Everyone wants healthcare that is better, more personal, useful, effective, and cheaper. The key to conquering these conflicting objectives: technology. Fortunately, we sit on the cusp of the biggest medical tech revolution in human history.
But as every sentient citizen knows, the epicenter of action in this arena has just moved from the innovators and entrepreneurs in Silicon Valley and San Diego to the legislators and bureaucrats on Capitol Hill and K Street.
Weve seen this movie before, most recently in the energy arena where, even setting aside the lobbying-centric favoritism, cronyism and even scandals, the billions spent on new energy tech has yielded little of value. We shouldnt be surprised now to see Solyndra-class projects and scandals in the near future for medical tech.
For those who dont live in or follow the machinations of Washington D.C., herein a lucid summary from a Wall Street Journal story on the heels of the Supreme Court decision:
- A new front opened Friday …. Employers, insurers, hospitals, drug makers and others are angling for an advantage as the government writes the regulations and sets the policies that will bring the law to life. …. "Lets face it, this law is going to be amended and adjusted for years and years to come," said Rick Pollack, executive vice president of the American Hospital Association, a lobbying group.
- The White House gave lobbyists fresh hope that they can win changes to the law after President Obama said Thursday he wanted to improve the overhaul. Although the legislation Mr. Obama signed in 2010 spells out most aspects of the law, federal officials can materially change it depending on how they write regulations to implement each provision.
For technology innovation the shift toward Washington D.C. comes at a particularly unfortunate juncture in history. Lets take a brief trip down memory lane for a relevant lesson in the march of technology.
Just 20 years ago, the Postmaster General of the U.S., Marvin Runyon, gave a speech to the Economic Club of Detroit predicting the continued growth in the volume of mail. The word "email" didnt appear in his speech. Understandable. It was a different time you understand. Who could have foreseen what happened next?
Only a year later America Online began the public email revolution. People began to use the wondrous new Internet in earnest. The volume of physical mail soon started to shrink and has been in free-fall ever since.
What would have happened if our government had launched a vast new program to embrace email and the Internet, and re-structure and re-regulate everything the USPS touched, to improve service and reduce costs? Such a grab would have been easy to rationalize. After all, as Postmaster Runyon said in his 1992 speech: "We play an important role in the nations economy. We help all of Americas businesses, from big corporations to mom-and-pop outfits, communicate with their customers and achieve success for their employees." Pretty vital stuff.
If the government had decided to assimilate the fledgling Internet, in all likelihood email would still exist. But under governments heavy hand, the chaotic and fertile bottom-up creation of technologies and companies that ensued would never have happened.
Healthcare is more complex than mail, and the technology of e-medicine will be more challenging than e-mail. But emerging technologies are up to the task. In both relative and absolute terms, theres been far more progress in technology since 1992, than there was from 1972 and 1992 – when the impact of email and the Internet took everyone by surprise.
One hears the argument, in defense of government-centric development, that our military successfully fosters innovation, so why not healthcare. The analogy is specious. The Department of Defense is a single mission business, and for innovators a single customer. Healthcare has staggeringly complex and often conflicting missions, and millions of customers. But seriously, does anyone believe the Pentagon, or their kin agencies, would out-innovate Apple and or would have invented an iPhone or iPad?
While were dismissing shibboleths, the Apollo Program analogies are equally silly. If we could put a man on the moon…. yadda yadda. In healthcare — as with much else, like say, energy — we would need to put everyone on the moon. Its an entirely different scale and scope of challenge.
Ive previously chronicled in this column some of what the silicon and Big Data revolution promises medicine. (See for example my columns on Scanadu and the Tricorder X-Prize.) The depth and scope of technologies now possible are so radical and exciting that one easily slips into hyperbole. All of it promises to make health care more effective and personal, bringing more individual control, clarity and collaterally cost containment.
The potential advances go far beyond the often-highlighted migration to things like on-line medical records – thats about as exciting as when on-line channel guides replaced the paper TV guide.
You want to see the future of healthcare? Link up to Web journals like iMedicalApps where tech-centric physician-editors track mobile medical tech and healthcare apps. Technology is about to unleash an era of hyperpersonalization of health care. Given how personal and specific health is, thats precisely what is needed.
The underlying technologies that will remake healthcare should sound familiar. It is the holy alliance of three profound macro trends: a) smart sensors that are radically effective and cheap, b) anytime everywhere wireless broadband, and c) the Cloud. Much of this will be realized in the form of a smartphone or smartphone-like device (hence the Star Trek invoked Tricorder X-prize).
In our near future anyone will be able to link information about what theyve been doing, eating, etc., and marry it with a rich stream of real-time physiologically-specific data about whats going in their body, wherever they are, linked wirelessly to the Cloud. In the Cloud the entire canon of medical literature and research can be instantly accessed to diagnose and provide advice specifically relevant to you, your body, now. Its a new world when any citizen can access super-compute power that only a decade or so ago was classified and available only to military-class customers.
This doesnt cut out the doctor or the hospital. The same kinds of tools show up in the hospital, in operating rooms, clinics and ambulances. It empowers citizens to make decisions, and helps physicians and hospital staff see or make rapid and early diagnostics. Setting aside personal suffering caused by late diagnoses, it is vastly cheaper to catch things early. And hyperpersonilized diagnoses can minimize spurious, expensive and for we patients, annoying visits.
Just one example (courtesy iMedicalApps): startup Cellscope developed a smartphone camera attachment to create a personal otoscope (for looking at your eardrum) that links to a Cloud-based diagnosis engine to determine whether your child has an ear infection. As the iMedicalApps docs write: "In America alone, the most common trip to a pediatrician is for an ear infection, accounting for around 30 million doctor visits a year."
Another recent announcement typical of the trend comes from GE Healthcare regarding their partnership with AirStrips product that links over 100 clinical measurements, not just physiological data, but waveforms from patient monitors, direct to doctors iPads any time, anywhere.
Or check out what researchers are doing at the University of Southern Californias telegraphically named Center for Body Computing, or at the MIT Computer Science and Artificial Intelligence Laboratory where, for example, one project uses smartphone video analytics to remotely deduce a persons vital signs.
The future looks a lot more like science fiction in health care than in any other part of our daily lives. Redolent of what was once far-off science fiction when Asimov wrote the script for the 1966 movie Fantastic Voyage, researchers at Stanford earlier this year announced a prototype device small enough to swim in your bloodstream, make measurements and transmit them wirelessly to your iPhone.
True, you will still have to wait a few years for an app that is linked to sensors you can swallow; but its coming. For now, nearly all of the available apps for your iPhone or Android are focused on diet, exercise, and images – not diagnostics, not yet. One of Apples AppStore first medical apps was diagnostic-anchored. Mobile MIM fuses and displays diagnostic images from all manner of technologies (MRI, CT, PET, etc.).
There is a torrent of such innovation ready to emerge here in the United States. But can it thrive under the monolithic structure of a national healthcare system? A lot of intellectual capital, time, energy – and money – are going to be expended by the entire ecosystem of health care on lobbying, gaming and dealing with Washington, the new rules, and the fat federal purse.
No disrespect to my friends in the USPS, but the future of medicine could look more like snail-mail than e-mail.
Original Source: http://www.forbes.com/sites/markpmills/2012/06/30/the-solyndrafication-of-healthcare-technology/