Health Care Technology Integration and the Future of Digital Health
News Insiders from the health care technology industry discuss their career origins, why technological upgrades can be a good thing, and where they see digital health ending up in the coming years.
What is your background in the health care technology industry and how did you end up in your current role?
Todd M. Pope: I had my eyes on the medical device industry quite early on and have spent more than 25 years working in leadership positions within the industry, including at Johnson & Johnson and Boston Scientific. Following my experiences at these well-established medical device companies, taking the helm at a startup was not a difficult choice given my appetite for entrepreneurship. The opportunity at TransEnterix was exhilarating. It was an opportunity to start something transformative from scratch.
Sonia Arista: My career started as a business analyst and management consultant for an IT outsourcing firm whose clients were in multiple industry verticals. My initial work in supply chain alignment — and later, enterprise resource planning — implementation gave me a solid foundation of fundamental operations and the navigation of corporate financial fundamentals. Later, my work as an IT program manager for a large hospital system started me down the path of information security. I began to observe the criticality of data security in patient care, trust in integrity of the data and understand the imperative of availability with the advent of system mobility and cloud computing.
Lee Waskevich: I’ve been in a technology-related role since 1997, when I started in telecommunications work. Phone systems quickly became IP-centric and I entered into data networking. After many years as a network/security architect, I moved into leadership and support roles to help guide and develop the security practice within ePlus. My current role includes development and strategy execution for the security solutions and services we provide our clients at ePlus. It includes examining emerging technology trends and coupling requirements from various business verticals to craft our approach and engagements with clients.
Jodi Euerle Eddy: I like to joke that I was a geek from the beginning — I memorized the Rubik’s cube at age six, coded a database for my father’s coin collection at age nine and managed my college UNIX lab…before it was cool! After starting as a programmer and analyst in the Corporate Headquarters of a restaurant franchise business, I went on to work in nearly every IT-related role available at GE, eventually working my way up to Commercial CIO of a $20 billion division. The opportunity to serve as CIO and as a member of the executive committee at Boston Scientific is my dream job at my dream company. It’s exciting to advance the use of IT technologies like innovative digital solutions and actionable analytics to improve patient lives and help physicians deliver better care.
What are some of the biggest challenges that health care professionals face in terms of technology?
TMP: One of the challenges, specifically for surgeons, is that minimally invasive surgery has remained fairly static for the past few decades. Millions of surgical procedures are performed laparoscopically each year in the United States with manual tools that limit surgeons’ capability, comfort and control. The current state can be improved for both patients and surgeons. The challenge is to leverage technology that can meaningfully enhance surgeon skills and clinical outcomes while working within today’s value-based health care. At TransEnterix, we have commercialized a new digital interface between the surgeon and the patient to bring the benefits of robotics to more patients and more procedures.
SA: In the clinical setting, caregivers are still struggling with technology and user interfaces that were not initially designed with workflow in mind. The multitude of applications, multiple user screens and “click-through” interfaces, along with slow churning session processing is frustrating to the clinicians trying to provide good, but expedient, medical care. To exacerbate the problem, legacy security technologies implemented for authentication, virus and malware mitigation and web filtering have added more user interface steps. This has heavily taxed processing speeds and operating systems. Thankfully, security technologies have gotten better — more transparent and workflow-friendly (e.g., biometric identification and “badge in/badge out” session management). But for the majority of clinical applications, developers still have a lot of work to do in terms of adopting security and privacy by design, and adapting for the highly mobile health care workforce.
LW: Challenges in health care include the adoption of technology into the current workflow of patient experience. There are so many new ways and techniques that are meant to improve the quality of diagnoses and patient care. It’s a lot to learn and adapt to when your primary mission is around patient outcome and the ability to save lives and health. Along with workflow challenges, there are numerous security and resiliency challenges that come when adopting technology. Will the technology be available for use 100 percent of the time? And will the software, hardware and data sets used in the technology maintain patient privacy and confidentiality?
JEE: While the promise of digitally-enabled, seamless health care is exciting, IT solutions have historically been cumbersome and can even distract from the purpose of delivering optimal care. We understand this and strive to simplify care and delight a broad range of users — patients, caregivers, clinicians and health care administrators. Our digital solutions focus on avoiding harm and resolving the inherent complexities and hassles of health care — for patients and for physicians. We strive for solutions that not only deliver insight but enable action that improves care. And while technology is a powerful enabler, I don’t believe it will ever replace human insight. For example, advanced analytics and artificial intelligence algorithms help doctors focus on the toughest, most complex cases by analyzing vast amounts of data, leveraging the best of computers and human expertise.
Technology integration has endured a stigma of being intrusive. How would you categorize your experience in creating technology for good? What role does your organization play in this?
TMP: TransEnterix is generating such excitement because we offer disruptive technologies that have the potential to change the landscape of the current standard of health care. We believe the Senhance Surgical System can help reduce surgical variability, operating room inefficiencies and workforce challenges, which are big concerns in today’s value-based health care landscape. For instance, the Association of American Medical Colleges forecasts a deficit of over 33,000 surgeons and specialists by 2030. High-volume laparoscopic surgeons are in critical need of a surgical platform that improves their ergonomics, so they can deliver the best clinical outcome possible for more patients. Poor ergonomics for laparoscopic surgeons is a well-recognized issue that may lead to shortened careers. The main predictor of surgeon performance-related symptoms is case volume. Digital laparoscopy made possible with the Senhance Surgical System is ushering in a new era of minimally invasive surgery.
