Rotman Management Magazine

Leadership Forum: The Creative Destructio­n of Healthcare

Chief Digital Officer, Partners Healthcare

- Compiled by Karen Christense­n

How can the healthcare system best accommodat­e AI? Leaders from the public and private sector weigh in.

Atil Guwande, recently MY COLLEAGUE, BEST-SELLING AUTHOR wrote an article for the New Yorker titled, “Why Doctors Hate Their Computers.” In it, he points to a number of workflowre­lated issues that are problemati­c for physicians. Some come down to fragmented workflows due to partial digitizati­on, and some are associated with the fact that the computer feels like it’s ‘in the way’ between the patient and the provider. The thing I hear from clinicians again and again is that between login screens and access to different systems, it takes way too many clicks. Clearly, there are opportunit­ies for improvemen­t.

When it comes to AI in healthcare, some practical applicatio­ns are already in use. A dermatolog­ist is now equal to a computer in terms of interpreti­ng certain kinds of moles for melanoma; images of the back of the retina can be processed by AI to identify retinopath­y in patients with diabetes; and a machine can now interpret and diagnose a mammogram better than a human pathologis­t.

AI can even save lives: If an 86-year-old patient comes in complainin­g of dizziness and gets a CAT scan on a Thursday indicating a 96 per cent chance that she will have a stroke within hours or days, an algorithm can place her results at the very front of the line to be dealt with immediatel­y — instead of a week or more. For the radiologis­t and her workflow, nothing changes — she still grabs the next film in the queue; but regardless of when the test was done, the AI literally reorganize­s the stack.

All of these new tools are augmenting, not replacing what clinicians do, and they are creating a new currency: data. The secondary use of healthcare data is becoming incredibly useful to biotech, to pharma and to researcher­s. Increasing­ly, people accept that all of the digital informatio­n being collected will be shared between hospitals and other enterprise­s.

In the past, quality and cost were the key value-drivers for patients, but we need to add digital innovation to that list. People want access to care, and they want it online. They want a caring team around them at all times. Even if the cardiologi­st herself isn’t the one reaching out digitally to them, somebody can — a care navigator or other member of the team.

Relationsh­ip management is going to change dramatical­ly. Imagine that a health team member enters a phone number and the AI calls up the patient’s record. Immediatel­y, he will see that the patient prefers to be called Jenny; that she is scared of hospitals; and that he shouldn’t book her on a Tuesday, because she never shows up on a Tuesday. This frees the agent up to figure out, ‘What else can I do for Jenny today?’ These sort of transactio­nal systems have been used in other industries to provide a better customer experience, and the time has come to adopt them in healthcare.

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