In new book, Singh explains how technology can shape future of health care
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Key takeaways:
- Wearables, sensors and artificial intelligence are transforming the practice of medicine.
- Technology may bring a future of personalized continuous care, with more of a focus on prevention.
Healio | Cardiology Today Editorial Board Member Jagmeet P. Singh, MD, DPhil, FACC, FHRS, and some of his patients were profoundly affected by the COVID-19 pandemic. That got him thinking about the sustainability of the health care system.
Three years later, Singh, former clinical director of the cardiology division at Massachusetts General Hospital and professor of medicine at Harvard Medical School, has produced a book, Future Care: Sensors, Artificial Intelligence, and the Reinvention of Medicine, which outlines how technological advancements such as wearables, sensors and artificial intelligence have the potential to reorient the health care system into something more sustainable and equitable. The book, published by Mayo Clinic Press, came out June 13.
Singh spoke with Healio about why he believed a book like this needed to be written, how technology is already transforming the practice of medicine, how these changes can shift the focus of the health care system from treatment to prevention, the implications for health equity and how the delivery of care should look very different in 10 years from how it does now.
Healio: Why was there a need to write a book on this topic?
Singh: We all recognize that health care is in a state of transition and is progressively becoming unsustainable. In my book, Future Care, I bring together the evolving facets of digital health and the story of how this might interface and make health care sustainable. I talk about the digital transformation using sensors and artificial intelligence, and how it can change not only how we deliver care, but how we receive it. I believe the soul of this book is centered on improving lives through forecasting and averting disease by providing well-timed interventions. The book is inspired by my own personal encounters with disease and that of several patients in my care. The book is punctuated with real-life medical situations, vibrant stories, anecdotes and characters. I feel the burgeoning digital metamorphosis in medicine provides us an opportunity to scale personalized care globally. To that end, the book highlights new models of care, it provides a vision for what the hospital of the future might look like, and within it, I try to outline the concepts of modular medicine, disease management models and third-party vendors, and I also postulate what the evolution of the classic academic medical center will be.
I think the digital transformation of medicine is already here. We have a unique opportunity to understand it, embrace it and adapt to this new world of sensors and AI.
Healio: How are wearables, sensors and AI transforming the practice of medicine and what do cardiologists need to know about AI right now?
Singh: Wearable sensors provide us the opportunity to digitize the entire body and its organ systems. Just like our automobiles have a check engine light, these wearable sensors can provide us information akin to that, which can help alert us, and thereby predict and prevent disease. Sensors by themselves are useful, but we can get overwhelmed with all the information that comes from them. Therefore, having predictive analytics and artificial intelligence strategies to collate that information, help digest it and provide solutions will be the way for the future.
It is important that cardiologists as well as non-cardiologists start adapting to that change, because it is here to stay. It is probably the only way that we can get patients engaged in their own health care, which will be important for making health care sustainable.
Healio: What needs to be done to shift the focus in medicine from treatment to wellness and prevention?
Singh: If you look at care in general, one of the biggest drains on the national treasury is chronic diseases. Three out of four dollars of the treasury funds dedicated to health care are going toward treating chronic diseases. Part of that is because many of them develop and progress unchecked, and patients manifest with complications on their initial presentation. Therefore, having wellness approaches where patients take some of their own health care in their own hands, and accompanying strategies to predict which patients are going to develop diseases through a continuous care model is probably the best way of preventing illness and making future costs much more controllable.
Regarding how care can evolve, conventional care right now is transactional. You see patients every 3, 6 or 12 months. Wearable strategies will allow us to make care more continuous and to drift toward exception-based care, which means you track a patient continuously and see them as and when they need to be seen.
Healio: What are the implications of the technology transformations we are seeing for health equity?
Singh: A lot. One thing that digital strategies provide us is an opportunity to ensure global equity for health care. Obviously, we need to be aware of the digital divide in terms of literacy and accessibility to digital tools. However, the fact that nearly 70% of the global population and 85% of the U.S. have smartphones, and the percentage is increasing, provides us a unique opportunity to give care to those for whom it has been inaccessible, and to provide care that is up to date and up to speed.
With digital technologies, we have the chance to correct the inequities of the past. Looking ahead, we should not proceed with the intent of backfilling the gaps later, but make fixing this inequity a proactive forward journey.
Healio: What do you think patient care will look like in 10 years?
Singh: The next 10 years will be challenging and complex as we try to find our way around adopting these new technologies. But I hope that within 10 years, care will become fairly seamless, with a great patient and provider experience that will translate into better outcomes. In 10 years, there will be continuous streaming of information through sensors, with AI technology that will enable the provision of continuous care, which is personalized, and in which patients will be more involved in their own care. Much of the routine care will be remote, with the construct of digital twins to help us predict and prevent disease. The future of care will be virtual, sensor-aided and powered by predictive analytics with sustainable workflows that will translate into better clinical outcomes.
For more information:
Jagmeet P. Singh, MD, DPhil, FACC, FHRS, can be reached at jsingh@mgh.harvard.edu.
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