10 years of progress in healthcare and technology equaled in just a few months. Discover what's next.

by Jason Rzutkiewicz, SVP of Client Strategy, YML

October 13, 2020

Every now and again society experiences seismic shifts. Now would be one of those times, as we see pivotal, decades-worth changes happening in the span of just a few months. Change is happening on all levels.

Jobs that weren’t possible to do remotely are now happening without missing a beat. People who have never used online grocery services now depend on it. Medical needs that couldn’t be met via a video visit now happen regularly. Shifts that have been building up for a while are moving society to think in more inclusive ways.

Many wonder when will we get back to normal. Yet, perhaps, the more productive question is—what does the new normal look like?

If we look to history as a guide, the 2003 SARS pandemic that permanently altered society offers similar parallels in digital transformations. Like today, retailers faced drastic disruptions to business (previously they were dependent on traditional retail channels). But within the climate of the SARS pandemic, Ecommerce in China grew by leaps and bounds, creating a fast-forward effect. Alibaba who had $10 million RMB in sales the prior year quickly soared to seeing that same amount daily. At the end of 2005, they reported $1.2 billon RMB in sales; a 120x increase.


In the last few months alone we’ve seen 10 years of progress equaled in just 12 weeks. 


Many wonder if people will revert to pre-COVID behavior once a vaccine becomes widely available. If we look at reversion patterns after the SARS pandemic passed, the clear answer was ‘no’ in that case. Ecommerce adoption and growth in China took off and never looked back. In 2019, China reported sales of $1.935T which was 3x the $611B reported in the United States.

Now, six months into COVID, we are seeing similar implications with an immediate and rapid acceleration of Ecommerce sales. Many retailers are reporting 100% increases in Ecommerce, impacting behaviors and society at large. In the last few months alone we’ve seen 10 years of progress equaled in just 12 weeks. 

While impressive, this current acceleration isn’t the same slingshot moment that we witnessed back in 2003. To find that we need to look towards digital healthcare. Pre-COVID telemedicine visits held at best, a high single-digit share of total visits.

That changed almost overnight.

At Kaiser Permanente, known to be one of the leaders in the use of virtual visits, telemedicine is now delivering 80%+ of care for its patients according to Prat Venama, their Chief Digital Officer. For those with a less mature trajectory, the impacts are even more dramatic.

Ascension Saint Thomas Health, located in Central Tennessee, conducted about 50 of 60,000 visits virtually in February. They now average 15,000 telehealth visits a month, a 300x increase. Whether it’s Stanford Health Care where televisits are 50 times higher, or Sutter Health who have seen the number of patients being served system-wide expand 175-fold by video visits, exponential growth stories are plentiful in today’s news cycle.

These changes have huge implications for the future of access in healthcare. And while many of these implications are positive, we also need to proceed carefully and inclusively as telemedicine has the potential to leave behind the ones that need it most.

Today, providers are struggling to reach vulnerable communities — including low-income and minority patients — during the pandemic. This can be directly linked to the safety net clinics provide for communities that don’t have the funds to support virtual care. This leaves those who are those most impacted by COVID at an inherent disadvantage.  

So what might the new normal look like? And how might we avoid the mistakes of the past and ensure it is equitable and inclusive? 


With as much innovation as there is coming online to advance telehealth, there is also a great opportunity to build additional, more inclusive, pathways within health care.


To begin with, COVID has forced many of the constraints that have previously held back innovation to be lifted out of immediate necessity. Reimbursement has been solved, cross-border care has been solved, and Centers for Medicare & Medicaid Services will now reimburse for more than 80 additional services. These changes are now being made permanent.

Todd Askew, the AMA’s senior vice president of advocacy, said during a recent “AMA COVID-19 Update” video. “We have moved forward a decade in the use of telemedicine in this country and it’s going to become, and will remain, an increasingly important part of physician practices going forward.”  

Premera Blue Cross agrees and is launching its first-ever virtual primary care plan. Likewise does McKinsey who recently reported that virtual visits, which accounted for an estimated $3 billion before the COVID shutdown, could potentially account for $250 billion annually, a nearly 100-fold increase, within the next year. 

With as much innovation as there is coming online to advance telehealth, there is also a great opportunity to build additional, more inclusive, pathways within health care.

