His recently published book Hacking Healthcare: How AI and the Intelligence Revolution Will Reboot an Ailing System is a memoir of how technology helped mitigate the COVID-19 pandemic and a guide on building next-generation Intelligent Health Systems.
Tom, let’s start with a no-frills question which is also a subtitle of your latest book: How will AI and the Intelligence Revolution reboot an ailing healthcare system?
A lot has changed since I published my last book AI in Health, over two years ago. The keyword is COVID-19. Already before the pandemic, we saw how AI could be used to change the way we provide health and medical services and empower clinicians and consumers so that they can take control of what’s important to them.
The coronavirus crisis has given us a solid nudge to make greater use of Artificial Intelligence to analyze data we already have. For example, AI was applied to fast forward the development of the COVID-19 vaccine.
Or look at consumers who are taking more control of their own health by downloading and using smart apps. Now, the momentum that the pandemic has created is not going to stop. Innovative health and clinical leaders are looking at how to take what we’ve learned and apply it to solve other big problems in healthcare.
When traditional health systems were focused on fighting COVID-19, consumers—often left alone with their conditions—started to learn how to take control of managing their own health and well-being. This genie can’t be put back in the bottle. Now we have to look back on what we learned and then start applying it to make the transformation in healthcare go even faster.
You call for building “intelligent health systems” or “systems of health” based on new approaches to overcome the “old-age” challenges. What makes them different from traditional health systems?
Prior to COVID-19, there was already considerable interest in the uptake of AI in healthcare. But AI was still what I call a shiny object in healthcare: a trend, the next big thing, something everyone was talking about and writing about. But what was actually being done? Not much.
The pandemic showed us that we can’t continue like that. Today every health system in the world, at least in developed countries, is trying to leverage the power of AI.
Nevertheless, traditional health systems are making use of AI mainly to improve existing processes. They ask questions on how to make workflows more efficient, use fewer resources or reduce treatment time. Intelligent health systems are using AI not just to improve existing processes but actually to rethink the entire health delivery model.
They’re aiming to evaluate how to make health services more efficient across all touchpoints, channels, and experiences. They are looking at how to better support health consumers and empower clinicians, doctors, and nurses to get them out of the box that we’ve often put them in.
With AI, we will build a new super highway in healthcare, paving over the old structure that existed for over 100 years. Intelligent health gives us the ability to rethink everything from the efficiency of services needed when you’re sick to, more importantly, improve the experience and keep people healthy.
Do you think we are already fit for this revolutionary transformation toward intelligent health systems? I remember an article in the New York Times titled Why doctors hate their computers I read a few years ago. Many healthcare workers are still frustrated about computers and afraid of AI…
The proper use of AI is going to empower clinicians to become better—better at things they care about. When you break down physicians’ frustration, you will find they are using very old-school technology, especially Electronic Health Records (EHR).
The research shows that a doctor in the United States spends more time interacting with the EHR than with a patient. Many of them feel like we’ve turned them into data entry clerks. They didn’t study medicine to end up like this.
AI has the ability to decrease highly repetitive, low-value activities that chew up to a third of physicians’ time. Imagine giving clinicians back a third more time to see patients, do research, or even get home for dinner with family. That’s the promise of AI. And there’s a lot of good data that shows that AI actually can deliver on that promise.
The driving value within AI is less about the technology and much more about what I call the leadership imperative. As great as the clinician may be, they’re still humans—they’re always going to pull back and say, “what does this mean to me in my practice?”
Leaders from health organizations have the ability to help educate clinicians on what AI is in order to have their hands on the steering wheel. Introducing AI in healthcare is not about turning physicians into data scientists. It’s about understanding AI’s capabilities to make physicians’ work more precise and safer. Good leadership has the power to explain the actual value of AI and get rid of prejudices.
In your previous book AI in Health: A Leader’s Guide to Winning in the New Age of Intelligent Health Systems, published in February 2020, just before the global outbreak of the coronavirus pandemic, you also describe the transformative power of AI and the cloud in healthcare. So why should the readers read your new book?
My first book was a primer on AI and its use in healthcare. The second book broadens the lens of what’s happening in healthcare today and looks at how AI can help with the transformation everyone’s talking about.
When the pandemic hit, we experienced several things at a macro level. First, we learned what economists and public health experts had known all along: When people and populations are healthy, everything works. When they are not, we come face-to-face with how the lack of health affects everything from the economy to our own sense of security and family safety.
The first chapter of my book is titled We Interrupt this Pandemic to Bring You Some Good News. The good news is that health systems known historically to move at glacial speed can, in fact, move at warp speed when there’s a big challenge. And we’ve learned that some clinical and health leaders are capable of leading this agile transformation.
It’s really the people that led and won the battle against the pandemic. But when you look closely, you will see it was possible because of the tools and the weapons they chose. So I decided to wrap all the observations up in the new book. You will learn how AI can be applied to manage chronic conditions and mental health, boost clinical research, improve access to care and empower consumers. I deliver many examples to make you realize how the shift towards AI-driven healthcare has been accelerated over the last 2.5 years.
In 21 chapters, I describe less the technology and more the transformation processes that stem from social and cultural changes. You will also read about the impact of AI on healthcare in the future. AI will change every aspect of the economy; our lives will be very different 20 years from now. However, we will likely see healthcare as the industry most transformed by AI.
Now is the time for all of us—not just geeky people like me—but all of the health professionals and the health consumers to ask the question: How will we take what everyone has been talking about for decades about health reform and health transformation, and then use the last two and a half years and the momentum we’ve built up to actually bring about change?
