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Roundtable: The Patient Will See You Now

Roundtable: The Patient Will See You Now
AI

We turned to a handful of health industry experts get their crystal ball predictions on what the future of health holds

Emily Wasik
  • 9 august 2017

PSFK’s Roundtable series takes its inspiration from the traditional roundtable: bringing together industry insiders to share their insights on emerging and compelling trends in an idea-friendly manner. PSFK guides the discussion and our roundtable helps guide the future.

Healthcare? More like sickcare. That’s right, the modern day healthcare system is essentially a sickcare system, reacting when people become ill rather than proactively keeping them well. Although there have been significant tech evolutions in recent years when it comes to medical diagnosis and treatments—from massive data, networked analysis, sensor technology and bespoke production capabilities—one area that has been left in the dust while every other element of the healthcare experience is riding off into the sunset is care delivery itself.

Just think about your last trip to the doctor. Let me guess. You went to a brick-and-mortar doctor’s practice because you were already sick. You then waited 45 minutes in the waiting room, and when you were finally called in, your doctor spent the majority of your 30-minute visit fumbling through records from 1992 to 2017, and then you spent an additional hour waiting in the pharmacy line afterward to pick up your meds. Well, this is how your healthcare experience should’ve looked: You received a notification on your iPhone telling you your temperature was high, so you checked your other vitals on your Scanadu Scout (evocative of the Star Trek ‘tricorder’) and sent them to your doctor. They pinged you back in real time telling you that you’re getting a common cold and used the Capsule app to send you medication directly to your office, along with offering advice on how you can prevent it from worsening before the weekend.

Think about it: if we book flights and shop online in real time, why shouldn’t we expect our healthcare to be managed in real time as well? Just like other industries who focus on “consumer-first” strategies—retail, advertising, design, you name it—healthcare has to follow suit and put the consumer, or in this case, the patient, first. By helping the patient understand the driving factors that impact their health—whether it’s their DNA, environment or lifestyle—they can play a more active role in managing it. Considering that you have to live in your body 24/7 for the rest of your life, your level of care should reflect that.

To get some crystal ball predictions for what the future of health holds, we’ve turned to a handful of experts, who include:

Eric Kinariwala | Capsule Founder & CEODubbed the “next-generation pharmacy here to make your life simpler and healthier,” Capsule is a smartphone app that connects directly to your doctor to deliver your medicine to your home or office at your convenience.

Emanuele Musini | Pillo Founder & CEO –  Pillo Health combines facial recognition, video conferencing and machine learning to create a personal health assistant that can answer your health questions, connect you directly with healthcare professionals, and securely manage your vitamins and medication.

Walter de Brouwer | doc.ai CEO— Doc.ai is building a robo-doctor, via medical dialog systems for personalized healthcare, a conversational AI that follows biological blood markers across the phenome and the genome.

Anura Achyara | Mapmygenome Founder & CEO — Mapmygenome is a molecular diagnostics company that offers personalized health solutions based on genetic tests that help people learn about themselves and be proactive about their health.

Leslie Michelson | The Patient’s Playbook Author — The Patient’s Playbook discusses actionable steps and practical tools to empower readers everywhere to achieve the best possible health outcomes.

Christina Agapakis | Ginkgo Bioworks Creative Director — Ginkgo Bioworks engineers new organisms to solve challenges across a range of industries from fuels to pharmaceutical production. Their biological engineers make use of an in-house pipeline of synthetic biology technologies to design, build and test new organisms.

Blaine Warkentine | Caregoals Founder & CEO — Caregoals is a wellness company that empowers patients and support physicians in shared decision-making for end-of-life care, while creating a better experience for caregivers and families.

Andrew Norden | IBM Watson Health Deputy Chief Health Officer — Having trained the supercomputer to understand the complexities and nuances of human language, IBM developed Watson for Oncology, which provides information to physicians to help them identify personalized, evidence-based cancer care options.


How is your company turning the healthcare industry on its head?