Patients who don’t have access to a greater resource pool (monetary, educational, social) can also miss out on health and digital literacy that is often needed to engage with these products. For many more, English may not be the primary language. These same patients are also less likely to own digital devices. How do we ensure that this doesn’t limit their access to care?

How can digital experiences help bridge these divides instead of widening them?

As technology managers, builders and contributors, the responsibility lies in our hands to create authentic spaces for as many different needs as possible. These issues must be addressed to ensure a new normal that is both equitable and inclusive.

And while these are exciting times, this slingshot moment is just the beginning. Using SARS as our reference point—eCommerce in China continued to grow by 50% annually in the decade that followed. For Digital Health the most meaningful growth and innovation still lies ahead. Will your healthcare organization play a role in this once-in-a-generation transformation? The window is now. We can help.

Illustrations by Kevin Tudball.


About the author: Jason Rzutkiewicz

Jason is YML’s Client Strategy leader, playing a critical role in helping brands navigate the complex digital landscape of web, mobile, apps, search, and data and bridging them with physical spaces to create seamless experiences. He currently leads the YML healthcare practice and has led crafting experiences across a diverse range of audiences from physician, nurses, patients, caregivers and insurers. He augments his understanding of the digital health landscape with a long history of delivering complex engagements across a wide variety of industries for companies like Walmart, T-Mobile, Sephora, Adobe, Honda, Wells Fargo, and Choice Hotels.  

Jason leads multi-disciplinary teams of strategists, media experts, creatives, interaction designers, technologists, data scientists, and more to deliver experiences that drive results and exceed business expectations. He is particularly sought after for his ability to create alignment, accelerate velocity, and quickly resolve issues.  Prior to YML, Jason was at SapientRazorfish from 2004-2018, before which he spent time with Pricewaterhouse Coopers, Diamond Management Consulting, and McKesson. Jason lives in Marin County with his wife and three children. He enjoys cycling and the great outdoors.

By Ashish Toshniwal, CEO and Co-founder of YML

January 9, 2020

The digital transformation that has reworked countless industries finally seems to be getting real traction in the medical world. The intersection of genetics, biotechnology, data and science is starting to be realized throughout healthcare. 

With political pressures building and new demands from consumers, startups and large-scale healthcare providers are in a race to drive impact.

What is the best way forward that balances emerging technologies while exceeding customer expectations? How do we improve healthcare while lowering costs for all Americans? What does anyone who is focused on this issue need to consider to ensure success?

There’s no single, right answer.  This is a big, messy, complex system. But it’s also a massive opportunity (which I recently discussed with leaders from Abbott, Sutter Health WIRED and more).

I believe the future of healthcare will be defined by technology so seamless that it will disappear into the background; as reliable and essential as running water.  Healthcare will become anytime everywhere.

To understand the future of seamless, anytime everywhere healthcare, we need to have a firm grasp on the context of this moment in healthcare technology.

Here’s the seven insights about the current system and the principles that will inform the future of healthcare and technology. 

Principle 1: Be Human

Patients want to connect on an emotional level. That means creating an experience that leverages all we know of our patients.

The key insight to being more human is to provide individualization versus just personalization. It’s critical that the healthcare community balance functional goals with emotional need states. 

Principle 2: Be Available

There’s a misperception that care is difficult to access. Providers need to make it easy to navigate various care options. They can do that by sourcing options by availability as well as patient need.

They key insight here is the same one that must permeate the majority of digital, customer-centric experiences — empathy.

That means everything from being sensitive to financial constraints, or considering the intricacies of the experience by streamlining the path to appointments and visits.

Principle 3: Be Seamless

A fragmented ecosystem leads to a disjointed experience. One’s health is perhaps the most personal experience people have. There’s a legitimate need to design the ‘universal remote control’ for care and coverage.

Connect the systems (plan, delivery, fulfillment) around moments in the journey to remove friction. Once that foundation is built, we can create stickiness through engagement mechanisms that reinforce a central source of truth.

Principle 4: Be Clear, Informative and Encouraging

Clinical information is often hard to find, confusing, and doesn’t typically motivate adherence. Tone of voice matters, which is why it’s critical to communicate in our patients’/members’ voice, not compliance speak.

Part of that is also about identifying opportunities to explain the ‘why’ behind medications and therapies.  

