The cynics amongst us will perhaps agree that giving certain politicians and certain business people purporting to be philanthropists free rein with large amounts of grant money is fraught with peril. The latest shiny object tends to catch their eye, and vast funds tend to be wasted chasing pipe dreams rather than practical projects.
Nowhere is this more common than when it comes to technology, and digital health is a prime example of fields full of broken dreams. Added up, there has been a colossal amount of money floating around out there for digital health start-ups, scale-ups, projects and programs over at least the last 20 years, accompanied by bucketloads of hype and tripe.
So it is with not a little cynicism that we saw the announcement this week of yet another digital health “challenge”, this one from the WA government to help improve the delivery of healthcare in the Pilbara, supported by its mining royalty boosted Future Health Research and Innovation Fund and a couple of mining companies themselves.
What made us notice this one though is its emphasis on embedding the proposed projects in the actual community they are meant to help, and providing a good bit of cash to get out there and prove that the technology actually works before showering the winner with prize money. And the projects themselves are a good mixture of the usual pie in the sky, proven technology taken to new settings, and the practical testing of new ideas in the field.
Our eye was certainly taken by a silver bauble in Telstra Health’s proposal to use digital twin technology to develop a “synthetic” chronic disease registry by mapping the physical environment, healthcare needs and cultural sensitivities of a distinct population. This is a great application for healthcare of digital twins, which IBM defines as “a virtual representation of an object or system that spans its lifecycle, is updated from real-time data, and uses simulation, machine learning and reasoning to help decision making”.
We are also keen on projects that use existing technology to do new things. Perth’s South Metropolitan Health Service has worked with the CSIRO for quite a few years on an app to share clinical photos, particularly wound and scar photos for the Fiona Stanley Hospital burns service. This existing technology, built on the FHIR standard, is going to be further developed to share medical records and photos in the Pilbara and use “digital yarning” to make it more culturally relevant and appropriate.
There’s also some great stuff with an AI-powered retinal camera, smart glasses that Aboriginal health workers can use with a patient while being fed by expert knowledge from medical specialists, and the Pilbara’s own Lyfe Languages app, which translates medical terminology into Indigenous languages used in the region.
These are all really sound projects, most with a defined need and a ready market, that are likely to do some real good. This, unfortunately, is not overly common in Australia, where we have been waiting in vain for the promised digital health revolution that will disrupt healthcare forever. The industry is saturated with start-up incubators that promise the world but tend to instead just replicate existing trials and projects. It’s all apps looking for a market rather than a market looking for an app.
We’ve been covering health IT for 15 years and we have seen every pitch that can be imagined, every thought leader wanting to disrupt healthcare and every shonk looking for publicity and a government grant out there. While there’s a role for blue-sky thinking, all too often it’s just pie in the sky.
Which conveniently brings us to AI. Following a call for a pause on using consumer-grade applications of AI and an argument that Australia needs to develop a national strategy for AI in healthcare, we asked readers last week if they agreed. An overwhelming number said yes: 92 per cent were in the affirmative. What was interesting was when we asked who then should develop it? Turns out it’s not academia or even industry that our readers want put in charge, but good old government. Here’s what you said.
Not going for academic groups may have less to do with the current, Trumpist-inspired trend of rejecting expertise and more to do with the time it takes the academy to get things done. Developments in AI are moving so fast that there’s a danger it will swamp all of us, including the very experts who have been calling for scrutiny for quite a few years now.
So in the spirit of indulging our cynicism, we thought we’d throw this question out there again:
Is the disruption of healthcare through IT overhyped?
Vote here or leave your comments below.
It’s the wrong question. The transformative effect of AI is not overhyped, the disruption is also a necessary phase so that radically new ways of working can emerge but it is under hyped because it hasn’t really happened yet.
The software industry overwhelmingly supports and exploits organisational and technological immature healthcare providers through ‘innovative’ ideas that are essentially a different flavour of what already exists – but it is profitable.