Eric Kinarawala | Capsule Founder & CEO

If we rewind to two and a half years ago, I had a sinus infection and my head was throbbing. I got a prescription from my GP and went to the basement of a pharmacy on the Lower East Side of New York. My cell phone wasn’t working. I was in behind 25 people and I ended up waiting for an hour. I finally got to the counter and it turned out they don’t have my medication in stock. I went home scratching my head, like, “How could this be the experience today at pharmacies on every street corner in America?”

Then I ran into an old friend of mine, who’s been a pharmacist for 15 years. We started trading stories and asked ourselves, “What should a pharmacy in the modern age—in 2015—actually look like, as opposed to the pharmacies that exist today, which still look the same as they did 50 or 100 years ago?” For us, the key elements are to create a completely simple and seamless experience by utilizing technology. I think technology is the key ingredient that’s been missing from this space for forever.

Emanuele Musini | Pillo Founder & CEO

In 2005, my father passed away because he was not taking his medicine properly and since then I discovered that 125,000 people per year in the U.S. die because of this. Pillo is the first AI healthcare assistant with a mission to bring health into the home, allowing our healthcare partners to monitor and deliver personalized services to their patients, significantly improve health outcomes and reduce costs. This is a true revolution in value-based care.

Anu Achyara | Mapmygenome Founder & CEO

One of the biggest challenges in the medical industry today is that most of it is still leveraged according to what’s available in the U.S., so the majority of the data represents Caucasian people. This means that the largest pharmaceuticals in the world only have a small percentage of data for the largest populations in the world like India and China. That sparked me to ask: “What is the country’s population versus what is the actual presentation of data that can provide truly personalized medicine?” and that’s how Mapmygenome was started.

Mapmygenome offers a wide variety of genetic testing services that can be broadly categorized into two main segments: 1) Prognostic Testing which provides health information and actionable steps to individuals through genetic analysis and counselling, even before any of the health traits or conditions are manifested, and 2) Diagnostic Testing which provides molecular diagnostic tests customized for the Indian population for clinical cases of genetic disorders, conditions and diseases. These include whole genome sequencing, whole exome sequencing and targeted panels. That will enable us to do what we had set out to do, which was to get enough data points, especially for the Indian population.

Walter de Brouwer | doc.ai, Scanadu and GenLife Founder

The field of healthcare is under the pressure of quantification and number crunching, so it’s no longer about gut feelings, where the doctor sees you now and says, “Oh, you don’t look good.” It’s more like, “OK, well, where are your last blood results?” “Did you go to your cardiology exam?” Just like how Eric Topol discussed in his book The Patient Will See You Now, all of the omics are now within our reach as consumers.

All of the companies I have founded—doc.ai, Scanadu and GenLife—have one thing in common: machine learning, which is a big part of my background as a computational linguist. For example, at Scanadu, I use machine learning for devices. One of the devices is a urine diagnostic device that you put in urine, then using the algorithm on your phone, you have a diagnosis.

Christina Agapakis | Ginkgo Bioworks Creative Director

We’re an organism design company. Essentially we’re trying to bring biology into technology across a variety of different industries, so we work to build tools that make it easier for us to understand and work with biology.  When you think of biotechnology, you think of pharmaceutical, maybe you think of agriculture, but you don’t necessarily think of flavors, fragrances, cosmetics or all of the other markets that are now opening up through ingredients and products that can be made via biotechnology. We find biological sources to get ingredients that might be coming from plants that are hard to grow because perhaps the plants are endangered or are having some sort of supply chain issue or are comprised of ingredients that are made via petroleum products.

Leslie Michelson | The Patient’s Playbook Author

My passion is helping people get the very best medical care from a very complex and challenging health care delivery system. At our company, Private Health Management, we get retained by individuals and corporations to help employees, dependents, family members get the very best care, whether it’s cancer or heart disease, orthopedic issues, back pain, developmental disorders, autoimmune conditions, symptoms that no one’s been able to figure out. We bring in the benefit of the research literature. We identify the experts in the city and their regions in the world on exactly what they have. It’s extraordinary—the degree to which we save people’s lives. We restore function. Many, many people today who have been told by their physicians that there’s nothing left to do, they’ve got weeks or months to live, and we’ve got them, in some instances, entirely disease free, and in others, living many, many years that their local treating physicians didn’t believe they would able to get.