Principle 5: Be Transparent

Costs, billing and benefits are obscure at best, black box at worst.

Healthcare numbers tend to be daunting, but again, this is an opportunity. We can find creative ways to estimate average costs, prioritize plan benefits as a ‘progressive reveal’, and ultimately centralize and modernize billing and payments.

Principle 6: Be Omni-Useful

Patient experience is tied to ecosystem adoption. It’s by no means easy, but it’s urgent that we define the value proposition for each ecosystem actor.

Once we do, we can ensure patient solutions reduce, rather than increase, patient, provider, and fulfiller complexity, ultimately creating stickiness and giving them answers to the question why they would never leave.

Principle 7: Be Anticipatory

Patients work hard to advocate for themselves. It’s on the healthcare community — providers, nurses, doctors etc… — to ensure the experience is low on cognitive load and high on emotional satisfaction.  

Be one or two steps ahead of patient needs.

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Google has been at the forefront of this type of thinking.

They’ve laid the foundation with their product strategy of ambient computing, which ensures the services and features of its technology are accessible everywhere at any time. As Rick Osterloh, Vice President of Devices and Services, shared in the Made by Google 19 Keynote, “Pixel phones, wearables, laptops, and Nest devices for the home. Each one is thoughtfully and responsibly designed to help you day to day without intruding on your life.”

This presents a new opportunity to transform the most critical part of the healthcare system — the patient and doctor experience. The future of this relationship will be impacted by the four pillars of the anytime anywhere future.

Passive

Wearable activated - Jacquard’s Jacket allows users to interact with Google’s Assistant with a gesture or touch to their sleeve.

Quick

Instant Aid: Mobile AI platform that engages in natural conversations with patients through the use of a virtual healthcare assistant. 

Informative

AI Powered Reoccurring Checkins: Sensely's Mobile AI platform that engages in natural conversations with patients through the use of a virtual healthcare. 

Observational

Trackable wearable health: Integrating wearable tech, capturing daily snapshots of patients activity and health

How do I know this?

Over a decade of experience in Silicon Valley building digital products and experiences for Fortune 500 brands, an array of innovation technology work with companies across the healthcare spectrum, and all the while listening and learning from our clients and partners about the needs of their customers.

By Jason Rzutkiewicz, September 25th

In the 1970s, the federal government “began using EHR … with the Department of Veteran Affairs’ implementation”. At that time (1975) physicians spent on average 60 minutes with every new patient that visited their office.

Today, physicians spend a mere 12 minutes with those patients.

And yet healthcare as a percentage of GDP has exploded (from 8% to 18%)!

How did we get here?

For starters, EHR was not designed with the patient or the sician in mind. In hindsight its primary purpose was to support billing and administration. It is often referred to as the intruder in the room as patients and physicians interact. Physicians are often now forced to be more focused on screen time than patient time.

Source: Is Your Doctor Getting Too Much Screen Time?

This starts to speak to the cumbersomeness of these systems. Training new physicians to use EHR is a 20hr + experience.

As Eric Topol shares in his recent book Deep Medicine, 80% of new notes in EHR systems are copied and pasted from a previous entry. The electronic health record has turned physicians into data entry technicians with more time spent tending to the keyboard than the patient.

Clearly physicians see limited value but are forced to adhere creating a “lose-lose” situation.

Physicians were passive while major new changes took hold in the business of healthcare like EHR (along with managed care, HMO’s and others). They know full well that their ability to listen and engage have been severely compromised.

In hindsight they missed an opportunity to be better advocates for themselves and their patients.

So where are we today?

Source: The next generation of EHRs will be fundamentally different

There is tremendous pressure on physicians time. This is leading to burnout and depression (doubling the risk of patient safety). “Shallow medicine” is taking hold. The path of least resistance is often being chosen which is leading to over diagnosis of conditions, procedures and surgeries.

The implications are vast, including driving inflated healthcare costs and even playing a role in the opioid crisis the nation is facing today.

But the role of EHR today is more important than ever. It is positioned to play a critical role in enabling AI to drive better health outcomes for all. But that depends in large part on meaningful physician adoption and engagement.

Otherwise garbage in, garbage out will compound the problems we’ve faced over the last 40+ years.

