By Sonal Somaiya
In the past 50 years, we have undoubtedly experienced a technological revolution. Tasks that used to require human direction can now be completed by machines – arguably better than humans can. Given the speed at which we have welcomed technology into our homes, workplaces and lives, it is surprising that more often than not, I still have to fill out a paper form with my medical history every time I go to my doctor’s office. This begs the question, why has it has taken so long for technology to transform how healthcare is delivered?
The introduction of technology in healthcare is not a novel idea; today, robot assisted surgeries already happen daily in hospitals around the country and FitBits wrap the wrists of millions of people each day. According to a study by Accenture, 36% of people think that technology is “very important” when it comes to managing your health. Even more striking, almost 50% of respondents have used websites, mobile devices and electronic health records to manage their health in the past year. So, if patients want it, what has prevented the widespread adoption of healthcare and medical technologies? Why does my doctor’s online portal look like a website from the AOL era?
I would be remiss if I didn’t mention the huge impact government regulation and the structure of healthcare systems have on the rate of technological progress in the industry. Up until recently, HIPA compliance was a huge hurdle to sharing medical records electronically. Privacy of health records is important and sensitive for many people – more so than my likes on Facebook – 53% of respondents in the Accenture survey noted that they wouldn’t be willing to wear technology that tracks vital signs or fitness and lifestyle. As we are seeing with recent government focus on the use of data collected by various technologies, we have a long way to go to earn the trust of society with something as personal as health data. Though this caution is warranted, it also creates a large barrier to entry to tech startups interested in disrupting the space. Unless companies have scale and ability to disrupt on a large scale, it can be daunting to enter into such a fraught space. This has slowed down the pace of adoption of innovative technologies.
Another hurdle for disruptive technology to be adopted universally by healthcare providers is misaligned incentives around actually testing and collecting data on patients. Consider for a moment the advent of genetic testing technology. Advances in this field have made gene therapy an affordable option for millions of patients with a family history of diseases. Even so, there has been a much smaller increase in the frequency of genetic testing. In an interview, Dr. Dr. Joseph Kvedar, vice president for connected health at Partners HealthCare in Boston and associate professor at Harvard Medical School, noted that “many doctors…remain skeptical as to whether the data coming in… are even useful. There’s a fear of data overload [among physicians] that is realistic.” These concerns are amplified especially when consumer technology companies tend to develop their products siloed off from doctors, nurses and actual healthcare providers. So, though there is certainly potential in gathering and sharing more data, healthcare providers themselves are averse to using data that has been collected in an unknown fashion.
Perhaps not surprisingly, healthcare providers – doctors especially – have been most vocal in opposition to technology in the exam room, and rightfully so. There are certain irreplicable qualities that differentiate a doctor from WebMD – the art of medicine, if you will. Though an algorithm might become refined enough to parse through the latest database of clinical studies to find the best diagnosis for a patient, there’s no arguing the value in a doctor’s expert eye and gut feeling upon seeing a patient.
These moving parts and conflicted interest hinder technology adoption even if technology does make it past the ideation and creation hurdle. When regulation and the end users are not aligned, it is difficult to incentivize private companies to disrupt a space when there is little chance of widespread success and adoption of a technology.
So, if doctors have an aversion to leveraging data that’s being collected as it is today, why not include them in the conversation? With the support of more forward-looking regulation that will hopefully to come out of ongoing Facebook conversations on Capitol Hill over the past few weeks, there’s no bound to what algorithms, artificial intelligence and engineering can achieve in the exam and operating room. At the same time, this development needs to happen in close conjunction with healthcare providers. If technology is going to continue to develop at the rate it has, consumers will inevitably be accustomed to a certain degree of technology driven decision making in their lives and expect the same when managing their own health. If we don’t navigate this evolution deliberately, we risk missed opportunities and the potential for technology to develop without patients and doctors’ best interests in mind.