I vividly recall the day when my daughter, with her infectious enthusiasm, first truly grasped the concept of zero. We played games of "What's 95 plus zero?" or "What's 2 minus zero?" Her answers, initially hesitant, grew confident and triumphant as she understood this foundational mathematical principle. Little did I know, this seemingly simple concept of zero would later become a central point of discussion in my professional life.
Not too long ago, I had an enlightening chat with a distinguished physician, who also happens to be the Chief Digital and Technology Officer at a renowned specialty hospital. Our conversation revolved around the burgeoning healthcare market entrants, particularly those planning to roll out virtual care services. As we delved deeper into the topic, his tone became more urgent. He emphasized that no matter who offered the service, the number of practitioners available to provide care remains constant – essentially rendering it a zero-sum game. The image he painted was akin to a large-scale version of musical chairs, where we shuffle skilled caregivers around without increasing their overall number.
This conversation took me back to a recent study conducted by the University of Chicago. The study revealed a daunting reality: primary care providers would need to work 26.7 hours per day if they were to comply with all recommendations for preventive, chronic disease, and acute care for their patients. This issue is further compounded by the World Health Organization's estimate of a global shortage of 4.3 million healthcare professionals, including physicians and nurses. These figures underscored the stark reality of the executive's comments.
He emphasized that no matter who offered the service, the number of practitioners available to provide care remains constant – essentially rendering it a zero-sum game.
I wholeheartedly endorse the use of telehealth and virtual care as a means to improve accessibility and convenience. Nevertheless, simply introducing new telemedicine or provider matching services that depend on human caregivers does not solve the fundamental math problem at hand. We're reminded of this by the recent decision to discontinue Amazon Care, highlighting the challenges of sustaining such a business model.
With these challenges in mind, it becomes evident that we must place greater emphasis on the development of digital healthcare solutions that:
A. Enhance provider efficiency,
B. Facilitate patient self-management,
C. Utilize AI to address simpler, more routine tasks, and
D. Ideally, combine all of the above.
Each of these approaches is critically important to the future of healthcare.
Gartner coined the term "Digital First" to encapsulate the idea of shifting from a traditional, in-person, patient-centric model of healthcare delivery to a model that prioritizes digital engagement. This model seeks to integrate digital products and services into every aspect of an individual's health journey.
The "Digital First" concept in healthcare is commendable, but its successful implementation will necessitate a significantly higher level of digital maturity than what we currently observe. For instance, we can improve provider efficiency by streamlining business transactions, such as the prior authorizations for care – a global healthcare system requirement that often disrupts patient care continuity and overburdens providers. Interoperability-focused solutions that leverage the HL7 FHIR standard are promising in mitigating this issue, albeit most are still in the pilot stage.
Patient self-management tools and digital therapeutics, especially for chronic conditions, are attracting a considerable amount of investment. Venture capital flows into the digital health sector at a rate five times higher than in other industries, lured by a $10 trillion global opportunity and successful ventures like Livongo. However, as the subsequent devaluation of the Livongo acquisition implies, a successful start-up doesn't necessarily equate to a significant transformation in healthcare. We need more comprehensive data on what works and what doesn't, and for which population cohorts. Sharing health information will be instrumental in generating this evidence.
Let's consider the extension of caregiver capabilities through AI and other technologies. It's heartening to witness the extensive adoption of technologies like teleradiology, remote ICU monitoring, and AI for pathology and imaging interpretation, among other initiatives. These advancements are making waves and revolutionizing the way we deliver healthcare. However, upon conducting a survey on AI adoption in healthcare across the US, UK, and Germany, we found a somewhat different story. The mainstream adoption of other AI applications remains relatively low, and approximately half of the respondents cited a lack of clean, high-quality data in sufficient volumes to support AI/ML development.
This evidence underscores the fact that to realize the potential of a "Digital First" healthcare approach, we need to continue to prioritize interoperability, information sharing, and access to high-quality data. These elements are the foundation for empowering healthcare professionals across all treatment venues and enabling consumers to effectively manage their own health and wellness. They provide the much-needed solution to alleviate healthcare staffing shortages and improve the overall healthcare experience.
Just as technology continues to evolve, so does the healthcare landscape. New tools are constantly being developed, each with the potential to make a significant impact on the way we deliver care. But these tools are only as effective as the data they utilize and the systems they operate within. Ensuring these technologies can communicate with one another, share information seamlessly, and access the high-quality data they need is the key to unlocking their full potential.
And so, we return to the concept of zero. The zero-sum game of healthcare staffing is a challenge we must tackle, not just through the redistribution of existing resources, but through innovation and smart use of technology. We can't add more hours to a day for healthcare providers, but we can ensure that the hours they do have are utilized as effectively as possible.
On a personal note, my daughter, having grown up with a solid grounding in mathematics, decided to apply her skills in the digital health field. She's now among the many dedicated professionals striving to shift the balance in the healthcare sector's zero-sum game. It seems she has indeed learned her math lessons well, and perhaps more importantly, she's learning how to apply them in ways that could make a real difference in the world.
In a sense, the digital healthcare revolution is a lot like my daughter's math lessons. It's about building on foundational concepts, learning to see problems from different angles, and continually striving to find more efficient solutions. It's an ongoing process, full of challenges and opportunities, but one that holds great promise for the future of healthcare.