The next generation of EHR

Source: Hospitals Utilize Artificial Intelligence to Treat Patients

How do we create the next generation of EHR?

One that starts with the patient, the physician and their needs — to truly connect with each other — at the core.

And for physicians, how do we ensure that as we move towards a world of AI assisted care that they don’t make the same mistakes as they did with EHR?

The opportunity is now to ensure that the productivity gains from AI are reinvested into more time with patients rather than more schedule slots on the calendar.

About the Author

Jason Rzutkiewicz is the Client Engagement leader at YML, playing a vital role in helping brands navigate the complex digital landscape of mobile, social, search, and data and bridging them with physical spaces to create seamless experiences.

In recent years, artificial intelligence has proven it’s capable of changing and improving our lives.  In the coming years, AI is expected to streamline processes across a wide range of industries, particularly healthcare A recent Accenture report found that AI may be able to generate as much as $150 billion in annual savings for the healthcare industry by 2026.

According to Accenture’s findings, robot-assisted surgery and virtual nursing assistants stand to yield the greatest savings. In fact, approximately one in four U.S. hospitals already uses the surgery assistance robot called da Vinci to some degree. By 2015, the robots had performed nearly half a million annual operations.

Robot-Assisted Surgery

The concept of a robot performing surgery used to be a scene in a science-fiction movie, but not anymore. In fact, the technology already exists. Consider the feats of the Smart Tissue Autonomous Robot, or STAR.

In one study, researchers programmed the robot to perform a procedure in which a pig’s intestines are stitched back together after being cut through during an operation. While STAR required minor human guidance during some of the trials, most of the time it successfully performed the procedure on its own.

Perhaps more striking is the fact that the robot’s stitches were generally less prone to leaks than those made by human hands. While it may be some time before robots replace surgeons, this proof of concept indicates that they could play a very important role assisting physicians in the near future.

Another healthcare AI technology providing surgery assistance is the da Vinci robot. It has already leant its precision to over 3 million surgeries. It continues to improve the patient and doctor experience by offering greater dexterity than a human hand, and therefore make procedures safer and even less invasive.

Experts are quick to point out that da Vinci and similar AI technologies in healthcare haven’t reached the point where they can think and solve decisions like a human surgeon. However, they can help surgeons perform delicate moves with much greater accuracy and safety than ever before.

Researchers predict that future iterations of these robots will also help physicians interpret what they see when looking inside a patient. This will significantly decrease the amount of time it takes to make treatment decisions.

healthcare AI

 

Virtual Nursing Assistants

Robots that perform delicate procedures may be impressive, but don’t show off the full potential of AI in healthcare. AI offers the most impressive benefits when it has the ability to learn.

That’s why people working in the healthcare industry, especially nurses, should take note of a recent experiment involving a robotic surgical assistant. By uploading pictures of basic arm movements and having human participants guide a robotic arm, the robot was able to learn how to perform those movements independently.

Utilizing a healthcare AI bot for the purpose of handing a nurse or doctor a needed instrument may not seem that useful, but there are many instances in which it can significantly improve and streamline treatment. Understaffed hospitals could use robots to offer assistance when not enough nurses are available. Unlike humans, who can get tired during long procedures, a robot will be able to help for hours on end without making errors.

The Savings Are Endless

AI for healthcare can also help diagnose patients. This will save physicians a lot of time because instead of scheduling an appointment, patients can remotely provide an AI assistant with a list of their symptoms. The AI won’t just relay this information to the physician, it will also help interpret the findings to offer a probable diagnosis.

Keep in mind that these are just two general applications for AI in healthcare. Artificial intelligence is also likely to boost savings in the healthcare industry by offering administrative workflow assistance and fraud detection.

Together, all these applications save hospitals, physicians, and patients a significant amount of time and money. They boost the efficiency of every aspect of the healthcare process, from diagnosis to surgery, and in the meantime also help to conserve resources.

Imagine this: you’ve been dealing with chronic pains for some time and are considering major surgery. Before you take this big step, however, you visit multiple doctors for their opinion on your upcoming surgery. During this process, you find that you’re having an incredibly difficult time collecting the notes you need from your multiple previous doctor visits.

As frustrating as the aforementioned scenario is, it’s also a common one. So it’s not hard to imagine how the promise of solving these kinds of problems for doctors, patients, and hospitals has stirred up excitement for years.

