff. 2018 Mobile Health Survey Results. Physicians Practice. 2018 Feb 20.
6. Trend 1: Citizen AI. Accenture. 2018 May 24.
7. Siwicki B. Zocdoc appointment booking app now verifies insurance with AI. Healthcare IT News. 2017 Oct 25
8. Schepke J. What’s your healthcare gamification strategy? Becker’s Healthcare. 2018 May 31.
9. November 2018 healthcare data breach report. HIPAA Journal. 2018 Dec 20.
10. Siwicki, B. Zocdoc appointment booking app now verifies insurance with AI. HeathcareITNews. 2017 Oct 25.
11. Schepke, J. What’s your healthcare gamification strategy? Becker’s Health IT & CIO Report. 2018. May 31.
12. November 2018 healthcare data breach report. HIPAA Journal. 2018 Dec 20.
Note: Background research performed by Avenue M Group.
Emerging technology has long been a driver of change in health care, and the pace of technological change has accelerated dramatically in the past decade. Physicians are being challenged to incorporate blockchain technology, virtual health care, artificial intelligence, gamification of learning, and the rapidly developing Internet of Things into their work and into their interactions with patients.
Blockchain in health care
Blockchain is a log of activity that is time stamped, tamper proof, and shared across a network of computers. Each transaction that goes into the log of activity is enclosed in a block and linked together in chronological order to form a chain, now called blockchain.
The potential applications of this emerging technology in health-care delivery are almost limitless.1 Shared, secure, and linked data that can be accessed by all can give rise to the automation of complex problems, community-generated solutions to problems that empower patients, and an increase in trust, transparency, and incentive alignment. Currently, insurance claims, prescriptions, and payments mostly reside in sequestered computer systems, but a blockchain of the transactions among them would open up a wealth of learning and efficiency possibilities.2 Hospitals, medical centers, insurance companies, clinical trials, and large practices can collaborate to create a blockchain of transactions in which all members can view access, share, and analyze the data.
Burton Lesnick, MD, FCCP, has given the topic of technology change and the practice of medicine some thought. He is a member of the CHEST Board of Regents and the former founding medical director of The Children’s Care Network, a pediatric accountable care organization of 1,800 providers in metro Atlanta area. Dr. Lesnick notes that blockchain is still in its early phases, partly because it is expensive in terms of computing power and electricity to adequately maintain a distributed ledger.
“I would see it being used in the next decade for high-value public registries, especially where the authenticity of data is critical. For instance, in Europe, we are already seeing a lot of effort to prevent counterfeit drugs from entering the pharmacy chain. We may soon see blockchain being used to track expensive drugs in our health-care system, thus ensuring chain of possession and preventing fraud,” he said.
Virtual care
Some traditional face-to-face encounters between doctor and patient will be replaced by virtual care of different types. Telemedicine is growing, thanks in part to advocacy from Medicare and Medicaid, although the lack of federal guidance on coverage and reimbursement could be a barrier.3 mHealth, the delivery of care via mobile devices, is being utilized for preventive services, appointment confirmation, and follow-up information, but the future of this technology will probably expand into transmission of data from patients and health devices, as well as health alerts.
According to a report by the World Health Organization, an increasing proportion of the population is accessing health information and services through mobile phones.4 According to the Physicians Practice 2018 Mobile Health Survey, a majority of practices that participated in the study stated they use mobile health in their practice on a weekly basis.5 Those still not using mHealth cite concerns over HIPAA compliance. Dr. Lesnick offers some cautionary perspectives.
“Many of us can already download data from medical devices such as CPAP machines and home ventilators. A prominent pharmaceutical company has recently gained FDA approval for an inhaler that date and time stamps when and how the inhaler has been used. Wearable health devices, such as fitness monitors and watches that can alert users about life-threatening arrhythmias are wonderful. But the potential for physicians being overwhelmed by the incoming data flow is concerning. This is especially true when physicians are already reporting high levels of burnout associated with frustration using electronic medical record systems. We can only hope that algorithms will be developed to sift the precious stones from the digital effluent.”
Despite the security concerns, health-care providers, along with the Centers for Medicare & Medicaid Services and the insurance industry, are planning to address the projected shortages in the health-care workforce with virtual care.3
Dr. Lesnick added, “Doctors need to be engaged at the level of their health-care systems and national organizations. Providers are needed to provide context and balance to ensure that new technology utilizes appropriate scope of practice, optimizes care, and reduces costs, while reducing burdens on caregivers.”