SA: Speaking as a former CISO, and having been engaged as an interim CISO for an organization in the throes of incident response, the key to innately understanding points of risk lies in having full visibility to let metrics within your security environment. Cyberattacks leverage lateral network movement to fully infiltrate and look for weaknesses in your IT environment, inclusive of any networks and data stores that are hosted by other parties. The digitization of the clinical setting (telemedicine, IoT medical devices, mobile applications) and the more prominent IT portfolios comprised of primarily software as a service (SaaS) applications are pushing health care organizations to an edge-computing model with significant reliance on cloud providers for security and availability. Having regular diagnostic metrics on the security posture of all endpoints (devices), networks (owned and leveraged) and having the ability to dynamically adapt to threats is critical. Fortinet’s technology provides consolidated threat intelligence that traverses from the device level to your data center assets and extends to hosted cloud environments. In addition, Fortinet’s machine learning technologies and applied science of artificial intelligence proactively learn the habits and normal functions of your computing environment, which then provides immediate alerting and remediation options to thwart cyberattacks.
LW: The integration challenge is about adoption and ensuring that the people and processes in place are positioned first, with technology overlaid in the equation after. When people try to work backwards from the technology to the process and people, it’s an uphill battle that is rarely successful. Our organization takes a consultative approach to business problems, working to provide inclusion of not just IT, but also the lines of business to understand how they operate today, the unique challenges or problems technology can address and how to steer policy, people and process ahead of technology adoption.
JEE: The beauty of working in health care is that your products are used for good. Our work in technology and digital health is grounded in empathy and the mindset that we don’t have all the answers on our own. We’re focused on delivering technologies that engage and empower patients, caregivers and physicians. This work requires an integrated understanding of the clinical need, best practice, the user experience and the broader context. The only way to gain this knowledge is by listening to customers and patients and working together, often iteratively, to create solutions. One exciting example of how Boston Scientific is doing this is our HeartLogic™ Heart Failure Diagnostic, an alert that works with our cardiac defibrillator technologies and uses physiologic sensors that detect early signs of worsening heart failure. The goal is to be able to predict heart failure events weeks before they happen, so that doctors can provide proactive versus reactive care, intervene earlier and help reduce patient hospitalizations.
What do you think the future of digital health looks like?
TMP: The future of digital health will enable more predictable and positive clinical outcomes by giving surgeons more clinical intelligence, comfort and confidence to improve the patient experience. By digitizing the interface between the surgeon and patient, technology like the Senhance Surgical System can improve minimally invasive surgery in meaningful ways. For instance, there can be fewer patients on opioids post-surgery by using tiny 3mm computer-assisted instruments. We offer specialized sensors to alert the surgeon if excess force is being placed on the patient’s body while operating to decrease patient trauma. The Senhance is an open surgical platform that integrates with the latest technology to allow surgeons and hospitals to harness the power of the most advanced technology to deliver both value and best-in-class quality. I believe the future of digital health will create open-source platforms to incorporate technologies from many different companies versus today’s vertically-integrated platforms.
SA: Modern medical practices and enabling technologies are increasingly dependent on remote computing (telemedicine and increased care in community settings), sensor technologies (predicting fall risks, gathering remote vitals) and gathering of data provided by ingested or implanted medical devices for more accurate clinical diagnosis. Couple these trends with patient and caregiver data relationships enabled through mobile applications (on-demand measurement of exercise levels, nutrition counts, blood pressure, sugar levels, etc.), include all your health and lifestyle habits that are gathered through surveillance technologies (how fast you drive, restaurants you frequent and what you are purchasing at the grocery store or online) and the result is an extensive, data-saturated proposition in providing complete patient care!
I foresee that as health care providers and insurers struggle with market consolidation and vie for “owning the patient,” the patient expectation is that caregivers will utilize all viable data sources and analysis to provide excellent patient care. They will gravitate to those service providers that have this vision in mind, and only trust those that have a solid commitment to privacy and security of their data.
From a technology standpoint, advancement in quantum computing and the ability of organizations to process data on a macro level will no longer be relegated to monolith organizations like IBM (Watson), Amazon and Google. All contributors along the health care lifecycle will need to employ these methods as well.
LW: The progress made in digital health will allow for more intuitive and comprehensive patient experiences. With the ability to gather, analyze, predict and cure based on data sets, technology will empower the industry to improve efficiencies and enhance standards of care. With this data comes responsibility, and as organizations embrace technology and adopt it in a clear, prioritized progression, it will ensure that privacy, protection and resiliency are a native part of the process.
JEE: Digital health will enable us to personalize care and extend our reach to individual patients and physicians, providing opportunities to improve health for entire populations. We’re especially excited about opportunities to close the loop between diagnosis and treatment, for example, through “intelligent” implantables in neuromodulation and cardiac rhythm management, and digital technologies that help patients and physicians achieve optimal care, avoid mistakes and reduce health care costs. The direction in which health care is moving is to help keep the patient out of the hospital both pre- and post-procedure. The opportunities are endless and inspiring.