Innovation in health technology such as medical imaging and biotech devices are innovative, but not disruptive. AI promises to be a disruptor but fears of control will likely hold it back. Ultimately healthcare is a people industry supported by tech. Changing this will be the ultimate disruption…
Let us hope they use the knowledge of how to do to from those who have trodden this path before.o Verma N, Mamlin B, Flowers J, Acharya S, Labrique A, Cullen T. OpenMRS as a global good: Impact, opportunities, challenges, and lessons learned from fifteen years of implementation. Int J Med Inform. 2021 May;149:104405. doi: 10.1016/j.ijmedinf.2021.104405. Epub 2021 Feb 5. PMID: 33639327.
o Ebola epidemic: Oza S, Jazayeri D, Teich JM, Ball E, Nankubuge PA, Rwebembera J, Wing K, Sesay AA, Kanter AS, Ramos GD, Walton D, Cummings R, Checchi F, Fraser HS. Development and Deployment of the OpenMRS-Ebola Electronic Health Record System for an Ebola Treatment Center in Sierra Leone. J Med Internet Res. 2017 Aug 21;19(8):e294. doi: 10.2196/jmir.7881. PMID: 28827211; PMCID: PMC5583502.
o COVID Epidemic. Mamlin BW, Shivers JE, Glober NK, Dick JJ. OpenMRS as an emergency EMR-How we used a global good to create an emergency EMR in a week. Int J Med Inform. 2021;149:104433. doi:10.1016/j.ijmedinf.2021.104433
So, is the disruption of healthcare through IT overhyped? Two-thirds of readers said yes. We also asked: If you vote yes, are you too cynical? If you say no, give us some examples of real disruption. Here’s what you said:
– We need more and we need people to learn how to use the information, AND analyse data to improve thier own service delivery AND share info with patients!!
– companies that have something to sell us want us to believe that disruption is there abd wonderful. But clinical care is person to person that can be assisted by technology. And the on line asynchronous prescribing services are improper, now out of order with the MDOs abd the MBA.
– When HealthLink is down am unable to submit patients’ drivers licence medicals-time consuming and worrying for patients
– Although there are awe-inspiring AI apps out there, until vendors make there EPRs open and allow interoperability without charging NDIS rates then it will remain hype
– Yes. New players in GP market, virtual ED’s, virtual hospital, pharmacy online ordering and distribution, AI in radiology
– The hype has been going on for decades with little being delivered. Unless you are talking about real technology in the areas of testing and medicine. But that’s called biomedical engineering.
– nothing seems to happen – just same old clunky stuff
– No, being realistic. Most IT products will seek to solve focused problem areas only while scope of healthcare is wide and deep. We will still have retain a lot of existing problems as too hard for a quick IT fix. Plus, will gain a bunch of new problems that arise from disruption technologies as well.
– While no one can argue the value of AI, it is just the latest disruptor, and one that needs to be critically appraised.
At a pragmatic level Healthcare has severe resource constraints and IT will not address this. Healthcare is a people business. It’s an end-to-end problem. It’s not politically palatable to fix the tribalism that is in place as politicians don’t take responsibility and like to blame others when the system fails. For a long-time, health has been under funded federally and at a State-level and its convenient to blame the health system when more money is required as you are unlikely to receive too many community complaints. The growing gap payments at a GP and particularly specialist level continues to entrench a two-tier system (those with money and those without) irrespective of where they live. If this is being cynical, so be it, but the facts speak for themselves. Can IT fix these and are the so-called benefits translating into an overall system improvement?
– I have worked in healthcare technology for decades and believe that the big gains have been with biotech with more mundane improvements in administrative applications, such as an EMR. AI driven tech promises to truly disrupt the industry, especially when it outperforms diagnosis by doctors – but will the industry and patients trust it? We are at a true watershed moment, but the ‘bread-and-butter’ admin systems will hold us back – this is where true disruption can occur quickly.