As an industry dedicated to helping those when they are at their most vulnerable, healthcare is arguably the most important sector in terms of technological investments. However, it is currently facing many challenges in meeting the needs of patients.
“The biggest challenges in healthcare today relate to the rising cost of care, disparities in the quality of and access to care, and the emergence of healthcare crises,” says David Rhew, global chief medical officer and vice president of healthcare at Microsoft.
According to a 2018 report from the World Health Organization titled Public Spending on Health: A Closer Look at Global Trends, a “swift upward trajectory” of global health costs is resulting in an increase in domestic healthcare spending and out-of-pocket expenses. “At the policy level, this means less funding for other important programmes, such as education,” says Rhew. “In the US, healthcare represents almost 18% of the total spend and the federal government supports half of healthcare costs, which are still rising. This is unsustainable.”
The rising costs of care do not equate to better quality care. Several studies including Health Care Spending, Quality and Outcomes by The Dartmouth Institute for Health Policy & Clinical Practice, have demonstrated that there is no or, in some cases, an inverse relationship between healthcare spending and the quality of care delivered. “Moreover, healthcare is rapidly becoming unaffordable for most people,” Rhew explains. “According to a Kaiser Family Foundation Health benefits survey, the average US health insurance premium for a family exceeds US$20,000.”
Caregiver burnout is another major challenge facing healthcare providers and institutions. “A 2019 study by the National Academy of Medicine Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being found that 54% of US physicians and 35% of nurses are experiencing professional burnout,” he says. “While electronic health record (EHR) systems have digitised health records, much of the burden of documentation has fallen on the shoulders of providers.”
Other issues slowing the progress of modern healthcare include chronic diseases caused by environmental factors and an aging population, but while there is no single answer or magic ‘silver bullet’ to solve all these problems, Rhew believes technology can play an important supportive role.
“Knowledge and information lead to smarter decision-making, but too much information can be overwhelming,” he explains. “Today, a medical article is published every 30 seconds, and by 2020 medical knowledge will double every 73 days. Computers can help support clinicians and researchers by analysing massive amounts of information and using artificial intelligence (AI) and machine learning (ML) technologies to emulate the clinical decision-making process, enabling clinicians to focus their time and energy on the patient.”
Despite the broad adoption of EHRs, healthcare data is still not truly interoperable, and is often difficult for patients to access. “However, with a rule pending from the Office of the National Coordinator for Health Information Technology, organisations are rethinking what is possible when data is aggregated onto a common secure platform, made accessible to patients and those who take care of them, analysed using AI and ML, and made actionable through collaboration and clinical decision-support tools,” Rhew adds. “And at Microsoft, we are looking to apply technology to directly address these issues.”
The quality and cost of care are directly impacted by clinical decision-making. Clinicians currently rely on their training and the knowledge they gather every day by seeing patients, reading journals, and talking to colleagues when making clinical decisions, such as which tests to perform and whether to hospitalise a patient. “Through alliances with organisations like The Jackson Laboratory, Microsoft is seeking to synthesise the vast amounts of medical information available and provide real-time clinical decision support for clinicians and researchers treating cancer,” says Rhew. “This approach requires the development and maturation of data platforms.”
To enable this, Microsoft is partnering with pharmaceutical company Novartis to create data platforms that allow otherwise siloed research and development teams within a pharmaceutical company to share data, ML models, and algorithms more effectively.
In terms of providing patients with high-quality and affordable care, providers are looking to offer access to care anywhere and anytime, for example through virtual healthcare visits.
“As such, Microsoft has launched its open source software release FHIR API for the internet of medical things to support the secure capture and communication of data from remote patient monitoring devices, such as wearables,” he explains. “Care collaboration between provider, patients, family members and others such as visiting nurses and pharmacists will also enable high-quality care beyond the four walls of the hospital. We are hoping to reach this with Microsoft Teams and the Microsoft Healthcare Bot, to securely view and share personal health information between the relevant parties.”
“We are also providing increased access to medicines through innovative collaborations with traditional healthcare organisations, pharmaceutical companies and non-traditional healthcare partners,” he adds. “For example, Microsoft’s partnerships with Walmart, Walgreens Boots Alliance, and Kroger represent unique opportunities for healthcare, medicines, and healthy foods to be delivered to patients anywhere and at any time.”
Rhew believes that clinician burnout is an issue that, if unaddressed, could lead to an even greater shortage of healthcare providers, which would exacerbate the existing problems. “As it is directly linked to the increased administrative workloads facing clinicians, Microsoft is developing new voice-enabled, AI-powered products that can streamline the clinical workflow and documentation process,” he says. “Software provider Nuance and Microsoft have partnered to create an ambient clinical intelligence solution that acts like a ‘virtual scribe’. It transcribes the conversation between a physician and patient into a clinical note, and then integrates the note into the EHR.”
The World Health Organization has estimated that by 2050 over 22% of the world’s population will be age 60 or over, which represents an increase from 900 million in 2015 to two billion. As a result, alternatives to hospital treatment will become a necessity. “In response to this ‘silver tsunami’, Microsoft will help create innovative solutions in telehealth, remote patient monitoring and connected care solutions to assist in home care,” Rhew explains. “We are also in the midst of co-developing offerings with partners such as health insurance company Humana to reinvent the senior care experience.”
“Microsoft has a mission to enable every person and organisation across the world to achieve more. From a healthcare perspective this means re-imagining what is possible and building technologies and creating synergistic partner ecosystems that allow us to achieve those goals. Microsoft has broad ambitions and wants to address the biggest challenges we face today in healthcare, in the US and across the globe. Our approach is to work closely with clients and partners to better understand the issues, learn what needs to be done, and create scalable technology solutions and platforms that benefit individuals, healthcare providers, and society at large.”
This article was originally published in the Winter 2019 issue of The Record. Subscribe for FREE here to get the next issues delivered directly to your inbox.