I wrote The Patient’s Playbook to teach everyone how to become a better health care consumer. As you know, Americans are really great consumers. We’re driven when it comes to finding the best restaurant in a town, getting the best deal on a hotel, finding the cheapest airline fare, leasing cars, finding apartments, buying houses or getting the best mortgage. The availability of information has enabled people to get much more value for their dollar across the entire spectrum of the economy, except when it comes to health care. 

Blaine Warkentine | Caregoals Founder & CEO

One of the most basic problems in healthcare is that we endlessly procrastinate in taking the necessary steps or in having the important conversations that would lead to a better end of life, with less anxiety and fear. In America, health costs escalate exponentially toward the end of one’s life and quality dissipates inversely to the aggressiveness of care. Over-medicalized deaths filled with unwanted care lead to 30% shorter lives, cause prolonged pain and drive families to disagreement, argument, struggle and bankruptcy. Today the last year of life now consumes 60% of all health costs.

The Caregoals platform leverages patented multimedia as an advance directive, cloud storage and blockchain to help the system do a better job in supporting caregivers, patients and families in facilitating the many issues of aging improvement and end-of-life care. We do this by capturing video or audio conversations, year after year, giving health providers the ability to successfully introduce, bill and code for advance care planning reimbursements. Our tool improves efficiency to $400 an hour, as each engagement generates and stores the compelling content and data that make decisions easy. We store the data to blockchain, enabling powerful security and privacy as well as enabling family and health systems appropriate access. The data then makes aging improvement and better end-of-life care a real goal-oriented pursuit.  Caregoals helps all parties start much earlier in life, at age 65, when decisions are easier. 

Andrew Norden | IBM Watson Health Deputy Chief Health Officer

Healthcare was actually conceived as a critical first-use case for Watson back when IBM Watson was being used on Jeopardy!. IBM opted to partner with Memorial Sloan Kettering in New York City around cancer and created Watson for Oncology, a tool that helps physicians efficiently and accurately choose an optimal evidence-based therapeutic option for a given patient. Watson for Oncology leverages Watson’s natural language processing capabilities, which we had developed for Jeopardy!, with expert training over the years, so that Watson could read not just common language, but also healthcare language and, specifically, oncology language. Watson reads the medical records for a given patient, looking both at the structured and unstructured data. Then once it’s identified the key attributes for a given patient, Watson looks into a corpus of data that includes guidelines, textbooks, thousands of pages of journal articles and published abstracts, while also relying on its expert training from doctors at Memorial Sloan Kettering over thousands of cases. Then it makes evidence-based treatment recommendations for the physician to consider in deciding how to treat a given patient.


What are the important consumer attitudes or behaviors around personalization in healthcare that you see shaping the marketplace?

Eric Kinarawala | Capsule Founder & CEO

When you look at pain points that exist today, the pharmacy’s everything but better, smarter, faster, kinder. We basically rebuilt the entire pharmacy from the ground up to make the entire experience—end to end—completely effortless. We provide free delivery whenever you want it, wherever you need it, to all five boroughs of New York. We’ve built technology and smarter refills to make the inventory predictive, so you don’t ever have to deal with out-of-stock medications. Your pharmacy will know exactly when you’re taking it and will bring you more medication before you run out. We have price transparency so you can know the actual price of your medications before you pay to get it. We coordinate with your doctor and your insurers to make sure you’re always getting the best price for the medication that you want.

The final thing that we’ve changed about the pharmacy is the privacy element. The last place you want to ask a personal question about your health is when there’s 20 people in a line behind you. We’ve built the ability to be able to chat with a pharmacist in a completely discreet way. For example, you might be about to eat dinner and you think, “Gosh, am I supposed to take this with food?” All those moments where you want somebody to be looking after you, we enable that to happen in a completely private and instantaneous way.

Our brand promise is: “Everybody needs some looking after sometimes.” That’s what we built the entire experience around, by asking the question, “What would it look like if your mom was your pharmacist?” She would do all these things for you. She would know the answer to all of your questions. She would make sure you never ran out. She would bring it to you when you wanted it. That’s how our brand and experience all tie together. Traditional pharmacies don’t do any of these things. What we’ve done is built an experience that not only does all of them, but they’re all tied together in a way that feels completely effortless.

