We are at a defining moment in human history where science and technology offer an opportunity to usher in a new generation of health care; one where machine assists with the technical and cognitive work while man reinvests in the humanistic dimension of care. When humanity is able to effectively strike this delicate balance between man and machine in the delivery of health care we will finally be able to care for populations in ways that meaningfully impact global health and wellbeing.
Growth in the Science of Medicine
Humanity has made great strides in medical knowledge in the last 25 years. In fact, medical knowledge is growing faster than our ability to assimilate and apply what we know. The science of medicine is actually outpacing our ability to take advantage of it! According to one study, by the year 2020 medical knowledge will double every 73 days.
Doubling Time of Medical Knowledge:
1950: 50 years
1980: 7 years
2010: 3.5 years
2020: 0.2 years (73 days)
Students who began medical school in the autumn of 2010 will experience approximately three doublings in knowledge by the time they complete the minimum length of training needed to practice medicine. Students who graduate in 2020 will experience four doublings in knowledge. This means that the first 3 years of medical school will cover just 6% of what is known at the end of the decade from 2010 to 2020. (source)
Meanwhile, a rise in the availability and affordability of medical devices is opening a new world of biometric data and remote patient monitoring. One report estimates that 3 million patients worldwide are already connected to some form of remote monitoring, and this number is projected to top 19 million by 2018. Another report estimated that 17 million wearable devices shipped in 2013 and by 2020 this number is projected to grow to 187.2 million units annually. As technology becomes more ubiquitous and capable of studying the physical world, science also offers a supply of real time data to inform disease management and prevention.
So how do we take advantage of this great progress in science rather than being buried by it? At this rate we will never be able to spend enough time educating to keep up with the growth of medical knowledge. Adding more years of high cost education isn’t a feasible answer. Nor will clinicians be able to take the time to understand the data generated by every biometric sensor. But this gap between the science of medicine and art of medicine must be closed; else we plateau and miss our opportunity to capitalize on the advancements science is offering. We need an assist, and machine may be here to help.
Decline in the Art of Medicine
While the science of medicine is booming, the art of it is suffering. Clinicians are marginalized and paralyzed by an economic and regulatory environment that emphasizes quantity over quality; spending less time with more patients and doing more data entry than patient education. Patient churn and administrative responsibilities are leaving little time for the art of medicine, obstructing humanity’s ability to actually prevent and manage disease.
Today’s primary care visits are scheduled at 15-minute intervals, and some doctors report being asked to see a new patient every 11 minutes. But not only are visits abrupt, research also shows clinicians are struggling to listen in this environment. A University of South Carolina study in 2001 found that primary care patients were interrupted after just 12 seconds, if not by the provider, then by a beeper or a knock on the door.
This tension is leaving patients unsatisfied and clinicians burnt out. Having to do an equal or greater amount of work in less time occurs on a backdrop of steadily increasing medical complexity; leading to increasing multi-morbidity and prevalence of chronic disease among populations. In response, one study from 2014 indicated that 54% of physicians in the U.S. reported at least one symptom of burnout – a 9% increase from three years prior. The order is getting taller for providers, but the desire and resources to fulfill it are waning.
Health care’s greatest asset is still the professional who is skilled in and passionate about caring for people, but that asset is overtaxed and ineffectively utilized. The secret sauce of medicine rests in the time of the provider who can invest in the humanistic dimension of care – doing things like listening, discerning, caring, and coaching. Yet these skills have been pushed to the fringes of health care, and with it has gone our ability to keep people happy, healthy, and productive.
Rebalancing the Art and Science
At this crossroads we see that man cannot keep up with science, yet science cannot supplant man. Providers need an assist from technology to do more, for more, while technology needs an assist from providers to be more. We believe that by using science and technology to drive efficiencies in the busywork of medicine, and helping apply the exponentially growing universe of medical knowledge and data, clinicians will be positioned to maximize their ability to meaningfully impact lives.
At Intellivisit we believe the most effective care happens when local clinicians are equipped with the best technology and science, yet are still able to maintain the personality that makes their practice special. We close the gap between the art and science of medicine by employing smart systems at every turn to assist with the technical and cognitive work of medicine so that providers can reinvest in the humanistic dimension of care.
For example, our platform employs an artificial intelligence-powered interview that dynamically assesses patients. This component of our smart system ingests device data, medical history, and patient inputs to formulate a thorough and personalized questionnaire, powered by the latest in medical knowledge and big data capabilities. Upon conclusion of the smart assessment, a clinician then steps in to review the information, consider the person’s context, and craft a personalized treatment plan – whether that be an immediate diagnosis or additional information gathering. As the artificial intelligence assists with the information gathering process, the clinician spends more time thinking about the person’s overall health as opposed to treating a single episode through which they must rush.
People are the heart of health care. But, people are more complex than a billable event, an RVU, or a single diagnosis. Machine will never be able to replace the art, empathy, and discernment of the human to human interaction. But it can help the human make the most of what science has to offer, and that’s exactly what we’re doing at Intellivisit.