Tagged: healthcare technologies


The end of doctors 

  • A second technology revolution threatens the future of healthcare
  • Healthcare systems that ignore evolving technologies will collapse
  • Most healthcare systems are trapped by three basic failures
  • Doctors are the interpreters and not the processors of medical knowledge
  • Will a computer decide to turn off a life support machine?
  • Who owns the medical information on the Internet?

The role of doctors is about to change more than it has in the past two centuries, as the technology revolution enters a new era. 

Radical change 

This is the conclusion of Richard and Daniel Susskind in their book, The Future of Professions, published on 22nd October 2015 by Oxford University Press. They argue that, over the next 20 years, “the second future”, dominated by artificial intelligence (AI) and the Internet, will drive radical changes in healthcare systems, which will involve the transformation of how medical knowledge is made available.

Today, computer systems can delve into vast amounts of patient data, identify trends and make more accurate predictions than doctors. Machines such as IBM’s Watson, which can attain high levels of intelligent behavior is already being used in medicine. In parallel, the Internet provides people with new and effective ways to build communities and share healthcare information. 

Never too big to collapse 

Some doctors argue that their activity will never change because it depends on deep expertise, creativity and strong interpersonal skills; none of which can be replaced by computer systems. Earlier, managers of global companies that dominated world markets made similar claims before there enterprises grew obsolete and collapsed.

Twenty years ago, the failure of global companies to meet transformational challenges resulted in 74% of them leaving the Fortune 500 as new technologies and innovations opened the way for agile start-ups and entrepreneurs. The list is long, but here are a few examples. Digital Equipment and Wang Laboratories, once leading computer firms, disappeared completely. Even resurgent giants such as Apple and IBM stared into the abyss of irrelevance, and made painful changes before clawing their way back to the top.

In the 1980s the advent of digital photography, software, file sharing, and third-party apps ended Eastman Kodak’s world market domination, during which time Kodak made breakthrough technologies, which included the Brownie camera in 1900, Kodachrome colour film, the handheld movie camera, and the easy-load Instamatic camera. Motorola, another global giant, that developed and built the world's first mobile phone, and dominated that market until 2003, failed to focus on smartphones that could handle email and other data; and as a consequence, rapidly lost share to newcomers such as Apple, LG, and Samsung.



Dr Devi Shetty, world-renowned heart surgeon, founder, philanthropist, and chairman of Narayana Health, India’s largest hospital group is viewed as the person who will have the biggest influence on 21st healthcare. Here he describes how information technology is set to radically change healthcare:

        (click on the image to play the video) 

Healthcare systems not immune

The Susskind’s agree with Shetty, and believe that healthcare systems, predicated upon antiquated patient-doctor technologies, face a similar demise to that of large companies that failed to adapt and change. The more successful healthcare systems will be those, that copy large companies who survived by collaborating with smaller, agile firms either as suppliers or partners. Rigid bureaucratic healthcare systems that find it more difficult to innovate will fail.

Three reasons for failure 

Failure to address three major challenges accounts for the failure of most healthcare systems. The first is the continued investments in failing antiquated systems, and the consequent failure to pursue fresher, more relevant ones. The second is psychological: healthcare systems and doctors fixate on what made them successful in the past, and fail to notice when something new is replacing it. The third challenge is strategic: healthcare systems that only focus on today, and fail to anticipate the future will fail.

Previous HealthPad Commentaries have illustrated these three failures by the billions spent on failing diabetes education programs over the past decade, while the incidence of the condition escalated. This is because diabetes education and awareness programs fixate on antiquated systems, and fail to embrace, smarter and more effective ones. See: Behavioral Science provides the key to reducing diabetes

The concentration of medical expertise

A doctor’s raison d'être is to provide solutions to problems that people do not have sufficient specialist knowledge themselves to solve. Previously doctors were the ‘processors’ of medical knowledge, but with medical information becoming ubiquitous, increasingly doctors are becoming the ‘interpreters’ of medical knowledge. Doctors are gateways to specialist medical information.