Emanuele Musini | Pillo Founder & CEO

Everything we are doing for Pillo is consumer-centered, as we believe that the more personalized the experience, the more effective the results. First of all, we have a camera that can easily recognize people’s faces. This makes the interaction personalized from the very beginning. Secondly, the anthropomorphic look of Pillo makes people feel they are talking to a someone that they can relate to on an emotional level.

Walter de Brouwer | doc.ai, Scanadu and GenLife Founder

Very soon it will no longer just be, “the patient will see you now,” but “the participant will see you now,” because we will all be conducting clinical trials of one. We want to have our own clinical trials, and we are willing to pay for it. I think that’s going to create a whole new way of looking at healthcare. The concept of an ‘average human being’ will be exiled to the 20th century as a sort of a museum piece because we are now all very personalized, unique individuals with unique values. We are going not for the ‘average’ results. We are going for ‘optimal.’ For longevity. 

Leslie Michelson | The Patient’s Playbook Author

A lot of the treatments are becoming much more personalized, and it starts with, really, the capacity to decode DNA, which determines your susceptibility to disease and your capacity to metabolize different drugs. Clearly, what is happening—and it’s going to happen at an accelerating rate—is doctors will be taking much more holistic evaluations of people, and doses and treatments will be much more customized. For example, there are huge debates over the appropriate recommendations for mammography, for PSA testing, for colonoscopy, and all of those efforts struggle in part because they’re trying to develop a one-size-fits-all approach. That clearly makes no sense, because we all have different bodies and different predispositions.

What’s happening now is we’re beginning to understand who has what predispositions so that early detection protocols for breast cancer, for skin cancer, for prostate cancer, colon cancer, are all going to be individualized based on someone’s personal history, their family history and the sequencing of their DNA. There are many drugs that people metabolize very differently, and with a simple Q-tip swab of the cheek or the tongue. If you can get enough DNA to test whether this individual person, the degree to which they’re going to metabolize a particular drug, and be able not to give them that drug or adjust the dosage based on that.

Andrew Norden | IBM Watson Health Deputy Chief Health Officer

I look at Watson as an engine for personalized medicine therapy because its first step is to extract all of the known, relevant attributes of a given patient that need to be considered in making treatment recommendations. As one looks to the future, I think there’s also the reality that there are many likely undiscovered attributes of given patients and given tumors that will impact treatment. I believe that Watson has the capacity to help us identify what some of these factors are.


What will be the biggest impact of your healthcare innovation on society?

Eric Kinarawala | Capsule Founder & CEO

Pharmacists go to school for a really long time and they are experts in medication. Oftentimes pharmacists know far more about the specific medications than physicians do, and that makes sense, because those two things are very separate. That said, when you think about a chain pharmacy, you’re at the counter and there’s somebody checking out 20 different things that aren’t prescriptions, or somebody’s asking, “Hey, where’s the toilet paper?” “In aisle five.” That’s not the right utilization of a healthcare professional. Our aim was to really remove all of that clutter and to be able to focus on the health care and medication aspects of pharmacy.

We think about the pharmacy as a system. We’re holistically connecting all of the different parties in the ecosystem—the doctors, insurers, hospitals and drug companies, because everybody has a stake in medication and because it’s such an important part of everyone’s healthcare.

Anu Achyara  | Mapmygenome Founder & CEO

If we have more specific data for different countries and ethnicities, we’ll potentially have more targeted and precise medicines for every individual population. For us, the biggest impact will be on the Indian population. It could also be a great way for some countries or states to be able to look at their resources and readily distribute finances towards these areas, rather than reactively doing so as problems arise. If people start to realize that they can prevent a disease and live more healthily by understanding their own genetic predispositions, then we can make a much larger impact on society if this is done right and at scale.

