It’s that time of year again to talk about the future, in this case, the state of healthcare in 2023 and beyond. Armed with a computer and a crystal ball, Dr. Yan Chow, MD, MBA, global healthcare industry leader for Automation Anywhere, offers his view of trends in the industry.
Dr. Chow: Going forward, the healthcare industry and patient care will be shaped by a combination of new technologies, care practices, business models, and aggressive government regulations. On the technology side, we’re looking at the roles of artificial intelligence (AI) and intelligent automation in supporting all care delivery areas. In clinical practice, telemedicine, the de facto form of physician-patient interaction during the pandemic, and its twin, remote patient monitoring (RPM), will continue as viable options while best practices are being studied. On the commerce side, expect an ongoing evolution in the way forward-thinking retail businesses are adding healthcare to their offerings, as well as the growing influence of consumerism in shaping the patient care experience. In a tough economic climate, mergers and acquisitions will accelerate to create more sustainable and all-inclusive care delivery ecosystems.
So, let’s start with the first topic you mentioned, artificial intelligence
Dr. Chow: The poster child for AI and healthcare is the area of image-based specialties, which include radiology, pathology, and dermatology. AI is particularly suitable because training images are available by the hundreds of thousands, and patterns can be analyzed to diagnose pneumonia, cancer, and other conditions. Where AI is more likely to fail is where data are limited, as in rare conditions that require the expertise and experience collected in a much more powerful computer—the clinician.
AI may even extend into clinical decision support systems (CDSS). Decision-making is problematic because when AI issues treatment recommendations, the traditional proof of efficacy, randomized controlled trials (RCTs), may be lacking. AI’s value is tremendous, but its explainability may elude us. Today, just saying “the computer told me so” is not defensible. As a result, AI augments but does not replace the physician. In the future, it may take discrete, objective, FDA-approved AI systems acting on our behalf to validate new AI technologies that we can never fully understand.
Nevertheless, AI and intelligent automation are playing increasingly critical roles in improving care outcomes. We are building the boat as we sail on it.
And that improvement can be seen in the second trend, right?
Dr. Chow: Absolutely. That area is virtual care or telemedicine/RPM, which got a big shot in the arm (along with humans) during the pandemic. From all indications, it’s here to stay. But it’s not without its drawbacks. As with AI, there is little in terms of defined or standardized best practices. So, when it comes to treatments based on telemedicine, clinicians are on their own.
Most clinicians are using telemedicine in the treatment of benign conditions. For more serious or complicated conditions, an in-person visit is still the preferred course of action.
So, again, it serves more as augmentation than replacement.
How can intelligent automation improve telemedicine?
Dr. Chow: First off, there is always plenty of work to be done before and after a telemedicine visit such as scheduling, patient registration, and follow-up. Those processes can be automated to improve efficiency and reduce the chance of human error. Every telemedicine patient has a unique home setup with unknown vulnerabilities. Automation can help by enabling turnkey setup and configuration of a virtual private network and security settings.
The future of telemedicine includes more remote devices in the hands (or on the bodies) of patients. Automating the setup and operation, even in part, will make it easier for patients to use those devices efficiently. In addition, the devices will generate large volumes of data that will need to be collected, curated, transferred, and analyzed. These processes can be automated partly or fully to streamline and accelerate the right response and care.
One challenge with telemedicine is authentication. Are the patients you’re meeting with the people they claim to be? To help minimize fraud in the future, automation could be used to help integrate facial, voice, or even EKG biometric data with remote sensor systems.
The pandemic also extended the delivery of care beyond doctors’ offices to nontraditional locations such as the patient’s home and retail stores. Will these care options continue, and how does automation help?
Dr. Chow: I would classify retail health as the third trend. Chains such as Walgreens, CVS, and even Walmart have started offering clinics on-site for treating mild conditions such as coughs and sore throats as well as providing vaccines. Automation can automate the correspondence and data exchange with the patient’s primary physician, handling the e-paperwork involved with the medical records.
The future will also likely include self-service treatment kiosks in retail stores that are connected to healthcare professionals. Standalone self-help blood pressure stations already exist.
