Introduction: Technology and Partnerships

Cindy Lin, MD and Shwetak Patel, PhD

Over the past decades, clinical science and medicine have brought an explosion of knowledge, unprecedented ability to diagnose and predict certain diseases, improved management of previously fatal conditions, and groundbreaking innovation in precision therapies and surgeries. Despite these advances, healthcare is challenged in such basic dimensions as quality and outcomes, cost, scalability, and equity. COVID-19 has transformed healthcare by forcing the rapid adoption of telemedicine and boosting the need for technology—for both providers and patients. The pandemic and its associated mortality have cast light on socioeconomic and racial inequities in healthcare. The current system is unsustainable, and we must innovate to improve it.

A fundamental bottleneck in our system is the assumption that healthcare is performed by clinicians face-to-face in a facility, in short bursts centered around specific problems. Telemedicine has given many physicians their first glimpse into patients’ lives, bringing back virtually the lost art of the home visit; in giving doctors a sense of patients’ level of family support and home safety, video visits transform the medical history into a richer picture of the whole person.The pandemic has also highlighted ways in which the lack of exam data hinders telemedicine. Empowering patients to self-care, and encouraging self-monitoring and remote monitoring as a lifelong process, shifts healthcare toward a partnership between clinician and patient, while creating new potential for population-health management.

The implications of continuous, real-time data for patients are profound.Understanding a patient’s baseline metrics could allow us to diagnose diseases better, track trends, monitor costs unobtrusively over time, and even personalize therapeutics. Today’s procedural treatments—in which patients are instructed to follow a generic set of rules—will be replaced by declarative treatments, in which intended outcomes are specified and the system dynamically adjusts to achieve them. Medications and monitoring devices will be inextricably linked; treatments will be more holistic and fluid. Wearable technology and mobile phones have introduced the idea already; however, the additional data will be daunting to many physicians unless AI and machine-learning algorithms can support its adoption.

As research and development continues, it will be critical to foster collaboration between stakeholders so physicians and health systems alike will be supportive of our solutions. Our guiding principle should be investing in technology solutions and building partnerships that will strengthen our ability to improve population health and change the social determinants of health, so we can build a healthcare system that works for everyone.