Technology changes fast, and what the health care landscape looks like today may be completely different in a year. But what about in a decade?
Radio Advisory's Rachel Woods sat down with Advisory Board's John League and Nick Cericola to talk about the role of technology in the future of health care and what the next decade might look like in the health care industry.
Read a lightly edited excerpt from the interview below and download the episode for the full conversation.
Rachel Woods: One promise of technology that hasn't been realized yet but could be across the next decade is all about the internet of things. All this data that we get from the health tech marketplace through apps, wearables, implants, all of that. So far, my understanding is it's a lot of data and not a lot of action. What do you hope changes by 2030?
John League: Right now, we're in a world where, to some extent it's data, data everywhere and not an insight to drink. What do we actually do with these streams of data? How do we serve up the important few out of the trivial many so that it gets in front of a clinician or a care manager or someone who can actually intervene in an appropriate way on behalf of the patient? How do we serve up all of the new clinical information that is being created every single day in a way that can actually inform care decisions to drive better outcomes? That's the real question.
Woods: And I imagine this is going to be harder because we're talking about a future where there's even more data. That data is more mainstream, it's more connected. Maybe it's even better data than what we're using today.
But I imagine that the problem still has to be, how do we get people other than the consumer themselves to actually be the ones that are using and acting on that data? How do we get the clinical team involved?
Nick Cericola: Yeah, absolutely. And to be fair, Rae, I think the industry does hold the ambition to shift some control to patients. We want patients to be in a seat of greater agency over their care management, and we imagine that the internet of things, which I think someday are just going to become things, because everything's going to be connected at some point, will become sort of the chassis on which individuals can make more informed decisions about their wellness or health care.
We still want the clinicians to be a part of that paradigm, and I think getting the balance right is going to be really challenging. I already see a world in which we perhaps shift too much control away from clinicians and towards the internet of things to a point where we are less able to manage some of the risks that that creates.
Woods: I'm really interested in this idea because Nick, you're talking about the balancing act that we have to do between patients and providers. I might go a step further and call it a power shift. And we know that we've wanted to shift power away clinicians and to an individual consumer for some time. That is a good thing.
But what happens if we go too far, and we swing the pendulum too much towards the end consumer and all of the new power that they have because they have so much access to their own health care data from the internet of things?
Cericola: So I want to tee up John here to answer this, because he coined a term that I have since fallen in love with. But before I do that, I want to add an additional participant here in this power shift, because I think what you're describing is really interesting, Rae, but let's not forget that there are companies that sit behind the internet of things that are larger not health care organizations, and they use the internet of things, our personal devices, to prompt us to do things in our lives.
Sometimes those prompts are in line with health and wellness goals, sometimes those prompts are in line with their own incentives to get us to participate in their ecosystems, whatever those are, whether it's commercial or social.
And so I think as we shift control to patients vis-à-vis the internet of things, we have to remember, there are other actors sitting behind that that have their own interests here. But John, I want you to talk to us a little bit about the term that you've coined.
League: Well, the thing that Nick and I were thinking about as we sort of explored this problem was thinking about the ways in which all of those different influences on the consumer, both from their access to their own data, but also from these outside forces, these other participants now in the health care ecosystem, to what extent would the things that the patient wanted to do or the recommendations that they were seeing, be it odds with what a professional care team was telling them?
I think it's not too much of a stretch, given all that we've seen over the past year or so of pushback against valid, scientifically grounded health advice given to patients, that they would potentially reject a lot of those things if it didn't fit their worldview. And what we started calling this is technological homeopathy.
So basically, home brew health care that is derived from what the patient is able to access through all of these new technological channels, through their connection to data, through their connection to other sources of information and influence outside of the patient provider relationship.
What does it mean when patients disagree? When they feel empowered to debate medical professionals about diagnosis, about their health, about their treatment? I think those are incredibly important questions that we need be prepared for in a way that the largely paternalistic approach that most clinicians take to advising their patients is really not going to live very long in that world.
Woods: Okay, this is a wild idea to me, John, but I also love this term because when I think about what clinicians have to deal with today, and they have to deal with misinformation, and they have to deal with people who are saying "no, this vitamin or this supplement or this essential oil is the thing that I have learned or that I believe is going to support my care," and we all know how painful that can be in the middle of a clinical interaction.
But you're saying, what if it's not the essential oils and the supplements? You're saying, what if it's the technology? The very technology that we need to get us out of the problems that we face today.
League: For sure, and I think that just speaks to the unintended consequences of embracing a lot of these new channels for care delivery, for managing symptoms, for connecting people to information and even to other people. I think the unintended consequence element of it is something that we often don't examine enough.
We're perfectly content to have a projection in 2030 that is all rainbows and lollipops, and we're able to achieve all of these great things, when the reality is that with all of these changes that will be for the better in many ways, there are also other ramifications that if we don't think through how we implement those things, we will wind up with other problems that we have to dig ourselves out of.
Woods: Let's go there next, let me just take a step back and think about the future of a more technological world in general. Are there unintended consequences that you're worried about that you want to make sure the health care listeners, the health care leaders that are listening to this podcast, are aware of?
Cericola: We already know that digital hyperconnectivity brought about by smartphones, social media, et cetera, causes physical and behavioral health conditions. Depression, anxiety, sleep disorders, et cetera. I worry, what happens as the lines dividing digital spaces from real spaces become more difficult hold to identify?
If we create new types of interfaces with the internet that aren't based on hardware, that are screenless as we transition what we know of as social media today to perhaps an actual metaverse where we exist digitally alongside our actual selves, I worry that that leads to more public health challenges and challenges that are more insidious because they're less readily identified both by those who have the challenge, but also by the care community that's meant to serve them.
Woods: And maybe the treatments that that care community uses.
Cericola: I think so.
Woods: John, what about you? Are there bigger, unintended consequences you're looking towards or wary of?
League: I worry about the trajectory we're on with cybersecurity. I don't think we take this seriously enough, I don't think we invest enough in it. And I think it will undermine the ability of health care organizations to continue not only to have the trust of their patients and their payers, but I think it could eventually disrupt their funding mechanisms.
I think it could be that these attacks are just too sophisticated and just continue to drain resources if we don't take this seriously and start investing in the ways we should. And it's very easy to say, well, everybody just needs to invest more and we'll solve the problem. That is not the end of the solution, but it is the beginning of the solution, and I don't think we're there yet.