The healthcare system is ripe for disruption, according to some technologists. Ubiquitous sensors will be the change agents. Get ready for the “big kaboom.”
Despite the availability of powerful sensing technology, most people are ignorant of their own health metrics. We often know more about the health of our technological products than we do about our own bodies. As chairman and CEO of X Prize Foundation Peter Diamandis, MD, explains: “Today, my car, my airplane, my computer know more about their health status than I do, which is insane.” One of the main reasons for this knowledge gap is the average person’s lack of access to medical sensing technology, most of which is gated within doctors’ offices, hospitals and clinics. To monitor health metrics, most people only have a thermometer and a scale, which they rarely use.
The Power of Decentralisation
Famed economist Clayton Christensen has pointed out that as technology evolves, it has the power to spur disruptive innovations that make products simpler and less expensive and, hence, more accessible to a broad base of end users.
The computing industry is an obvious example of this principle at work. In the 1960s and 1970s, computers were enormous, expensive and difficult to use. One had to be practically an expert to operate one.
The debut of the microprocessor led to the development of the personal computer and, eventually, devices such as tablet computers and smartphones. In addition, computing technology, which costs a fraction of what it once did, is now ubiquitous in modern society. The smartphones that we carry around have billions of times more computing power than the large mainframes from decades ago. And computing technology has never been easier to use; it has been deskilled, converting the vast majority of the world’s population into regular users.
Healthcare: Next in Line for Disruption
The healthcare industry is poised to follow a trajectory similar to numerous other industries that have had their disruptive moments over the course of the past decades. “The whole context of deskilling and disrupting industries has been happening across so many other places, such as banking and finance, design and manufacturing,” says Eileen Bartholomew, Vice President, prize design, at X Prize Foundation. “Healthcare is kind of the last hold out of that transition—of that idea of exponential technology becoming cheaper, more accessible and easier to use,” she says. “I think health is the last domino to fall. And when it does fall, it is going to be a big kaboom.”
And with that kaboom, consumers, or, in this case, patients, will become empowered as never before. “[In the future], you may know more about your body and your health metrics than your doctor,” Bartholomew says. “Everybody, to some extent, can become their own doctor. And the health system will be used for what it is intended: that is, when something goes wrong, to help fix it.”
While such statements can sound radical, the status quo is not sustainable. “[This transformation ultimately] is not about replacing doctors, and replacing the system, it is about using what we have a heck of a lot more efficiently and judiciously,” Bartholomew says. “We have to change the conversation, and the only way to do that is to stop using the mass of people as a burden and turn them into an asset,” Bartholomew says. “Healthcare should be an asset for everyone. No one cares more about his or her health than the patient.” To fuel this transformation, patients need better tools and better information.
Advances in sensing technology will be a key driver of patient empowerment. “We envision a future where sensors will become not only more advanced and different and unique, but accessible in [unprecedented] ways,” says Bartholomew.
“You will see sensors embedded in your life—whether that is your phone, clothes, home or car,” she predicts. “They will not just be measuring the performance of the ‘Internet of things’ but the ‘Internet of you’—your metrics and your normal across-health information.”
In many ways, this transition will simply be an extension of what has come before. Clinicians have long used vital signs and biomarkers, for instance, to monitor patient health. But advances in sensing technology also will provide new metrics that will broaden our understanding of what it means to be healthy. That could encompass “novel ways of looking at everything from activity levels to sleeping patterns in a way that can predict, prevent, manage or even treat diseases in ways that we haven’t thought of,” Bartholomew says.
Competing to Disrupt Healthcare
To help make the future of healthcare a reality, The X Prize Foundation has launched two competitions:
The ultimate goal of the prizes is to create a new healthcare technology ecosystem. While the winners of the competition will be recognised and rewarded, the real goal is to disrupt medicine and help bring it into a new age.
“The history of medicine happens behind behind closed doors,” Bartholomew says. “It is administered only by people who have [substantial] training.”
A growing number of people are beginning to view the healthcare status quo as broken. “I think we are starting to see frustration at every level—not just at the innovation level but at the patient level,” Bartholomew says. “There is frustration with the ‘go to the mountain approach’ to healthcare because we know that health happens everyday and there are known things that you can do to improve your health but you don’t have the tools to do it. The tools are still locked behind glass.”
The frustration is beginning to escalate among developers of medical technology as well as in patient communities. Part of the aggravation comes from the fact that our culture has seen technology revolutionise so many aspects of our lives while the basic healthcare dynamic remains largely unchanged. The patient gets sick, takes a trip to the doctor and sits in a waiting room before finally seeing the physician. The limitations of this model are even more apparent in rural areas. In many cases, patients with a significant health condition must drive long distances to see a specialist, who is only able to draw on a limited amount of patient data.
By contrast, look at how the banking industry has been transformed. “Fifty years ago, you couldn’t imagine accessing your banking information without going through a bank teller,” Bartholomew says. “Now, your entire financial [record] is transparent and available online—to anyone at any time.”
“We will see that same transition in healthcare. It will become a 24/7 personally owned thing,” she says. “We don’t see any other way to support the current system [given the] scale and growth that it will need to deliver the kind of care that we are going to have.”
Before launching the two aforementioned competitions, the X Prize Foundation spent months in meetings and doing research to figure out how to bring about the “deskilling and disrupting of medicine,” says Bartholomew. “The two concepts that emerged from this, one of which is the Qualcomm Tricorder X Prize, are seeking to push not only the technology of sensing but also its integration, miniaturisation, and adaptation (meaning, understandability) into a device that a consumer could use for self-diagnosis,” she says.
The organisation realised that making their future vision of healthcare a reality would require several significant advances. “In addition to the integration work that will be required for tricorder teams, a lot of breakthroughs have to happen in sensor and sensing technology,” she says. Sensors perform the actual measurements; sensing technology collects data and makes a “so what?” analysis, Bartholomew adds.
The Biggest Splash in Healthcare
Time will tell which sensors and sensing technologies make the biggest splash in healthcare. Bartholomew says that she has great expectations for novel sensors that can detect central nervous system and brain-based disorders. Such sensors also can collect information on everything from mood to personality and behaviour. “This is still a big black box,” she says. “I am really excited to see the development of sensors that bring more clarity.”
Bartholomew cites Affectiva, a company that is developing novel ways of tracing emotion based on facial recognition and other types of information to assess levels of mood and emotion. “That is the beginning of cracking the code to brain-based behavioural diseases, brain-based function, mood, personality and all of the things that so many people suffer from,” she says. “People have no information and very little guidance to treat or manage some of their diseases. So I am looking forward personally to seeing some breakthroughs in that field that could change the way we diagnose, measure and manage these conditions.”
is Editor at Large of EMDT sister publication MD+DI