What Were You Doing?

By Michael Hodin

While most of the locals in Boston were watching the Red Sox march to a Series berth, a few thousand of us from Boston and around the world were at the Seaport for the 2018 Connected Health Conference (CHC). Maybe, not as much fun as Fenway, but at the CHC, there was a lot to applaud. After all, as the world ages — a billion of us over 60, inexorably marching to double that by mid-century — getting innovative technology to help us age in a more healthy and active way is not a small enterprise. I attended last year’s conference, and in only 12 months, you could sense the shift from skepticism to belief. We have reached the tipping point where — powered by the promise of AI — remote care is beginning to change how healthy we are as we age.

The spirit of CHC this year did indeed reflect this transformational shift. Five key takeaways stand out:

2. We are beginning to see results. For example, Intel’s virtual surgery is showing improved patient empowerment (at Hoag, retention rate improved by 50%), increased surgical throughput (at Mount Sinai, 100% say they had a better understanding of their anatomy), and increased patient satisfaction (at Stanford, 96.7% say it was a valuable experience). Remote care is delivering cost savings everywhere; for example, at University Hospitals, there was significantly reduced time per clip — 6 minutes — and decreased overall operating time. And this is just the beginning as remote care technology changes the game in areas from heart failure and diabetes to Alzheimer’s and nutritional health.

3. This year, there has been an important step forward: Medicare reimbursement codes. This is the breakthrough that shifts the use of remote care from pilots and hope to markets and reality. That the federal government has said they will pay for use of remote care is a big deal. This also shows that the aging of society — our longevity — is a driver of and lever for remote care usage.

4. Yet, there is still the limitation that remote care is primarily deployed in traditional acute care hospital settings. The vision for true scalability as a tool for better monitoring, earlier detection, and diagnosis leading to wellness and prevention care models will likely not take place inside the confines of the hospital or physician’s office. Or, as one expert said, data and healthcare are like oil and water. So, there remains the challenge of the broader and deeper use of remote care, even as it is powered for scalability by AI. Will it remain a tool for traditional health care or can it become the transformational mechanism to change health care and health systems themselves? At CHC this year, it was clearly the latter — profound changes to our health systems themselves — that one sensed in the air.

5. Yet, it was also clear that the biggest barrier to usage is what some have called the “trust factor.” But, through AI, remote care can move from the more technical setting of the hospital and its acute care model to the more attractive if subtle support of wellness through applications in homes and communities. In the process, remote care and health systems themselves will become de-mystified; maybe trust will follow?

If it is true that remote care is at the tipping point – “that magic moment when an idea, trend, or social behavior crosses a threshold, tips, and spreads like wildfire,” as Malcolm Gladwell first wrote in 2000 — we will know we are in fact on the other side when we see the fulfillment of trends now clearly underway, as reflected at this year’s CHC:

· First, when the reimbursement now possible for Medicare becomes widely used and spreads to other public payers across the globe as well as private payers in America and elsewhere.

· Second, when remote care becomes embedded in everyday life through the wonders of the Internet of Things. For example, this will mean that architects, builders, city planners, and urban designers treat remote care technology for wellness as they treat today’s environmentally friendly innovation applications. Architecture schools will be as interested in wellness technology as they are today in green technology, and we will come to design wellness environments as today we design green environments.

· Third, when there is in fact a well-recognized trust for remote care’s data and insights, which inform our individual, family, and community planning for long lives to a hundred.

· Fourth, and finally, when today’s patient becomes tomorrow’s consumer. Sure, remote care will always be there for the acute needs and to make it more efficient and lead to better quality outcomes for patients. But, the game-changer will be when we use remote care — powered by AI — for people — as people and not just patients — living our lives in healthier ways because regularized monitoring and earlier diagnosis will lead to more successful treatment and prevention solutions.

So, as one thinks about this year’s CHC, it is not just that remote care will be powered to scalability by AI, turning it into society-wide application, but that the true driver for change is the reality of 21st-century long lives to a hundred as a matter of course. It is in this longevity paradigm that health systems themselves must move from the acute to chronic care model — and move outside the hospital and other traditional health settings to our home, community, and, even, workplace.

CHC this year showed us the path to the future by imagining remote care powered by AI, predicting walking, sleeping, and nutritional lapses at home; or, for employers, who in their workforce will have a cardiovascular event or mental health condition. Wow, and I thought I was missing something not being at Fenway.

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