Wednesday, January 23, 2019

Lessons from Digital Health Summit at CES 2019

Brandon Rozelle
Innovation / Technology / Strategy

I had the pleasure of attending CES 2019. In addition to seeing more drones than you can shake a stick at (or 1000 sticks), I participated in the Digital Health Summit track, which assembles leaders and innovators in the healthcare vertical. Yes, there were representatives from Providers and Payers and Diagnostic Labs and Pharmaceuticals, and others present (some of which don't even have categories yet)—but there were also some of the largest companies in the world participating and possibly not some you might guess.

There were exciting topics like 3d-printing of prescription drugs for individual patients (yes, that is a thing). We heard from experts who were pioneering (and investing) in digital therapeutics where the therapy is an interactive experience or video game. Many of these interactions have been shown to positively impact some patients, such as children with ADHD. And even discussions around molecularizing individual pharmaceuticals for a single patient—one genome, one chromosomal map, one drug.

We heard from leaders who are innovators but also physicians. We heard from AT&T's healthcare division (yes, AT&T has a pretty sizable investment in the health space). We heard from Google, and Microsoft, and other technology firms dealing with IoT communication and secure data volume management. My head was spinning with impressive speakers, presentations, and a moving kaleidoscope view of what the next 3-10 years will likely hold for the evolution of healthcare.

A few thoughts on the broader macro trends.

Industry 4.0 is coming to Healthcare

If you know anything about Industry 4.0 (my colleague and friend Rob Hendricks authored a really great post about it here) it deals with connecting devices that can communicate status, location, and other KPIs to systems that can contextualize that status with an understanding of complex workflow, or the Digital Twin. Rob defined the Digital Twin in his post:

  "Most research defines the digital twin as a digital replica of different assets, processes and systems in a business. This generic definition is basically correct. However, it's more accurately    described as an integrated set of digital replicas or models driven by a rich information model called a digital thread."

So, the important thing to know is that IoT (or the connected devices) connect into a system that resembles the Organization's Complexity, but in a digital construct. I think this is simple to grasp in the context of manufacturing, because I'm only producing so many things and that work often occurs start-to-finish over some timescale. Well the same thing is coming to the healthcare experience, except the complexity is a whole order of magnitude greater.

Think of the fact that most health systems have tons of machines and devices reporting status. MRI machines, EKGs, Imaging Scanners, literally thousands of devices produced by different manufacturers with differing standards for communicating information to other devices or complex software systems. Now let’s think of the intersection of those devices with the systems clinical staff are using to log treatments or pharmaceutical distribution, many of which are offline in the sense they don't talk to those other systems.

This leads us to a broader trend, which was well on display at CES, that healthcare consumers now want to bring their own data to the party. Whether you own a Fitbit or an Apple Watch--we're entering the 5th generation of devices that provide us some context of our health or our "healthiness" relative to some baseline. These devices are now getting accurate and the value of the data they generate has value to someone fighting a chronic illness, trying to lessen their chances of developing certain conditions, or just generally trying to follow the instructions of their physical therapist as meaningfully as possible.

The "Digital Twinning" of healthcare is going to be a seismic shift in better connecting valuable information for everything from capacity planning (when is the MRI in-use and when is it free, can we get someone else in there?) to finding correlations in healthcare treatments and outcomes that we cannot see today because the data isn't connected. The real impetus is that this work HAS to be done to allow more advanced AI to parse through these complex data sets and eventually anticipate a care situation by assembling thousand and eventually tens-of-thousands of data points to create more efficiency, offer better care, and identifying greater factors that contribute to wellness and health. As a result of this trend, data management and AI is going to quickly generate a goldrush in the healthcare industry.

Data is Healthcare's New Currency

I had  the pleasure of hearing Dr. Jessica Mega (MD and MPH) speak on the topic of patient data. She is the Chief Medical Officer of Verily (formerly Google Life Sciences). She projected that we're only a few years away from living in a world where the volume of data being generated and housed will be on average terabytes (plural) per patient. Think about that. It sounds like an AWS or Azure dream to be able to hold and transact on those data volumes--but the standards around how we will safely transfer or manage these data sets have not yet been written. How we store, share, and analyze these data sets will require amended privacy, security, and HIPAA laws not to mention API and accessibility requirements that will challenge how we think of transactional information and secure information today.

Why is this necessary? Something Dr. Mega went on to discuss… the spectrum or of certain diagnoses are getting more nuanced. We no longer think of Diabetes as just Type 1 and Type 2--it is beginning to be understood that there are at least 3 distinctions and possibly (current evidence suggests) up to 5. As we navigate these continued subdivisions in diagnosis we also open opportunities for more specific and nuanced treatment, which opened up another heavy topic: Personalized medicine.

We are approaching a moment where understanding why a treatment for one patient isn't working for another with similar symptoms or a similar diagnosis is possible, but it is going to require advanced AI to parse through these vast data sets to help us understand that the complexity of the body and of disease is far greater than our current science allows us to exactly understand--but data can help us accelerate our understanding and the technology to help drive that now exists. The technology exists today and is rapidly coming to market which would allow us to achieve a one medicine / one molecule approach to tuning very specific blends of pharmaceuticals to an individual patient. This would allow providers to deliver better, hyper-personalized treatments with less adverse side-effects.

This trend of navigating even more nuanced datasets with connected data streams led to another emerging observation. Paraphrasing Dr. Mega:

"Insights through data will allow us to identify moments that matter. We can imagine linking patient sets across diagnoses and even crowd-sourcing reactions or improvements to more rapidly evolve a therapy or treatment."

Think of Waze for patient types or clinical trials. She goes on to observe:

"The classifications and taxonomy of disease and condition state will likewise need to evolve to allow for sub-classification and a spectrum of care that does not exist today."

This points us towards a future where the care for a patient might truly achieve a 1-to-1 care plan. As tailored to one individual as the data around that individual allows us to go.

There was so much more to share from Digital Health Summit and CES 2019. I'll revisit some of them in future posts. What I'd love to leave you with was a final observation from the opening  panel on the topic of Unleashing the Power of Innovation on the Next Decade. When asked “What are your predictions for the next 10 years of healthcare innovation?” one of the panelists offered a quote from Bill Gates:

"We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten. Don't let yourself be lulled into inaction."

Healthcare transformation is already happening. For my clients in the space, I feel a renewed urgency to embrace the work that lies ahead of us so we can lead from the front. Read more about healthcare and the hospital of the future in this recent post by Greg Raiz, Chief Innovation Officer at Rightpoint.

Brandon Rozelle is the Vice President of Strategy at Rightpoint. Follow Brandon on Twitter and LinkedIn. Brandon is working within the Healthcare space to help develop innovations that improve lives through technology and design.

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