Artificial intelligence and the Internet of Things
Artificial intelligence (AI) in health care is the use of complex algorithms and software to approximate human analysis of complicated medical data. The applications in medicine are potentially limitless given the rapid accumulation of data related to health care.
According to Forbes, AI for health-care IT application will cross $1.7 billion by 2019.2 By operationalizing AI platforms across select health-care workflows, organizations could see significant productivity gains during the next few years. Forbes also predicts more AI solutions will be used in imaging diagnostics, drug discovery, and risk-analytics applications.2
At the Icahn School of Medicine at Mount Sinai, New York, researchers use an in-house AI system known as Deep Patient, to predict risk factors for 78 different diseases. Doctors use the system to aid in diagnoses.9 AI is being used to diagnose patient wounds via smartphones, remotely monitor the elderly, and help health systems to digitally verify a patient’s insurance information.
Dr. Lesnick observed that chess computers started beating grand masters more than 20 years ago. However, the best chess players, in combination with a computer, can still reliably beat a computer alone. We need organizations like CHEST to help us become more adept at using technology. AI is a powerful tool but just another instrument to be employed in care of patients.
Big data and AI will combine to create a new ways of practicing medicine in the coming years, but what this trend will mean to individual clinicians remains to seen.
An area of rapid development is the Internet of Things, the extension of internet connectivity into everyday objects and devices designed to monitor and send information. Health-care devices now incorporate AI, real-time analytics, machine learning, physiologic sensors, and embedded systems.10 Physicians will increasingly have access to real-time data on individual patients. For physicians, managing, storing, and analyzing data from the personalized health-care devices of their patients will be a major challenge as the Internet of Things continues to expand into health care.
Dr. Lesnick noted, “In my collaboration with Georgia Tech [in Atlanta], one area I’m really excited about is process mining. Instead of sorting individual data points for statistical correlation, process mining looks at groups of actions and decisions. We’ve applied this to our local emergency room. I’m hoping we can find the most efficient processes and hardwire them in order sets. If we can eventually apply process mining to the health-care system as a whole, we might start to see gains in efficiencies.”
Gamification
Gamification is the term used to describe any tool or platform that applies game mechanics to nongame initiatives in order to encourage and increase engagement. Elements of gamification often include the use of badges, reward points, prizes, social interaction, and leaderboards. Gamification is frequently used by sales teams, marketers, employee training and performance management, onboarding, learning management, and health and wellness.11
The rise in smartphone ownership and wearable technology will likely increase the adoption of gamification technologies to manage health-related concerns and issues. Patient education via gamification is a potentially powerful tool to enhance engagement around disease management. Maintenance of certification and CME are also growth areas for gamification.
Cybersecurity and data breaches
The rapid development of mobile devices and the Internet of Things, in addition to the transmission of health data on a massive scale, will mean more health data will be stolen for a variety of illegal purposes. Hacking and unauthorized access are now common occurrences. Privacy breaches, potential HIPAA violations, and financial damage to patients and institutions are all areas of concern that accompany technological changes.12
Dr. Lesnick stressed that all health-care professionals must be accountable for safeguarding patient information and using the latest security software. “Physicians can be advocates for their patients by cautioning them about the risks of placing their private medical information into public spaces, such as social media. Patients should also know that they may be waiving their privacy rights when they utilize commercial entities that collect and store DNA analyses for purposes of ancestry tracking or medical screening,” he concluded.
References
1. Dhillon V et al. “Blockchain in healthcare: Innovations that empower patients, connect professionals and improve care.” (New York: CRC Press, 2019).
2. Das R. Top 8 healthcare predictions for 2019. Forbes. 2018 Nov 13.
3. 2019 Predictions. Teladoc Health. 2019. http://go.teladochealth.com/predictions/3/.
4. Director-General. “mHealth: Use of appropriate digital technologies for public health.” World Health Organization. 2018 Mar 26.
5. Physicians Practice Staff. 2018 Mobile Health Survey Results. Physicians Practice. 2018 Feb 20.
6. Trend 1: Citizen AI. Accenture. 2018 May 24.
7. Siwicki B. Zocdoc appointment booking app now verifies insurance with AI. Healthcare IT News. 2017 Oct 25
8. Schepke J. What’s your healthcare gamification strategy? Becker’s Healthcare. 2018 May 31.
9. November 2018 healthcare data breach report. HIPAA Journal. 2018 Dec 20.
10. Siwicki, B. Zocdoc appointment booking app now verifies insurance with AI. HeathcareITNews. 2017 Oct 25.
11. Schepke, J. What’s your healthcare gamification strategy? Becker’s Health IT & CIO Report. 2018. May 31.
12. November 2018 healthcare data breach report. HIPAA Journal. 2018 Dec 20.
Note: Background research performed by Avenue M Group.
