I was once part of the Internet of Things. A sensor on my sneaker linked to a tiny computer on my wrist. When I plugged the computer into my laptop the battery recharged, and statistics from my morning run were uploaded to the cloud. The web site tallied my weekly progress; charts recorded distances and speeds, and on-line coaches challenged me to new goals and awarded virtual trophies. Perhaps the technology interfered with the endorphins but one way or another my digital tether took away the magic of a run at sunrise and I abandoned it with my old sneakers.
But I see inferences for the future of healthcare. Inexpensive sensors linked to powerful computing and smart analytics hold the promise of low cost personalized medicine. Professional and consumer products already provide monitoring of a variety of vital statistics outside the hospital and clinic, from heart rate, weight, blood sugar levels, sleep patterns and retinal health. Extending the range of metrics, tailoring sampling to individual users and integrating monitoring into a patient’s daily routine could result in early detection and the avoidance of medical intervention.
Shifting focus from treatment to pre-emptive health management will pose major challenges to the healthcare status quo; including changes to a business model that today relies heavily on provider payments in the form of fee for service. The heavily regulated nature of the industry may help keep innovators at bay but healthcare is not immune to the disruption seen in other industries as new entrants find ways to deliver higher productivity without significant capital investment. And those disruptors will enjoy widespread support from consumer advocates and employers alike as the rising costs of the existing model are passed on by insurers.
A bigger challenge to the development of precision medicine and remote monitoring may be the design and delivery of a healthcare cloud platform. The most valuable gains to come from the Internet of Things and, in the healthcare space, the Internet of Patients, will come from data and pattern analysis. To allow data mining, data needs to be pooled from across geographic, institutional and discipline silos while meeting needs for privacy, security and availability. At a minimum that requires a common understanding across vendors of data structures and access controls. That itself is a challenge in an industry where providers’ instincts are for proprietary solutions that favor vendor lock-in. The long history of the Vendor Neutral Archive attests to the stickiness of proprietary solutions.
But the lessons from the proliferation of Apps on our hand held devices, and the development of Airbnb and Uber is that innovation and participation rates can explode when providers have access to a foundational platform. It’s not clear that existing consumer oriented clouds can efficiently manage the specialist algorithms and data management needs of a healthcare cloudThe healthcare industry needs a dedicated cloud, where where core facilities around security, privacy, custody, information sharing, workflow and payment management are baked into the system. That would provide an easy on ramp for providers of new diagnostic services.