Healthcare providers are no strangers to the impact of technology on their operations. Over the past several years, for example, the move to electronic health records, though painful, has helped organizations develop the IT capabilities to pursue other innovations, with an eye toward better outcomes and improved operational efficiency. While many technology advancements hold tremendous potential to transform the industry, their timing and viability are unclear, particularly since promising technologies must often go through years of testing to obtain approval for use. Industry regulations, such as safeguarding patient information, can further cloud the timeline.
But first-movers—companies that are introducing products and capabilities faster than the average—stand to reap big rewards in the form of larger market share, lower development costs and the perception of being a trendsetter. By understanding technology solutions currently in the pipeline as well as their potential to disrupt how healthcare is delivered, providers can be well prepared to integrate them once they hit the market. Two categories of technology—patient monitoring and new treatments—hold particular promise.
Wearables have huge potential in monitoring both healthy people and those with chronic diseases. Several digital technologies offer new ways to track patients and support treatment regimens. Products such as the Fitbit already offer more detailed health monitoring for the fitness-minded, and the Apple Watch promises even more sophisticated capacities in merging data with electronic health records.
Three challenges are currently preventing the use of wearables in healthcare. “Wearables are starting to intersect with another area of consumer appetite: fashion,” says Ashraf Shehata, KPMG International’s Global Healthcare Center of Excellence and principal with KPMG in the US. Making the public want it is key to their acceptance. “The more wearables become commercial and mainstream for the consumer, the more consumer acceptance for smart wear will rise. And healthcare will become part of that.”
The other issue, he says, is that wearables have to “untether” from human input, so that they’re just running in the background, silently. “The moment wearables go hands-free, are untethered and connect back to cloud,” says Mr Shehata, “that’s when they’ll really be useful.” The flipside of this, of course, and the final challenge, is the culling of that massive data: we know how to gather it, but sifting it for relevant information is the big challenge. Too much data is useless and can actually set us back: “The key is to extract and organize data,” says Mr Shehata. “That’s where the breakthrough lies.” Privacy will also continue to be an important issue, as it has been in the past with expanding HIPAA laws; and security of patient data will need to be given top priority so that patients feel comfortable with using the services in the first place.
Implantable monitoring capabilities courtesy of nanotechnology have also fueled the imagination of providers. This sounds sci-fi, but the technology is on its way—though it may take a number of years before the economics make sense. Richard Bakalar, MD, of KPMG International’s Global Healthcare Center of Excellence and managing director with KPMG in the US, says that once the cost comes down, implantables could one day do what sonographic imaging did for surgery decades ago—allow doctors to see what’s going on inside a patient before going in surgically. “Nanotechnology is taking it down another level, to the cellular and molecular,” he says. “There’s a big cost-avoidance here in the long run, but it will take time.”
Nanotech could also enable tracking chronic problems from the inside—for example, if a doctor can place a pin with a sensor in a bone, the sensor could track its health or degeneration, and alert doctors to “the point of no return, where surgery is necessary,” says Mr Shehata. “Pins could detect degradation of tissue. It’s about taking technologies and combining with things we’re doing today.” The key will be to combine the therapeutic and diagnostic aspects of nanosensors.
The ubiquity of social networks may provide a foundation to connect doctors and their patients and enable remote health monitoring. “If we can drive a vehicle remotely,” says Mr Shehata, “we should be able to drive and manage clinical devices remotely. The answer? Remotely manage and configure social networks so patients don’t have to come in.” This, he says, could work especially well with pain management, where medication doses need to be tweaked periodically, and in senior care, where the emphasis is on aging well and in place. Facebook apps that let a patient’s stats be viewed by their social network (including family members and caretakers) and his or her doctor will be a reality within a few years.
The irony is that social networks for therapeutic purposes have to be somewhat structured and monitored. “Creating social networks as part of therapeutic [care]—with the need to be reliable, and credentialed—kind of goes against the normal setup, but it’s important,” notes Mr Shehata. “It needs to be in real time. We’re starting in the US to see healthcare reform, and many of these capabilities are becoming available on social networks.”
Disruptive technologies such as 3-D printing are quickly being adapted for healthcare, with the greatest promise in three categories: prosthetics, medical devices and human tissue. The concept of printing tissues—and even whole organs—is becoming more viable and could be a game changer, say experts. Jennifer A. Lewis, the Hansjörg Wyss Professor at Harvard University’s Wyss Institute for Biologically Inspired Engineering, is one of the field’s pioneers. Her work has centered on printing kidney tissue, and has recently developed a way to vascularize them, which is a critical element. That said, she emphasizes that she retains a “healthy skepticism.” She notes, “To recapitulate the complexity of living tissue is very difficult. But you could also argue that these are composed of biological matter, so using patients’ own cells, implanted in the body, and harnessing one’s own body to help do the work…this could become functional in a way that’s clinically relevant.” Skin, she says, for use in burn victims, will likely be the first to be widespread, since its two-dimensionality makes it easier to print.
Mr Shehata adds that he can envision an entire “remote printing industry” in the future, where a printing facility will “print medical devices, implantables, circuit boards that are personalized.” The caveat is that the same quality concerns elsewhere in healthcare will also permeate the printing industry: Is the manufacturing environment secure? Is it credentialed? “We have to proceed with caution, governance. There will probably be certified printing locations—labs or hospitals for printing.”
In five years, healthcare may look different but there are some hurdles to overcome. It’s clearly not just a matter of advancing technology and gathering data: it’s about creating the policies and the infrastructure to support the changes that we want to come. And this will take the main players working together to make it happen. “The other part I’d like to see,” says Mr Shehata, “is discussions between service providers, who are building infrastructure, and manufacturers, like HP, Cisco and Intel. All are parties that need to come to the table to build a scalable model.” As we’ve seen with big data, it’s not good enough just to do it fast or to do it cheap. With healthcare, it has to be both—and it has to be appropriate. And with time, these variables will, eventually, intersect.