The arriving future of tech in health(care): Lucien Engelen on LinkedIn

This is going to be a fascinating year, with a mix of social and technological change. On Saturday I started the year with The future of caring: careful, kind, “minimally disruptive.” Today I’ll flip to a completely separate channel: how technology is changing what’s possible.

Lucien Engelen, about whom I’ve often written, is the manically productive visionary at Radboud UMC, the Dutch medical center that sponsored my TED Talk in 2011. In particular, he’s head of their REshape Innovation Center … it’s fitting that @REshape’s Twitter avatar is a kid with a spyglass looking to the far horizon … far, but visible.

A post you should read:

Lucien’s just written a post on LinkedIn with his vision of what’s on the horizon and what is changing, now, already. It’s a short post but it’s a dense learning experience, with dozens of relevant links and a half hour of embedded YouTubes. Lucien’s view of the horizon is (a) different from most observers’, and (b) firmly grounded in what REshape is already doing, so this is not a distant pontificator’s view, it’s from the trenches, feet on the ground. With spyglass.

At bottom I’ll paste in a condensed copy of his list, minus the videos. But first I want to address the concerns of people who want to brush this off as just another two-bit New Year list, and of people who think this is ridiculous… because on LinkedIn the comments have a heavy component of “who are you kidding” skeptics.

When assets digitize, things change fast.

When you’re accustomed to things changing at one speed, and then things go digital, your head spins. Good, sober, experienced professionals get whiplash and fall off a cliff. It happened when desktop publishing killed typesetting, it happened when digital music killed record stores, it happened when online sales forever changed retail, and it will surely kill parts of medicine, in favor of what gets the job done better for the patient.

Home thermometers empower us, home pregnancy tests help us be better informed, the AliveCor lets cardiac patients know what kind of arrhythmia is happening. None of this insults clinicians; it frees them for more important work.

The art is in figuring out what on the horizon is real and what’s not. Perhaps the most spot-on thing Bill Gates ever said is this:

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.

The speed at which changes become widespread is accelerating insanely. This graph from Asymco shows how long it’s taken for new tools to go from 10% adoption to 90%.  It used to drag out for decades, but now look – things spread like wildfire – in recent years the “10 to 90” curve is almost vertical!

 

The arriving future is changing fast.

I say the future is changing fast because what’s possible is changing. That’s important, because when anyone – a planner, a policy person, a practitioner – is out of touch with reality on what’s possible, they can’t possibly plan for the best available future. So let’s do what we can to learn and anticipate – and expect change, and ask for it.

Outline of Lucien’s post:

2016 will:

1. Flip the coin where you as a patient will create more data than your professionals.
2. It will be common to have ambient experiences.
3. Invoke a broader enrollment of clinics in supermarkets, becoming the hub for many (now-hospital or GP bound) diagnostic routines.
4. Spark the use of Blockchain technology in healthcare to become the leading infrastructure for EMR and EHR, replacing the majority of current ‘middle-man’ technology. [I’ve never even heard of Blockchain!]
5. Will have lots of ethical discussions about Genome editing techniques like CRISPR, often named as the ‘word processor’ for genome editing.
6. Offer multiple examples of highly protocolled procedures to be replaced by algorithms (automated by computer-systems) based on deep learning and artificial intelligence. What if systems like IBM’s Watson or Wolfram Alpha could decrease 30% of GP’s work and cope with the growing healthcare demand?
7. Improve vizualisation systems that will help us understand how the human body works; like the Glass Brain.
8. Evolve the use of Social media as a common research tool in medicine. Like [Radboud Parkinson researcher] Bas Bloem and his group did in a study analyzing Youtube videos to discover a strange gait in Vladimir Putin’s walk.
9. We will get used to voice commands like Siri, Google now or Alexa from Amazon that will enter our daily live. We’re testing the latter to switch lights on/off for patient-rooms, make to-do lists or notes by doctors and nurses and patients, decreasing the potential number of hygiene-risks.
10. The business model in health(care) will start to shift towards prevention and more control by patients and new entrants will change payment systems and away from ‘in real person-only’ healthcare.

Think it’s not happening? Please think more.

#10 includes something that’s close to my heart – “Paradigm-shifts often are preluded by a phase of neglect.” Susannah Fox said something similar on e-patients.net five years ago, about resistance to such change, in Peer-to-peer Healthcare: Crazy. Crazy. Crazy. Obvious.