On the heels of such great discoveries as the germ theory, X-rays, DNA, and Penicillin, the next stage of our growth in healthcare will come from Artificial Intelligence (AI). This includes effective machine learning, neural networks, and a promise of greater pattern recognition, data analysis, 'general thinking', decision-making and efficiency.
Up until recently, a large percentage of our data was not digitized, nor did we have the storage and processing power. Now that we have this capability, we will soon see significant steps forward in AI innovation, growth of neural networking, and deep-learning technology including:
- Medical imaging & diagnostics
- Wearables
- Mental health
- Virtual assistants
- Risk management
- Drug discovery
- ER & hospital monitoring
- Health & lifestyle management
- Biotechnology
- Genomics.
Take a moment and see what's on the horizon. Smart, visionaries and emerging companies such as: Merge Healthcare, Zephyr Health, Lumiata, Ginger.io, Apixio, Zebra Medical Vision, Babylon Health, Sentrian, AICure, and HealthAware. Venture funding will continue to increase in the digital health sector, with respect to dollars invested and deals made. Look to see greater M&A activity in many of healthcare's largest industries.
These initiatives appear to be putting our country's health in a great place for the future. Many of these efforts are intertwined with the healthcare's industry's efforts to capture the Triple Aim. This encompasses improving the patient experience of care (quality and satisfaction); positively increasing the health of populations; and reducing health care cost.
DOWN THE ROAD, WE FIND THE 'CAN-KICKED' ISSUE
Coupled with the future of AI and the Triple Aim lies the U.S. healthcare sector. An exploding for-profit juggernaut, comprised of highly-connected, politically-influential, and nearly monopolistically-behaving industries. Segments in these underlying industries include publicly-owned health systems, medical device companies, biotechnology, pharmaceuticals, and managed care organizations. Their historical, upward expansion of R&D and growth led to great innovation in medical products, services, drugs, and therapies.
While the U.S. healthcare sector itself thrives, the often 'kicked can' issue is that large amounts of Americans can no longer afford coverage, medical services, or needed medications. As Dan Munro points out in his most recent Forbes article, the annual cost of healthcare for a family of four has boomed to $25,826.
The data places the rising portions of employee payments at $11,000 and employer payments near $15,000. In truth, it is really all the employees cost, as companies often blend their healthcare expenses into salary levels. YES - that means the average employee being paid $60,000 really should be at $75,000.
Moreover, over the last decade the average deductible that workers paid for medical care before their insurance kicked in, has more than tripled from $303 in 2006 to $1,077 today. Deductibles rose seven times faster than wages during this period. Employees paying more...insurers paying less.
And what of wages? The growth in healthcare costs have decimated wages. The Federal Reserve's own data shows clearly that the average American worker has seen wage stagnation dating back at least 18 years. Since 1989, real median household income has increased, in total, just 0.66%. That represents an annualized rate of increase of only .026%.
One wonders how such a great system of medical innovation and care could be allowed to economically punish the citizens and taxpayers, who funded it?
Simply stated, our healthcare system has and is based on regulated prices. Because free market forces are largely non-existent to consumers, costs and pricing cannot be driven down, as in other industries. Plus, we operated from a fee-for-service system, aligning the financial incentives of health insurers, hospitals, pharmaceutical companies, and providers on the same side through mass overutilization and claim billings.
Many healthcare companies, need to show continued profit growth to shareholders; hence, they continued to grow their cost and received greater levels of reimbursement. Health insurers passed on these surging costs (minus admin costs and profit) to employers and individual insureds; private and public employers passed on their new costs to employees.
Employees and taxpayers...well, what could they do? They paid it then, and continue to pay for it now. Though we see unsustainability coming back full circle, as the ACA is shifts more people to Medicaid, and high-deductible, highly-subsidized, lower quality health plans.
THE NEED FOR JOB REPLACEMENT FROM AI EFFORTS
Thanks to abundant processing power, previously available only on the world's most robust supercomputers, AI is developing faster than most predicted. As Medicine faces many existing and new challenges, it will seek to address many areas in healthcare ripe with rampant inefficiencies and waste.
By the end of 2016, the healthcare sector is set to have to have the largest workforce in all U.S. industry - including government. Near 19% of GDP and growing, our healthcare and political leaders are charged with recognizing that technologies like AI can serve a major purpose in improving the limitations of human-powered efficiency.
When one thinks AI in healthcare, they are immediately drawn to reducing medical error, better management of patient health, new discoveries in drugs and biotechnology, and new innovation. But the greatest benefit may lie in its reduction of human capital, a large direct and indirect contributor to cost.
Many medical professionals fear AI - especially in that they may lose their jobs. Early AI companies, especially courting large players such as IBM, recognize this. They are keen on holding hands, assuring medical clients that this will not happen. Clearly, we must walk before we can run, and augmented intelligence, as a form of AI in assisting human activity is this needed step.
However, our healthcare and political leaders must recognize the importance of the last leg of the Triple Aim. Until cost drops significantly - we will continue to see upward surges in consumer pricing, placing an even greater strain on many Americans to keep their financial well-being.
Outcome-based payments are set to help with this - though it might not be enough to offset such presently-large employment pools. Plus, we are dealing with many publicly-owned, for-profits that need to satisfy their shareholders with growing profits. The time will come when these entities and large healthcare industries will begin to push back politically.
Recently, a Johns Hopkins study put medical-caused deaths as the number three killer in America today - causing nearly 251,000 deaths or 10% of our country's yearly total. If there was ever a clear sign that human efforts, even the most meaningful, can eventually hit limitations for the worse, this is it.
When AI truly arrives, we must make sure our healthcare and political leaders are held firm to do what is best for the health and well-being of the American workers and taxpayers. Those that have kept, and continue to keep healthcare industries and companies in business.
If greater efficiencies and accuracies through replacing jobs with AI, can lend themselves to the Triple Aim and greater healthcare system sustainability, we must not be afraid to move forward. Healthcare is not only about business and profit, but its about serving what Lincoln called 'the better angels of our nature', by passing on a better system to the next generation.
★ Stephen Ambrose is a performance-driven leader in several different healthcare industries, as well as having recently led corporate strategy in the tech arena. He is a healthcare polymath, with interests including AI in healthcare, population health, data analytics, emerging technology, and chronic disease.
Selectively seeking his next path in business development for the right healthcare company, you may contact him directly: steveambroseucla@gmail