Self-service kiosks are a natural transition to the fourth trend you mentioned, the increased consumerism in healthcare.
Dr. Chow: Consumerism has spread across industries thanks to companies such as Amazon, and healthcare is no exception. People want broader, deeper, and faster access to services and information anytime, anywhere, via their device of choice.
They’re taking the time to learn more about their health and care options. And they want to make more decisions on their own, expecting to play a larger role in their care—in the prescriptions they get, in treatment plans, and in the medical devices associated with their treatments.
As a result, an increasing number of healthcare and drug companies are marketing directly to consumers. For example, a few years ago, before the pandemic, it was rare to see a patient getting a pulse oximeter without physician involvement. Now, oximeters are a common everyday item on Amazon and in stores. People are buying items that used to be available only with a prescription and, for better or worse, pre-diagnosing themselves.
Is that a good thing?
Dr. Chow: Well, it’s happening whether it’s a good thing or not. People are also making care decisions based on their subjective care experience, from scheduling to treatment, based on individual age and generational membership, culture, and a host of other factors. For example, the choice of a provider is being influenced by how soon someone can get in to see the doctor, how easy it is to schedule an appointment, and even how highly the doctor is rated by social networks.
How can automation help in this age of healthcare consumerism?
Dr. Chow: As I mentioned, automation solutions can be developed to make medical devices easier to set up correctly and to use for the patient, as well as curate and format the results to make interpretation easier for medical professionals. Automation can also be employed to handle scheduling, answer common questions, accelerate results, and integrate services and data to enhance the healthcare experience. As with bank ATMs, consumers may end up preferring, in some situations, to deal with a self-help system rather than a live person. And that helps with healthcare’s scalability.
The consolidation of healthcare businesses is another trend benefiting from automation.
Dr. Chow: Mergers and acquisitions are on the rise in the healthcare and retail industries. Many national or global companies such as Walgreens, CVS, Walmart, and Amazon are acquiring or partnering with healthcare insurers, prescription drug distributors, medical groups, and other related businesses to offer patients a comprehensive healthcare ecosystem. With this “one-stop-shop” strategy, patients can go to one place for all their healthcare needs. The potential synergies and competitive advantages are undeniable.
For that strategy to be successful, there must be robust interoperability—communication and coordination between all the entities in the ecosystem—delivering near real-time, accurate, and reliable results. That’s where automation can shine in bringing everything together.
Automation can also help national and local healthcare businesses deal with the final trend I mentioned earlier, which is also a big challenge for many organizations.
You’re referring to growing regulatory pressure.
Dr. Chow: Yes, there’s a lot of pressure for greater transparency. And four major laws are behind that, which will greatly influence the business of care going forward. The first two are the transparency rules for payer and provider, which means that when you, the consumer, walk into an office or store, the healthcare provider must be transparent about how you will be charged for care and the results you will most likely get.
The third rule is the No Surprises Act, which came with the 21st Century Cures Act (Cures Act). That means you must be able to get a good faith estimate from a healthcare provider so that, if you wish, you can comparison-shop between healthcare providers. That was the original intent. But what it really means is that patients don't get a surprise balance that can add six figures to their bill.
And the last regulation is the Information Blocking Rule. As of October 6, 2022, you can walk into your doctor's office and ask for your electronic health information, which includes not just care records but also any financial data that influenced the care you received. The office is supposed to deliver that to you within a few days in HL7 FHIR API format, an international standard specified by the government.
How will healthcare organizations meet those regulations in a timely and efficient manner? Automation bots, with their ability to quickly, easily, and accurately gather, input, organize, analyze, and report from multiple disparate data sources, will play an essential role in meeting that challenge.
Dr. Chow: Healthcare moves like molasses, yet change is inevitable. The healthcare industry and patient care will continue to evolve, being shaped by new technology, care and commerce practices, and government regulations. Intelligent automation will be there to help healthcare organizations, whatever their configuration and services, meet the challenges and provide high-quality, responsive care. In the middle of all the noise and buzz in the technology industry, automation is a proven first step to true transformation.