 When we started, people often thought that getting a genome map was about giving them a diagnosis, or essentially, telling them when they were going to die. Instead our counselors help them understand that this doesn’t mean they’re going to get something, but that their environment, nutrition and lifestyle habits are what’s going to contribute to the outcome. Take something like a diabetes for example. 26% is in your genes, but 74% is still in your control. We’ll look at what kind of food they are eating or if they’re regularly exercising. Based on the assessment, we’ll then say, “What is it that you can do now to make those changes happen in your life?” It’s a much more engaged process than giving them a report that says that, “These are the five things that you should be concerned about.”

Walter de Brouwer | doc.ai, Scanadu and GenLife Founder

We can go for a genomic full sequence and see what our genome has in store for us. We can have our own blood results without going to the doctor. Now there is also the microbiome—where the metabolomics, epigenomics and exposomics—all have numbers and these numbers somehow have an impact on the other numbers. Medical students today are probably better prepared for a quantified future than current doctors. Considering the average age of a GP in the U.S. is 50 years old, it’s been a long time since they studied. With all these new numbers coming at us as consumers, we are running out of the human capacity to explain these numbers to us.

Therefore a new category is knocking at the door, which is robo health, where a robot will know everything it has to know about a specific field. For instance, if we made a robot that knows everything about blood results and everything about you, it can say, “This is important for you,” or “This is not important for you.” This is what we call vertical intelligence. It’s not like a doctor who has much broader intelligence. Medicine is already subdivided into 150 pre-specialties and subspecialties. So if you really want to make artificial intelligence, you have to make it very vertical, either genomics or anatomy and what not. Replacing neurons with silicones means you can have unlimited visits and you can get treatment from anywhere—on your phone or desktop. They would only cost something like $1 per year.

As consumers, we will decide on our own health care, how we manage risks and how many bills we pay. If we take activity or not. How much we sleep. We are going to elevate doctors from blue-collar workers to white-collar workers, because we have disrupted the concept of a doctor. The doctor shouldn’t be there 55 percent of the time to fill in forms for patients’ insurance companies in order to keep our records. They’re not trained to do this. They’re not accountants. They don’t have to have homework after we leave. Ultimately, they deserve a more educated public.

Christina Agapakis | Gingko Bioworks Creative Director

There’s an awesome vignette imagining our microbial future in the year 2100 in Bruce Sterling’s book Tomorrow Now. He writes about toothbrushes and toilets that monitor our microbes, about the evolution of showers, medicine cabinets, kitchens and gardens, all explicitly non-sterile because ‘sterility’ is what people do need when they don’t know what’s happening on a microbial level. In a biotech world, sterility is a confession of ignorance. It’s a tactic of desperation.

This was published in 2002 and I think we’re already starting to see things moving in this direction, at least in the speculative imaginings of biologists and designers thinking about the future of how microbes will affect our daily lives. I think there will be important medical advancements and living therapies that can target and provide medicines when and where needed, but I think the dramatic changes of our everyday understanding of our environment is potentially so much more significant. Just to be able to consider and imagine things going on below the threshold of what we can see will change how we experience our everyday lived experience as humans.

Leslie Michelson | The Patient’s Playbook Author

Ultimately we want to help people become better healthcare consumers so they don’t become a victim of medical error. There’s 285 pages about this in the book, all of it detailed, sourced and helpful. One thing is if you have a significant medical issue, go to a major academic medical center where they’ve got the expertise and the resources to manage it. Before you let anybody treat you, make sure you know that the diagnosis is accurate and independently confirmed. 10% of all deaths in the United States of America are the result of diagnostic error, either incorrect diagnoses, delayed diagnoses or incomplete diagnoses. You should, before you get treated, make sure that you understand when and why your treatment needs to happen. If it’s back pain, for most back pain, it really makes sense to delay treatment as long as possible, because Mother Nature is really good at resolving a lot of back pain, much better than most surgeons. There are other instances. For example, if it’s pancreatic cancer, you need to be treated as soon as possible. There are certain things where you need to move very quickly and others where it makes sense to wait. You will make a very big difference on the quality of care that you get if you know that difference.

Also, the internet, which is a fabulous resource for patients. There is so much content, legitimate, really helpful, practical, patient-friendly content online, free of charge, to everyone. There are great websites like expertscape.com, free of charge to everyone, which can enable you in less time than we have been speaking, to identify the preeminent experts who publish the greatest and most literature, the most useful literature on exactly what it is that you have.

