If ever there was an application designed for cloud computing, it is healthcare. I’m convinced that any attempt – from free enterprise to government-managed – that has a chance of actually fixing our current healthcare crisis will have to go through the cloud.
In the process the hospitals, insurance companies, entrepreneurs and government bureaucrats will discover that the cloud will provide them with some important benefits that they haven’t yet even imagined. To understand why this might be, we need to take a closer look at the state of healthcare in America today, and where it needs to go.
Right now U.S. healthcare faces two enormous challenges which can be described as “too much care” and “too little care.” The former deals with technology and cost, the latter with adherence and access. The cloud offers answers to both.
By too much care I mean that the once a patient enters the medical system, he or she is eligible to receive the absolute state-of-the-art treatment using the latest technology in order to provide the best possible medical support until the crisis has passed or the patient dies. The U.S. does this better than any country in the world, which is why wealthy and/or desperate patients flock here to take advantage of ubiquitous MRI machines, patient monitoring equipment, and advanced surgical tools. To not offer these resources to everyone who needs them – including the poor and indigent – I believe violates the democratic spirit of this country.
The trouble is that by definition, cutting edge technologies and processes and the people who know how to operate them are hugely expensive. And that’s the primary reason why healthcare costs in this country are out-of-control. Unfortunately, the two logical solutions to this crisis – tax the rich or ration services – are, in the long-term either self-limiting: you run out of rich people, or cold-blooded: you turn your back on the people you are trying to help.
Meanwhile, by too little care, I mean that due to the rising cost of insurance, the creeping rationing of government healthcare, the declining per-capita population of doctors, and the frustrating unwillingness of at-risk patients to adhere to their drug regimens or make follow-up doctor visits, the average patient is receiving far less real healthcare than he or she needs. This is the great irony of healthcare in modern America: despite having the most powerful medical system in history, for the average American – especially one who is at risk, suffering a chronic condition, or old and feeble – the experience of that medical system has been declining for more than a generation. Tens of thousands of people die each year in the U.S. because they chose not to buy insurance, or didn’t refill or even fill their prescriptions, or visit their doctor.
This is not a situation that can continue for much longer. Whatever one’s opinion of the result, it is to the credit of the Obama Administration that it put a restructuring of the business of healthcare in the U.S. at the forefront of its agenda. That move has had the unexpected consequence – if only out of fear of ‘socialized medicine’ – of spurring an explosion of new technologies and products designed make quality healthcare not only cheaper, but more pervasive.
This technology-driven, entrepreneurial revolution in healthcare is very real, just ask a venture capitalist about the new business plans crossing his or her desk. It is taking place in every corner of the healthcare world from patient record-keeping, to hospital diagnostic, surgical and post-op monitoring equipment, to the whole new world of patient home monitoring devices. And when you look at each of these emerging industries it quickly becomes apparent that every one of them ultimately will turn to cloud computing in order to reach their potential.
Consider home health monitoring systems. These are small, microprocessor-controlled boxes that you will have in your home (an estimated 3 million of them in the next few years) to perform tasks that were once exclusive to the doctor’s office, including pulse rate, respiration, blood oxygenation, blood sugar, blood pressure, urinalysis, vision and tooth decay – even pill adherence (the box will ‘read’ your pills and give them to you per your prescription). In order to reach all potential patients in even the lowest income brackets, these devices will have to be very cheap, and ultimately the only way to do that will be to make them as ‘dumb’ as possible. Loading them with a lot of processing power or memory will just not be cost-effective. Rather they will have to upload the patient data via cable or wirelessly to the cloud, where the patient’s doctor, hospital, pharmacy or even concerned family members can access it.
The same will be true in the other emerging markets. Hospitals produce massive amounts of data every day, some of which must be instantly accessible to all stakeholders in a patient’s healthcare team. Right now all of this patient information data is stored on the hospital’s own in-house servers, a decision often made on the basis of information security. But as I think I’ve shown in my past columns, IT security at the company or hospital level isn’t nearly as secure as it has been portrayed. Meanwhile, IT professionals who see their jobs going away have overblown cloud data security risks. And because cloud providers can afford the very best security tools amortized over many users, data security in the cloud is often superior.
The same is true with insurance companies, healthcare networks and the Federal government itself. In the end, faced with a tsunami of new data pouring out of all of these new medical devices, they will find they can no longer manage their IT in-house and will have to jump to the infinitely scalable cloud. In fact the cloud is already prepared for them. Handling patient records in the cloud will be no more difficult than managing something like WEBFLIX, a task the cloud easily does right now.
My sense is that when that happens, these big institutions and the patients will not only enjoy huge leaps in healthcare quality and reduced costs, but also discover valuable network effects they hadn’t anticipated, both on the macroscopic and personal scale.
Once you get all of this data out of smaller, proprietary information silos it becomes possible to integrate it, prioritize it and crunch it. And that means that doctors and researchers will be able to realize the centuries-long dream of being able to follow changes in a population’s health patterns in real time. That’ll mean tracking the rise and fall of infectious diseases, the appearance of location-based toxic diseases, seasonal patterns, and even catch individual disease vectors before they can create an epidemic. Think of it as the SETI home computer project for disease.
By the same token, real-time monitoring of individual patients will not only add greatly to these macro records, but also radically transform the way we look at treating illness. Right now, we focus on prevention and treatment. But there is a middle ground between the two when health problems make their very first appearances in the form of minor or even fugitive symptoms. Real-time monitoring plus engagement of the patient in more precise self-monitoring (compared to warning signals when it is already too late), combined with the massive data crunching that can take place on the resulting stream of data can finally take on that middle-ground challenge . . and perhaps bridge the gap between prevention and care. The rewards in terms of human lives improved or saved would be incalculable.
Is all of this possible? It is certainly technologically feasible: just think of LifeAlert with home monitoring equipment on one end and the cloud on the other. As for economic feasibility, consider that we are already preparing to up-end one fifth of our economy to deal with this crisis. That’s a lot of money combined with a vast opportunity, a combination that entrepreneurs love. I’d be shocked if there aren’t already companies out there in stealth mode working on this.