Emerging technology has long been a driver of change in health care, and the pace of technological change has accelerated dramatically in the past decade. Physicians are being challenged to incorporate blockchain technology, virtual health care, artificial intelligence, gamification of learning, and the rapidly developing Internet of Things into their work and into their interactions with patients.
Blockchain in health care
Blockchain is a log of activity that is time stamped, tamper proof, and shared across a network of computers. Each transaction that goes into the log of activity is enclosed in a block and linked together in chronological order to form a chain, now called blockchain.
The potential applications of this emerging technology in health-care delivery are almost limitless.1 Shared, secure, and linked data that can be accessed by all can give rise to the automation of complex problems, community-generated solutions to problems that empower patients, and an increase in trust, transparency, and incentive alignment. Currently, insurance claims, prescriptions, and payments mostly reside in sequestered computer systems, but a blockchain of the transactions among them would open up a wealth of learning and efficiency possibilities.2 Hospitals, medical centers, insurance companies, clinical trials, and large practices can collaborate to create a blockchain of transactions in which all members can view access, share, and analyze the data.
Burton Lesnick, MD, FCCP, has given the topic of technology change and the practice of medicine some thought. He is a member of the CHEST Board of Regents and the former founding medical director of The Children’s Care Network, a pediatric accountable care organization of 1,800 providers in metro Atlanta area. Dr. Lesnick notes that blockchain is still in its early phases, partly because it is expensive in terms of computing power and electricity to adequately maintain a distributed ledger.
“I would see it being used in the next decade for high-value public registries, especially where the authenticity of data is critical. For instance, in Europe, we are already seeing a lot of effort to prevent counterfeit drugs from entering the pharmacy chain. We may soon see blockchain being used to track expensive drugs in our health-care system, thus ensuring chain of possession and preventing fraud,” he said.
Virtual care
Some traditional face-to-face encounters between doctor and patient will be replaced by virtual care of different types. Telemedicine is growing, thanks in part to advocacy from Medicare and Medicaid, although the lack of federal guidance on coverage and reimbursement could be a barrier.3 mHealth, the delivery of care via mobile devices, is being utilized for preventive services, appointment confirmation, and follow-up information, but the future of this technology will probably expand into transmission of data from patients and health devices, as well as health alerts.
According to a report by the World Health Organization, an increasing proportion of the population is accessing health information and services through mobile phones.4 According to the Physicians Practice 2018 Mobile Health Survey, a majority of practices that participated in the study stated they use mobile health in their practice on a weekly basis.5 Those still not using mHealth cite concerns over HIPAA compliance. Dr. Lesnick offers some cautionary perspectives.
“Many of us can already download data from medical devices such as CPAP machines and home ventilators. A prominent pharmaceutical company has recently gained FDA approval for an inhaler that date and time stamps when and how the inhaler has been used. Wearable health devices, such as fitness monitors and watches that can alert users about life-threatening arrhythmias are wonderful. But the potential for physicians being overwhelmed by the incoming data flow is concerning. This is especially true when physicians are already reporting high levels of burnout associated with frustration using electronic medical record systems. We can only hope that algorithms will be developed to sift the precious stones from the digital effluent.”
Despite the security concerns, health-care providers, along with the Centers for Medicare & Medicaid Services and the insurance industry, are planning to address the projected shortages in the health-care workforce with virtual care.3
Dr. Lesnick added, “Doctors need to be engaged at the level of their health-care systems and national organizations. Providers are needed to provide context and balance to ensure that new technology utilizes appropriate scope of practice, optimizes care, and reduces costs, while reducing burdens on caregivers.”
Artificial intelligence and the Internet of Things
Artificial intelligence (AI) in health care is the use of complex algorithms and software to approximate human analysis of complicated medical data. The applications in medicine are potentially limitless given the rapid accumulation of data related to health care.