Andrew Norden | IBM Watson Health Deputy Chief Health Officer

In healthcare, a lot of the most important information about a given patient exists in an unstructured narrative form in the electronic medical records. Doctors’ notes are highly variable from one to the next. When you look at those narrative documents, you can’t necessarily predict where in the given document a crucial piece of information might reside. Watson works by reading the text, understanding the content, making conceptual links between sentences and paragraphs, and ultimately is able to extract from that unstructured text the most important pieces of information. It’s able to do that from doctors’ notes, radiology reports, oncology reports, laboratory results, etc. It then compares that against these terrific knowledge sources that are constantly being updated.

There are a lot of barriers to clinical trial enrollment. Every clinical trial in which a cancer patient might participate carries with it a long and detailed list of eligibility criteria that must be met in order for a patient to be enrolled. The eligibility criteria includes things like the cancer type and stage, other co-morbid conditions and medications that the patient might be on prior to therapy. A given physician who’s enrolling patients in clinical trials typically has tens or even hundreds of trials to consider. The lists of eligibility criteria are generally tens of items long, so that’s obviously a hard thing for any human to keep track of. Watson Clinical Trials Matching benefits physicians and patients in much the same way Watson for Oncology does. It reads the medical records, structured and unstructured data, and pulls out key attributes. It can then, in an automated fashion, compare the patient attributes to the eligibility criteria and help physicians make matches.

Watson Oncology has a high concordance with doctors when it comes to treatment recommendations—above 80 or even 90% in most studies. This 80, 90% is the concordance between Watson and expert human physicians. But the studies were not intended to answer the question of, “Which is right?” In other words, if you get an 80% concordance number, it may be equally probable that Watson is right or the humans are right. If you take a group of well-trained doctors, even working in one hospital, give them a case and ask for their treatment recommendations, I think, in many cases, you would find quite a low concordance rate between them. That doesn’t necessarily mean that those doctors are right or wrong. Sometimes, it means that there are multiple good answers.


What are some of the biggest ideas and shifts that we’ll be seeing in the health industry in the next 10-20 years?

Eric Kinarawala | Capsule Founder & CEO

For years, doctors and hospitals got paid based on how often patients went or how long they stayed, regardless of whether patients were actually getting better or not. Now there’s new generation of companies, Capsule included, that are really focused on putting the patient experience front and center, because people do have a choice when it comes to where they go get their healthcare. For too long they haven’t had that choice.

Anu Achyara  | Mapmygenome Founder & CEO

One big change will be cost. In the next few years, hopefully a whole genome sequence will only cost $100. People need to realize that it’s so much cheaper to receive information upfront to prevent health issues, than waiting until they surface later in life. If you had every child sequenced at birth, it would be easier to have a baseline to be able to see what mutations actually occurred and how we should treat them.

Walter de Brouwer | doc.ai, Scanadu and GenLife Founder

We will change from having digital devices that measure health data on the surface of the body to inside the body. Blood and urine will be good markers, but we will probably also put sensors inside the body. Then we will get a lot more information. Any job in medicine that computes a lot of data is bound to be done better by machine. Now everything we measure goes to the cloud. It needs HIPAA and comes back to our device, and we see a prediction on our device. We are going to push these computations and predictions to the edge so that machine learning and prediction will happen in the palm of your hand. It doesn’t have to be transferred anywhere anymore because we now have supercomputing power in our smart devices, so why send it to the clouds? Because really the cloud is, by definition, centralization. If you put it on your own devices and store it there, you decentralize it. If you decentralize it, there’s no risk of privacy and you can store it forever.

Also, devices that can’t learn will disappear. If your doorbell doesn’t learn because it doesn’t have a camera in there that can sense what’s coming at it, or it can’t store information, then it will be replaced by something that learns. It’s the 21st century; a century that will be known for building actual intelligence straight into silicon, that is no longer imprisoned by the constraints of the human skull. This will happen with all devices and tools, but it will also happen with human beings, because if you do not learn all these new things, you will be replaced by a machine. I would say anything that can’t learn unsupervised will disappear. I see a machine as a child. When it is in kindergarten. you have to supervise it, but at university it’s unsupervised. We want our devices to go to university, because there are not humans enough to supervise all these devices.