Not only does AI for healthcare promise to make doctors’ jobs easier, it could also fundamentally change the nature of  patient care. The following three examples  illustrate some  essential ways AI can boost overall efficiency and effectiveness and transform healthcare for everyone.

1. Clears up insurance confusion and bolsters verification

Receiving  any kind of initial medical treatment for anything, from a minor injury to a chronic illness, is more often than not, a frustrating, drawn-out process. The current nature of insurance plans contributes to the problem. Statistics indicate that more than half of insured Americans struggle to understand what their plans cover. Even more, Americans find it incredibly difficult to find physicians within their networks. As a result, many people end up waiting much longer than recommended before starting their required treatment.

Thankfully, AI for healthcare applications has the capability to change all of that. Tools like the Zocdoc Insurance Checker reduce friction for patients by relying on AI to determine what a plan does and does not cover. Inevitably, it helps customers choose the right plan in an efficient,  timely manner.

With Zocdoc Insurance, customers simply upload a photo of their  insurance card, which is then automatically stored in your account. Before you book an appointment, the app will use the information from your insurance card to verify whether they cover the procedure. Additionally, it will let you know of an available doctor in your network.

It’s a simple concept, but one which will benefit patients in substantial ways.

AI for healthcare

2. Streamline communication between patients and physicians

Physicians don’t just provide care when you’re sick. They can also offer advice to help patients live healthier lifestyles.

Of course, few people have the time to visit their doctor every time they have a question about their wellness. Luckily, AI is solving the problem. Case in point is Doc.ai, a new product that allows users to input key information such as their  gender, age, and weight. It also lets them include a list of medications they take. When  connected to a Fitbit or other wearables, the app has even more data for managing customers’ health conditions and treatments.

The result is a detailed file on your overall wellness. Patients will be able to “converse” with an AI doctor, asking questions like “How can I lower my cholesterol?” The app generates answers based on the information on file. If the AI doctor, or agent, cannot answer the patient’s question they can determine whether they need a human physician.

That’s just the tip of the iceberg. Doc.ai’s creators also plan to release products that will interpret blood tests and other lab results for both patients and physicians. This is another way AI will reduce the amount of time it takes for patients to receive treatment. With too few doctors available to evaluate lab results quickly, it helps to have a technology on hand that can reduce the workload.

3. Helps hospitals sift through unstructured data that they can easily overlook

Subtle behavioral shifts, especially from those suffering from a mental illness like anxiety or depression, are often the first signs of bigger problems on the horizon. However, catching these subtle shifts when they happen can be challenging. This is especially true when you’re a busy physician with several patients to care for.

Now thanks to AI for healthcare, people can organize and manage anything from photos, videos, recorded dialogue, physician notes, sensor data, and genomic information in a realistic way. For instance, several companies are developing AI technologies that can identify when a person’s vocal patterns, facial expressions, and even key biomarkers indicate a change in emotional or mental state.

It’s rather exciting to think of a time in the not-so-distant future when a chatbot has the ability to “notice” that you’re experiencing severe anxiety.  Examples, like the three mentioned above, represent only a small sampling of the ways in which AI for healthcare is transforming the industry. These applications do, however, prove that, if done correctly, AI has the potential to dramatically improve the treatment experience for everyone involved, both healthcare professionals and patients.

We’ve been working with our friends at Box to imagine and execute a future scenario in healthcare, applying Amazon Alexa and Box Platform to the challenge of tracking medications and compliance to a medication regime for patients in the home.

As Ross McKegney, Director of Platform at Box, recently announced:

At Box we spend a lot of time thinking about the future of work and building the cloud content management platform that will make this future a reality. Today we’re delighted to highlight one of our partners on this journey, Y Media Labs, who is working with Box to develop a series of visionary demo applications for regulated industries.

Take a look at how our Alexa skill can help patients and hospitals manage drug intake, ensure regulatory compliance by insurance agencies, provide personalized care by physicians and manage drug efficacy during drug trials.

At Y Media Labs, we build what others don’t dare to.

Are you interested in taking your personalization strategy to the next level, getting more sales and driving up your customer engagement metrics?

We can help you get there, but don’t take our word for it – our work speaks for itself.

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