AAMI keynote: Converging technologies make for exponential advances
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CHARLOTTE, N.C.—Healthcare technologies are not just getting more sophisticated. As multiple areas of research, innovation and data management rise and converge, they’re leading toward exponential advances too—advances that will challenge even the most tech-savvy healthcare technology managers to keep up. That was the crux of the June 2 welcome address and keynote session at the 2012 annual conference of AAMI, the Association for the Advancement of Medical Instrumentation.

The bearer of the message, Daniel Kraft, MD, MBA, head of two healthcare technology companies and chair of the medical track at Singularity University in Silicon Valley, began his entertaining yet enlightening presentation by telling the audience how he came to meet a lady named Harriet with whom he shares an extremely rare type of mitochondrial DNA—Haplotype K1a1b1a: The two were introduced by one of the founders of 23andMe, the Mountain View, Calif., company whose personal genome test kit Time named invention of the year in 2008.

“We actually share the same DNA with Otzi the Iceman, so meet Ozzie and Harriet and me,” he said. “And of course we started a Facebook group, and you’re all welcome to join.” There was more and, when he finished with the fun stuff, Kraft answered his own question as to what he was getting at.

“The way I met Harriet is actually an example of how leveraging cross-disciplinary, exponentially growing technologies is affecting the future of health and wellness,” he said, “from low-cost gene analysis to the ability to do powerful bio-informatics to the connection of the internet and social networking.”

Kraft asserted that people trying to solve problems often think linearly and used a colorful slide to illustrate the potential of thinking exponentially. "If you had a lily pad and it just divided every single day, you would have a billion lily pads in a month,” he said, encouraging attendees to consider ways to leverage existing and developing healthcare technologies “to impact the future of our own health and of healthcare, and to address many of the major challenges that we have in healthcare today—from the exponential costs of the aging population to the way that we don’t use information very well, the fragmentation of care, and often the very difficult course of adoption of innovation.”

He pointed out that most healthcare dollars are spent over the course of the last 20 percent of people’s lives. “What if we could spend in a way to incentivize physicians and the healthcare system and ourselves to … [better] leverage technology?” he asked, then pulled out an iPhone and went through some of the ways it’s already being used in healthcare, showing slides of various applications and add-ons for diagnostics such as blood-glucose measurements for diabetics.

Kraft then ran through examples of how exponential technologies are building on one another to make healthcare “faster, smaller, cheaper and better. We’re moving to this integration of biomedicine, IT, wireless and mobile—the era of digital medicine. Even my stethoscope is now digital. And, of course, there’s an app for that!”

The handheld ultrasound may well supplant the stethoscope, he added, as the former are now at a price point where, “for about $5,000 instead of $100,000, I can have the power of a very powerful diagnostic device in my hand. And merging this with the advent of EMRs, making medical data available electronically, we can crowd source that data. And now I, as a physician, can access my patients’ data from wherever I am via my mobile device,” including data from radiologists reading studies on mobile devices of their own.

Kraft mentioned artificial intelligence (AI) that allowed IBM's Watson to win at Jeopardy, suggesting that the day may not be far behind when AI is used to replace physicians in making clinical decisions, and cited the growth of telehealth and its potential to make the need for actual doctor visits rare. (The latter point surely rang a bell for some in the audience.)

He also described a device he invented for harvesting bone marrow with a single, locally anesthesized puncture and spoke about such other advances as cellular engineering of patients’ own stem cells for various treatments, including reconstructing and even building organs.

“We’re entering an era of miniaturization, decentralization and personalization,” he said. “And by pulling these things together, if we can understand how to leverage these, we’re going to empower the patient, enable the doctor, enhance wellness and begin to cure the well before they get sick. … As a cancer doctor, I’m looking forward to being out of a job.”

Following the talk, Healthcare Technology Management asked Kraft how healthcare providers best avoid walking into early-obsolescence situations when it comes to acquiring new technologies in an era of exponential innovation.

“A lot of people buy these big, expensive legacy systems and the technology is moving so quickly that, sometimes, a smart way to go is with modularity that allows you to swap out things,” he replied. “One example is telepresent robots. Some of them cost $20,000 or $30,000. The head of our faculty at Singularity University, Dr. Dan Barry, is an astronaut, physician and roboticist. Last summer, a team of his students built, with $2,000 worth of electronics parts, the same kind of robot that would drive on your G4 mobile phone. And all those parts can be swapped out as better pieces come along to replace them. So a theme for quick-moving technologies is to build systems that allow you to swap parts out and don’t take 20 years to pay for themselves.”

What healthcare discipline should drive the acquisition committee’s “future-watch” duties? Someone who has the capacity to figure out how fast things are moving in the particular category of technology under review “so you don’t buy yesterday’s technology but, instead, buy a product that can grow,” answered Kraft. “If it’s a new EMR, for example, make sure it has space for the full genome to be slotted in. Or it may have a module where an IBM Watson could slot in for AI capabilities. These are trends that are going to merge. I’m sure there are regulatory hurdles for some of them, but you want to be building the hospital system of 2020, not the one you know everything about from 2010.”