Sean Kennedy, Salesforce director of health care and life sciences solution architecture, started off the 2018 Dreamforce panel on “Emerging Technologies in Health Care and Life Sciences" by describing an article about a chain of restaurants. The article examined how the chain has been able to scale quality across all of its restaurants, and determined that part of the reason was an approach based on defining outcome, not process: The chain's standards manual specifies how the final dish is supposed to look and taste but leaves it up to the individual chefs what the best way to achieve that is.
The article was written by Atul Gowande, a surgeon and public-health researcher, who was wondering how to do the same thing with health care—how to deliver consistent quality at scale. On a Freakonomics podcast, Gowande said that given the complexity of the task, it would be “the most ambitious thing humans have ever attempted."
Digital tools will be part of that effort, said Joshua Newman, Salesforce chief medical officer. “Health care is going to get disrupted," he said, the same way other industries have been. Emerging technology such as artificial intelligence (AI), connected monitoring devices and blockchain will help move us toward an “always-on health care system," he continued. All these technologies are in use, some even in health care, but they haven't been scaled yet.
Adam Asare, chief data officer at QuantumLeap Healthcare Collaborative, said his firm is using these kinds of tools to “give every breast cancer patient the best chance at survival." The top 10 cancer treatment drugs prove to help between 1 in 25 to 1 in 4 people, he said, and clinical trials tend to use a “frequentist" analytical approach to focus on average results across the whole patient population. Asare's firm is moving toward a more personalized “Bayesian" model and has sponsored the I-SPY 2 clinical trial method in an attempt to improve outcomes.
—Joshua Newman, chief medical officer, Salesforce
I-SPY 2 uses artificial intelligence in an adaptive learning cycle to improve the likelihood of positive outcomes. When a new patient enters the trial, they are given a drug or combination of drugs according to the subtype of their cancer and the probable performance of each drug on that subtype. The outcome is monitored and the probabilities updated and applied to the next patient.
Advice for the Future
Bola Rotibi, founder and research director of Creative Intellect Consulting, outlined five factors she sees driving transformation across the health care market:
- The need for speed and innovation
- Disruption from nontraditional competitors
- The mix of technologies and providers
- Increased focus on experience and reimagined processes
- Security in a changing threat landscape
She said that the health care industry is moving toward viewing the patient as a customer. Newman added that health care professionals aren't really trained in customer service, but that that is changing. The challenges in health care are similar to those in other industries, the two agreed: to put people (both customers and employees) at the center of the business and to reimagine processes. And like other industries, they said, health care organizations need a technology platform to support their customer-centric efforts.
To prepare for the future, Rotibi outlined eight foundations for technology investment:
- Usability, security, speed, performance and integration are paramount.
- Make it secure by design, no matter the application.
- The cloud speeds development and enables rapid scaling.
- User experience influences brand loyalty.
- Be smart with the development skillsets you have.
- Bridge the old and the new through APIs.
- Invest in the right processes, services and cross-platform capabilities.
- Engage with a supplier aligned to your needs with a strong partner ecosystem.