Lastly, my oldest son is 25. I cannot imagine that he would go out to his friends or meet girls without brushing his teeth. That would be very unhygienic. However, in the future, we will think of people who don’t collect their data as data-unhygienic because of mating reasons. If somebody doesn’t care about his health, that’s not a good sign. You can now have genetic tests before you marry to see if you are compatible. For example, if you have a defective copy of a gene and so does your partner, then it’ll be hereditary. We didn’t have these tests! Our grandchildren will say one day, “Granddad, when you met Grandma, you just kissed her on the mouth without having any values?” “You exchanged fluids without knowing?” 

Christina Agapakis | Ginkgo Bioworks Creative Director

I hope that we’ll be able to talk more about all the complex factors that influence health. Among the techier circles I travel in, I see so many articles about how genes or the microbiome affect our health, but so little acknowledgment of how poverty and racism have disproportionate impact on health and wellness. I’ve seen statistics that say that zip code is a much better predictor of health and life expectancy than any other number that you can get in a health screen. When we hear about boutique health monitoring and genetic sequencing going up to tens of thousands of dollars for one rich old guy that skews what we think of as the “future” of health. I hope that instead of these highly technologized and specialized shifts we’re seeing that we’ll also see shifts in understanding and caring for how our environment and health are so deeply linked.

Leslie Michelson | The Patient’s Playbook Author

Never in the history of the world have we seen biomedical research making advances at the current rate. It is the golden age of biomedical research. We are learning so much more about the causes of disease, what can be done to prevent disease, the ways to detect disease earlier, and to treat it in safer and more effective ways. It’s so exciting, and there are major breakthroughs in the capacity to decode the human genome, a three billion-based bearer of the DNA in every single one of the cells in your body, except your red blood cells. We can decode that DNA for a thousand dollars, and do it in a day. Even 25 years ago, nobody dreamed that that would be possible.

The second is we’re understanding the human immune system and the role that it plays in so many diseases, and harnessing it to attack different diseases, understanding when it’s being excessively aggressive and not aggressive enough, and tuning it to be more effective.

We’re learning about the biome, which is the bacterial sort of biome that’s in everyone’s gut to help us digest food, and learning for the first time about the link between issues in the biome and a whole array of diseases.

With technology now, we’re able to do continuous monitoring very easily, from wearable devices to doing blood pressure continuously, to counting calories that are consumed or burned in a variety of different ways. There’s so many different things that are being done with technology that enable us to measure what’s going on and to provide our doctors with far more meaningful information about our real health so that it only gets measured when it’s in a doctor’s office, where we all get a little bit of white coat syndrome.

Andrew Norden | IBM Watson Health Deputy Chief Health Officer

Although Watson wasn’t intended to replace doctors, I do think that cognitive computing in healthcare is going to become increasingly ubiquitous because of the reality that there is such a growing cognitive burden based on the rapid acceleration of knowledge in healthcare. I think that there are some things that cognitive computing systems do extraordinarily well. They can find patterns in large data sets that humans can’t find. They can search very quickly, they don’t need to sleep, they have unlimited storage, they’re often not subject to the same kind of cognitive biases that people are—that sort of thing. That said, there is and always will be, I think, a critical role for physicians to sit and look at patients eye-to-eye, to help patients weigh options, to be a compassionate voice, to help people explore their goals, fears and hopes. The offloading of some mundane or routine tasks from physicians by cognitive computing systems will free them up to be more available for those strictly human types of interactions.

PSFK’s Future of Health report explores how a new generation of medical practitioners are using machine learning, heightened sensor sensitivity and networked data systems to grow the industry’s ability not only to gather, but also to interpret data in real time and at scale. Download the full report here, request a presentation at your office and join the conversation on Twitter with #futureofhealth. For full access to all of PSFK’s reports, debriefs, articles and archives, become a PSFK Member today.

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