Thứ Sáu, 1 tháng 5, 2020

How Tech Companies Can Help Fix U.S. Health Care

How Tech Companies Can Help Fix U.S. Health Care

by Hemant Taneja - April 28, 2020


Pandemics, once considered black swan events, will become a routine occurrence in this era. Globalization, localization, and increased animal protein consumption have changed our world such that localized infections now have the potential to evolve into global pandemics with greater frequency.

The products, services, and conveniences developed by the tech industry over the past decade have helped carry us through the disruption and social distancing necessitated by Covid-19. Almost overnight, we have been able to rely on companies like Amazon, Instacart, and Zoom to keep parts of our economy open.

The same has not been true for the health care system. The virus has illustrated just how vulnerable this system is - and how little tech-driven innovation has been brought to it. As we grapple with this global, existential crisis, the tech community has to assume a new level of responsibility and proactively tackle the challenge at hand.

Like many other industries, tech has stepped up to support Covid-19 response efforts. Generous tech philanthropists pledging their fortunes, individuals partnering with local governments to create public health dashboards, startups pivoting their businesses to increase testing, and big tech companies developing apps and tools with health systems have all helped to flatten the curve. However, a resilient health system is defined as one that can maintain core function when a crisis hits; all these projects are reactionary. They are not the elegant, scalable solutions that technologists would create if they had the opportunity to design from first principles.

This outbreak has laid bare the dire need to rebuild our system in a way that not only suppresses a future pandemic but also functions normally while doing so. In taking on the challenge of building a system that is already struggling, technologists must rethink many of their assumptions about how to build and grow exceptional products.

We must partner with and empower health systems, not disrupt them

Technologists often see themselves as the solution rather than contributors to the solution. Technology alone won’t save us from Covid-19 or create the pandemic-resilient health system we need. Health workers and scientists are the true heroes of this crisis. We need to empower them, not disrupt or replace them. Rebuilding our health system will require an attitude of partnership with experts in the field and those who serve on the frontlines every day. Technology will only be a leverage point if it makes providers’ lives easier.

We must rethink our design principles 

While we should still strive to create delightful consumer experiences specific to health care, virality can not be our holy grail. In the past, we’ve lauded companies that disseminated a product everyone wanted. Many of the industry’s biggest success stories - Twitter, Facebook, Snap - were predicated on network effects and the power of exponential user growth. Ironically, we borrowed the k-factor indicator from epidemiology. Today, we’re forced to grapple with the k-factor in its original, pathological context.

Health care technologies need a new standard of success, one that is on the opposite end of the spectrum from minimum viable products, iteration to quality, and the notion of catching the hottest next trend. You can’t move fast and break things when the things being broken directly affect someone’s health. Earning an individual’s trust is the only way to ensure they feel safe enough to rely on your product for a prolonged period - that goes for tools that serve both patients and providers.

With these design principles in mind, technologists should begin working on the practical solutions that will push us closer to a pandemic resilient health system. Covid-19 has revealed two key pieces of infrastructure we need in place. The first, rather obvious system we must create is for testing, tracing, and isolating populations to contain outbreaks and get people back to work. Another more nuanced need is the development of “health assurance” services that can serve the ongoing requirements of patients in both normal times and times of crisis.

Creating an instantly scalable system for testing, tracing, and isolating populations

We can’t fight a pandemic if we do not have a way of conducting widespread testing. For Covid-19 alone, some estimate that the U.S. will need at least 750,000 tests per week. That number swells when we think about the fact that we’ll have to test many people multiple times over the next 18 months. Accomplishing this will require increased government funding, training of health workers to administer tests, and coordination across the global supply chain to manufacture and deliver materials. Tech can undoubtedly help in facilitating testing by easing the dissemination of information and handling the surge of requests. However, it can be even more instrumental in making test results actionable.

Apple and Google, for example, have partnered to develop an application that leverages the Bluetooth technology embedded in our phones for contact tracing. The system will pull testing data and immediately update people if they need to self-quarantine or get tested. The APIs the companies release will also drive an ecosystem of tools we can use to mitigate the spread of this and future pandemics. For us to do this well, however, tech companies need the trust and confidence of regulators and consumers. They need assurance that the information they choose to share in this environment won’t be abused for business conducted post-pandemic.

Furthermore, technology can be instrumental in using this data to get people back to work. It’s not enough to test and quarantine people without a way of reopening society. Knowing that people will continue to get sick, companies need ways of ensuring the health of their workforce. Technology can help businesses create programs that allow them to continue operations while mitigating risk. These efforts will benefit the thousands of employees in need of work by allowing them to maintain financial stability and keeping them aware of how their workplace is affected by the virus.

Developing “health assurance” services that are optimized by virtual care platforms

Before Covid 19, it was clear that our health system was already suffering. Despite spending more than any other developed nation on health care - almost 20% of our GDP - we rank the lowest in terms of access to care and population health outcomes. Covid 19 hit us worse because we did not even have the right infrastructure to support those who were not suffering from the virus. As hospitals and ERs are flooded with Covid-19 patients, those with chronic conditions - including mental health needs – often have nowhere to turn. This is especially the case for the large portion of the population that does not have a primary care physician or a specialist.

We must instead assure health consistently rather than treating people only when they are sick. This transition from “sick care” to “health assurance” - as we call it - would mitigate the negative second-order impacts of an overwhelmed health care system responding to a pandemic. Moreover, pivoting towards this model of care would increase positive health outcomes in normal times by ensuring that individuals receive proper care and thus avoiding preventable ER visits.

Technologies like the ones that support telemedicine are a core component of the health assurance model. As this pandemic has shown us, well-designed digitized systems can help doctors provide adequate care to patients who do not need a hands-on visit. By virtually treating those who do not require physical care, we quickly benefit from efficient allocation of a provider’s time. To do this most effectively, we will need entrepreneurs to develop specialty telemedicine platforms that cater to different patient needs, such as primary care, behavioral health, or chronic condition management.

Moreover, we’ll need to develop the underlying software that enables real-time, continuous care. We have many of the technologies required to give providers a constant stream of their patient’s health data. If we can create platforms to digest, streamline, and present data, it unburdens both patients and providers because information won’t just come to light when someone is experiencing an emergency.

Lastly, we need more ways to deliver in-home care for those isolated or at risk. During Covid-19, the elderly were disproportionately affected by the overwhelming of our health system. We did not have the tools needed to triage the needs of these individuals - whether that means getting them to a hospital sooner or meeting them where they are with urgent care capabilities. Many other vulnerable populations would benefit from technology that could better serve those with more complex health needs without risk of exposure.

It is tragic to see how Covid-19 has taken lives, devastated our economy, increased social inequity, and spurred a host of adverse second-order effects. While the situation is dire, it’s encouraging that it looks like we are on our way to successfully bending the curve. We can’t predict how the next pandemic will affect us, but knowing the havoc Covid-19 wreaked, we can’t waste any time in preparing.

Developing a robust health system is not only imperative, but it will also be the greatest boon for the technology community in the next decade. There is no better way to earn our place as responsible innovators than contributing to this effort.

Hemant Taneja is managing director of General Catalyst and co-author of Unscaled: How AI and a New Generation of Upstarts Are Creating the Economy of the Future.

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