The question is indeed legitimate. But do you have an answer?
With technology in hand, we’re empowering many people who previously felt less empowered. Let’s take the example of telemedicine and telehealth and how it was used in the last two and a half years. If you look in the clinical literature, you will find that for 30 years, we had evidence that shows telemedicine works.
Imagine how much waste is there when someone has to drive or take a train to get to the hospital, then find a place to park the car, register, wait for hours in the waiting room just to see the doctor for a few minutes, and get the prescription. We knew such an approach was not right. But we continued to do so. Then came the pandemic, and it demonstrated how inefficient that is.
Today we have even better tools like AI that can augment—not replace—the capabilities of a doctor and genuinely personalize medicine. As Forbes wrote in May 2022, tomorrow’s generation will demand something different from healthcare. We can deliver the Boomers or Gen Z what they expect by applying new technologies. Look at the millennials; they want to have conducted a medical consult from the same place they order dinner – their couch.
If traditional health systems don’t become intelligent, the market will prevail. It means people demand that their health plans provide good healthcare and new experience. And this is where AI can step in.
Why did the National Director of AI for Health & Life Sciences at Microsoft write a book about healthcare?
In my current role at Microsoft, I have the privilege of serving as an advisor to some of the largest health and medical organizations in America. Prior to the role, I did the same thing as Director of Worldwide Health with a focus on Western Europe and the Asia Pacific.
My best learning comes from working with people on the front lines trying to solve big problems and from our ability to bring in artificial intelligence and data to do so.
My motive is straightforward. I and many others believe healthcare is a very noble industry. At the same time, it’s one of the most challenged industries in the world. And it has an impact on every one of us. Some problems must be addressed urgently. How can we keep people healthy? How do we improve the quality of care? How do we improve access to healthcare services for all people, also in undeveloped countries?
AI gives us many new tools. The amount of data we have in the world to apply is growing almost exponentially. In what I call the intelligent cloud, AI can speed up big data analysis for research or health-related purposes.
We can’t count on anymore only on politicians to improve healthcare. Instead, I believe change will come from those on the front lines who have better tools and ways of taking control of what they care about.
AI can do great things. But AI can also do bad things—just to mention risks associated with black boxes or ethical challenges. So if AI is here to reboot health systems, AI must be safe.
It’s a great point: AI has the power to do good things, but it depends on how we shape and use AI. That is one of the reasons why there is a vast and growing area at Microsoft that we call responsible AI.
We must realize that, in the real world, there are many biases when it comes to healthcare delivery. Healthcare is uneven and inequitable. The challenge is ensuring that those biases and inequities in the real world don’t cross over to the digital world through algorithms. In healthcare, we must do everything to avoid uneven results or harm.
In the last chapter, you claim that in the future, healthcare will not be what it used to be. So what should it be like?
The pandemic demonstrated that we already have the ability to do things better—for example, telehealth. We can deliver health services to older people straight to their homes and improve their lives. With the increasing lifespan, we should also increase the health span so everybody can live not only longer but also in better health. And if AI is an enabler here, why not apply it?
Another challenge is the shortage of health professionals, especially when we consider the increasing longevity I mentioned before. We won’t have enough clinicians and nurses, so we have to find a way to improve their efficiency. Also, here AI can help.
I believe AI can help us solve many more problems. Of course, it’s just a tool. But if it’s utilized in the right way, the value will come. However, this shift needs leaders to drive this change.
BOOK REVIEW: Hacking Healthcare: How Ai and the Intelligence Revolution Will Reboot an Ailing System / Tom Lawry
The book by Tom Lawry takes us on an inspiring—but also somewhat unrealistic—journey to the future of healthcare.
Tom Lawry takes an in-depth look at the flaws in the healthcare sector and provides examples of how AI can correct them while envisioning a transformation from old-fashioned “healthcare systems” toward “systems of health” driven by digitalization and data analytics. The such created narrative he frames within the COVID-19 pandemic, a crisis that requires a rethinking of the current health delivery paradigm.
The 21 chapters address the well-known concepts of moving from reactive to proactive healthcare, intelligent aging, retail health, digital-first approach, care anywhere or personalized medicine. However, for this to happen, AI or Intelligent Cloud is not enough—AI-driven leadership, digital literacy of healthcare professionals and patients and an ethical approach to AI algorithms development are actually more critical.
Tom refers here to Microsoft’s Responsible AI Principles. He concludes his book with an overview of AI’s latest trends that can impact the future of healthcare: precision medicine, metaverse, quantum computing, augmented/virtual reality and emotional and conversational AI.
While reading, it is easy to recognize that Tom served in various executive management roles in hospitals and as Director of Worldwide Health. It helps him to move seamlessly between the topics of healthcare, medicine and technology. As a reasonable observer, he detects broken elements of health systems and suggests corresponding solutions delivered by AI.
On top of that, the book is engaging also because it’s just well researched and composed.
However, this rollercoaster through the medicine of the future can leave the reader dizzy. What is often missing are details on how to solve some of the challenges facing AI, such as equal access to the technology, trust or even reimbursement for AI-based solutions. IBM Watson has failed in healthcare because of, among other things, misunderstandings in the collaboration between humans and AI.
Tom portrays AI as a superhero that can solve any healthcare problem. Of course, we would all like this to be true, but in reality, it is too good to be true anytime soon.
Nonetheless, this is a book you should read to learn about the enormous opportunities that AI creates in healthcare. Like Tom, I am convinced that AI will have a major impact on medicine. Apparently, however, he is more optimistic than I am.
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