Hospitals are on their way to getting transformed. Hospitals will now have new access, and interaction paradigms at the outset and way better quality and reliability in the methods of diagnosis and treatment. It will be a powerful combination of experienced doctors and expert systems. The central piece of visiting a hospital is consultation and counselling with the doctor. Here is where the biggest paradigm shift is happening. Just as the illness doesn\'t take an appointment, care shouldn\'t ask for one. The Internet has shown us, in industry after industry, how distance and time boundaries can be completely removed. We can aggregate the availability in a powerful way to make on-demand access to the doctor a reality. We can completely get rid of the entire ordeal of appointments, travelling and waiting. This is just not an urban convenience use case, on-demand is the natural way to deliver care for millions of urban and rural populations.
Recently, we had the opportunity to listen to a very senior paediatrician in Bangalore, India talk about the kind of technologies which will empower clinicians. It was inspiring to see an expert with such a vast experience talk about technology that's needed to make his diagnosis more objective and to improve patient care. We were able to discuss and conceive very concrete solutions in the space of respiratory medicine with his inputs and the studies he has done for several years. For example, a combination of sound and image processing can decisively make respiratory disease detection, management, and treatment very simple, standard and scalable. It will avoid millions of unnecessary hospitalisations and save tens of thousands of lives. It takes great humility and a bold vision of the future for as successful a doctor as him to think about how to make medical judgments more objective, data-driven, and scalable. Being continuously in touch with doctors and hospitals as part of our venture, we have been fortunate enough to have met not just one but many such doctors in the last two years.
The vision of a new-age healthcare delivery is emerging very clearly in discussions with many such very respectable and accomplished doctors. We will probably still call that a hospital. However, it will be completely transformed and will have new access, and interaction paradigms at the outset and way better quality and reliability in the methods of diagnosis and treatment. It will be a powerful combination of experienced doctors and expert systems.
A lot of data can now flow from personal devices. There are, of course, often used examples of watches, wristbands etc. But we see a future where the dozen odd sensors in your phone, the camera and the microphone, combined with algorithms that process and learn from those data signals—are just enough to get to a diagnosis with a high degree of accuracy. There it is, the first step of the process that happens in any hospital today, vitals collection, moved and brought into one's own hand, literally. Mobile tech has made computer interaction less esoteric and more humane. Chat/Video, data tagging, note taking, document sharing is all now made so easy, simple, intuitive both for the doctors and users. You have to show a rash to the doctor? High definition images that you can tag and add notes along, is now possible, without any training requirements for the sender or the receiver. Machine learning is applied to auto-tag suspected cause of that rash by the time doctor looks at it and proceeds to confirm.
The central piece of visiting a hospital is consultation and counselling with the doctor. Here is where the biggest paradigm shift is happening. Just as the illness doesn't take an appointment, care shouldn't ask for one. We can aggregate the availability in a powerful way to make on-demand access to the doctor a reality. We can completely get rid of the entire ordeal of appointments, traveling and waiting. This is just not an urban convenience use case, on-demand is the natural way to deliver care for millions of urban and rural populations.
It's quite possible to do this with technology that aggregates doctors' availability and makes their time more efficient and effective. Ironically enough, removal of current appointment system can actually bring more predictability into the entire hospital visit process. A real-time triaging can actually determine who needs a physical examination, who needs doctor consultation, whose case is a simple follow-up, whose is a regular check-up etc. Knowing this and routing appropriately makes the entire process seamless, bringing in new levels of consumer experience and doctor efficiency. Thorough triaging (increasingly by machine, as the algorithms are becoming sophisticated) will happen for every case so that time of the patients and the doctors are effectively used. The end result being on-demand healthcare experience for the patient and massive improvement of reach and efficiency of doctors.
There is really no better alternative to carrying your health records in your hand. Consumers need to have access and portability from one hospital to another, one doctor to another. Without solving for consumer ownership and portability, EHR solutions cannot give any meaningful impact to people or providers. In the past, the problem was that, consumers never had so much storage capacity and analysis software in their control until the smartphone era. But now, it makes so much more sense that you just keep all your records in your personal storage—on the cloud and on the phone—and never lose it. You have the ownership and ability to authorise doctors to see the records as required.
We asked a hospital owner, who is also a doctor, a few simple questions:
• How do we build a high-quality hospital?
The answer came almost instantly, "We just have to build it at the right place and get some good doctors.”
• So, how do you make good doctors come to you beyond monetary incentives?
The answer this time pretty soon shifted to tertiary care. We were told that equipment, latest and great tech in both diagnostics and procedure equipment, etc. will be the deal breaker.
Most such conversations are similar. Primary and secondary care, which is the first point of contact for the patient with the doctors, is almost never, top of mind. The future will be different, though. More and more decision support, thorough data collection and evidencebased medicine are all becoming important aspects of the doctors' job. A good doctor can become a great one with these decision support systems. High levels of quality can be achieved in replicable and scalable ways with the combination of Super Doctors and Assistive Intelligence of the machines. Particularly in primary and secondary care—which are so much about early detection, prevention, management of the health and disease—quality will become objective and measurable. Things such as usage of antibiotics to prescriptions of diagnostics tests etc., can all be standardised, and the protocols can be codified to make operations transparent for the user and effective for the doctor.
Hospitals of the future will be equally present in virtual and physical channels. Care will be continuous across points of access and more and more tools and data will be handed over to patients to be able to manage their health and connect to doctor wherever and whenever needed.
Hospitals that we talk to are realising that the business model of building a large facility somewhere and waiting for patients to be extremely sick needing tertiary care is less relevant for the future. There is more meaningful opportunity and scalability to managing consumers health rather than sickness. Big x00 bedded hospitals are needed but they will be much more efficiently managed with no utilisation pressure. The hospital of the future will shift to offer healthcare as an Over-The-Air-Service and have a stake in keeping their subscribers healthy rather than just wait for their sickness and react with treatment.