In most healthcare systems, doctors are a huge and increasing expense, a large proportion of them use antiquated methods, and the expertise of the best doctors is only enjoyed by a few. This is changing by technological innovators finding ways to make medical expertise more widely available. Also, technology is enabling clinical expertise to be broken down into smaller tasks, which can be better achieved with a machine; telemedicine is just one example.

Who owns medical knowledge?

Online healthcare information empowers patients and threatens doctors by providing people with medical knowledge that previously resided in the minds of doctors. Such knowledge, which can help to diagnose illnesses, is free, increasingly common, and controlled by users. An important unresolved question is, who owns this medical knowledge?


Doctors exist to provide solutions to medical problems. If technology provides better more reliable solutions, the need for doctors dissolves. However, the most convincing objection for the displacement of doctors is an ethical one. Is it morally wrong to leave the decision to turn off a life support machine to another machine?

The debate is just beginning. 

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In 2015 expect increasing healthcare challenges from (i) aging populations and rising chronic illnesses, (ii) escalating costs and patchy quality, (iii) access, (iv) changing technologies, and (v) security. 
Aging populations and chronic illness
Aging populations and the escalating prevalence of chronic lifelong diseases, will drive demand for healthcare in 2015, and impose significant burdens on healthcare systems.
Europe has the world's highest proportion of people over 60. By 2017, 20% of Europeans will be over 65. By 2050 about 40% will be over 60. The US has similar trends. This aging and the increasing prevalence of chronic lifestyle diseases will continue to drive healthcare expansion, and pressure to reduce healthcare costs.  
Escalating costs and patchy quality
According to the World Healthcare Outlook of the Economist Intelligence Unit 2014, total global health spending is expected to grow at over 5% in 2015.
In Europe rising government debts, constraints on tax revenues, and aging populations will force health providers to make difficult choices about the provision of healthcare. Rising demand, and continued cost pressures will increase pressure on traditional healthcare business models and operating processes to change.
Despite the expected annual productivity and efficiency savings of some 4%, UK healthcare expenditure in 2015 is estimated to be about 10.3% of GDP. In the absence of changes to the delivery model, the UK's NHS funding gap is likely to increase significantly in 2015.
In their struggle to manage the escalating healthcare costs, health providers will accelerate their transition from volume to value. This will mean a greater emphasis on improving outcomes while lowering costs. This will drive payers to seek out global best practices of delivering affordable quality healthcare such as Narayana Health.
Improving access to healthcare will be one of the most pressing policy issues in 2015. Shortages of health professionals represent significant challenges in healthcare access, and healthcare systems will be pressed to recruit, and retain health professionals.The US is addressing this. US employment in healthcare increased from 8.7% of the civilian population in 1998 to 10.5% in 2008, and is projected to rise to 11.9% (nearly 20 million people) by 2018.
The UK is not in such a good position. In 2012 the UK had a shortage of 40,00 nurses, which it hasn't resolved. This is compounded by shortages GPs. Europe has an estimated shortage of some 230,00 doctors.
Increasingly, developed countries recruit health professionals from developing economies. The morality of this will be further questioned in 2015 as the policy significantly erodes the number and quality of healthcare professionals in emerging countries.
Changing technologies
The development of healthcare technologies has been rapid, and in some cases disruptive. Technologies such as telemedicine, electronic health records, mHealth, e-prescriptions, and predictive analytics have changed the way health providers, payers and patients interact, and contributed to improved quality of care, lower costs and improved outcomes. In 2015 expect the spend on healthcare technologies to slow.  
Reportedly, there is a growing and lucrative black-market for personally identifiable information, and personal healthcare information. Many healthcare organizations already have low security budgets, and only about 50% employ adequate encryption technologies to secure their endpoint data. Compared with other industries, healthcare experiences significant losses of endpoint healthcare data. Security challenges for the healthcare sector will accelerate in 2015. 
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