According to Forbes, AI for health-care IT application will cross $1.7 billion by 2019.2 By operationalizing AI platforms across select health-care workflows, organizations could see significant productivity gains during the next few years. Forbes also predicts more AI solutions will be used in imaging diagnostics, drug discovery, and risk-analytics applications.2
At the Icahn School of Medicine at Mount Sinai, New York, researchers use an in-house AI system known as Deep Patient, to predict risk factors for 78 different diseases. Doctors use the system to aid in diagnoses.9 AI is being used to diagnose patient wounds via smartphones, remotely monitor the elderly, and help health systems to digitally verify a patient’s insurance information.
Dr. Lesnick observed that chess computers started beating grand masters more than 20 years ago. However, the best chess players, in combination with a computer, can still reliably beat a computer alone. We need organizations like CHEST to help us become more adept at using technology. AI is a powerful tool but just another instrument to be employed in care of patients.
Big data and AI will combine to create a new ways of practicing medicine in the coming years, but what this trend will mean to individual clinicians remains to seen.
An area of rapid development is the Internet of Things, the extension of internet connectivity into everyday objects and devices designed to monitor and send information. Health-care devices now incorporate AI, real-time analytics, machine learning, physiologic sensors, and embedded systems.10 Physicians will increasingly have access to real-time data on individual patients. For physicians, managing, storing, and analyzing data from the personalized health-care devices of their patients will be a major challenge as the Internet of Things continues to expand into health care.
Dr. Lesnick noted, “In my collaboration with Georgia Tech [in Atlanta], one area I’m really excited about is process mining. Instead of sorting individual data points for statistical correlation, process mining looks at groups of actions and decisions. We’ve applied this to our local emergency room. I’m hoping we can find the most efficient processes and hardwire them in order sets. If we can eventually apply process mining to the health-care system as a whole, we might start to see gains in efficiencies.”
Gamification
Gamification is the term used to describe any tool or platform that applies game mechanics to nongame initiatives in order to encourage and increase engagement. Elements of gamification often include the use of badges, reward points, prizes, social interaction, and leaderboards. Gamification is frequently used by sales teams, marketers, employee training and performance management, onboarding, learning management, and health and wellness.11
The rise in smartphone ownership and wearable technology will likely increase the adoption of gamification technologies to manage health-related concerns and issues. Patient education via gamification is a potentially powerful tool to enhance engagement around disease management. Maintenance of certification and CME are also growth areas for gamification.
Cybersecurity and data breaches
The rapid development of mobile devices and the Internet of Things, in addition to the transmission of health data on a massive scale, will mean more health data will be stolen for a variety of illegal purposes. Hacking and unauthorized access are now common occurrences. Privacy breaches, potential HIPAA violations, and financial damage to patients and institutions are all areas of concern that accompany technological changes.12
Dr. Lesnick stressed that all health-care professionals must be accountable for safeguarding patient information and using the latest security software. “Physicians can be advocates for their patients by cautioning them about the risks of placing their private medical information into public spaces, such as social media. Patients should also know that they may be waiving their privacy rights when they utilize commercial entities that collect and store DNA analyses for purposes of ancestry tracking or medical screening,” he concluded.
References
1. Dhillon V et al. “Blockchain in healthcare: Innovations that empower patients, connect professionals and improve care.” (New York: CRC Press, 2019).
2. Das R. Top 8 healthcare predictions for 2019. Forbes. 2018 Nov 13.
3. 2019 Predictions. Teladoc Health. 2019. http://go.teladochealth.com/predictions/3/.
4. Director-General. “mHealth: Use of appropriate digital technologies for public health.” World Health Organization. 2018 Mar 26.
5. Physicians Practice Staff. 2018 Mobile Health Survey Results. Physicians Practice. 2018 Feb 20.
6. Trend 1: Citizen AI. Accenture. 2018 May 24.
7. Siwicki B. Zocdoc appointment booking app now verifies insurance with AI. Healthcare IT News. 2017 Oct 25
8. Schepke J. What’s your healthcare gamification strategy? Becker’s Healthcare. 2018 May 31.
9. November 2018 healthcare data breach report. HIPAA Journal. 2018 Dec 20.
10. Siwicki, B. Zocdoc appointment booking app now verifies insurance with AI. HeathcareITNews. 2017 Oct 25.
11. Schepke, J. What’s your healthcare gamification strategy? Becker’s Health IT & CIO Report. 2018. May 31.
12. November 2018 healthcare data breach report. HIPAA Journal. 2018 Dec 20.
Note: Background research performed by Avenue M Group.