10 Global trends impacting medical care and what ASCs can do about it
1) 90% of world’s data was generated in the last 2+ years. Vast portions of future data will constitute medical data generated through imaging studies, macro (lab tests, EHR, vitals, activity, diet etc.) and micro (genomic, microbiome, proteomic, other biomarkers) data. Additionally, medical knowledge is doubling every five years.
2) Whenever a field becomes more digital, it makes physical co-location redundant – examples, Amazon Kindle, ATMs, digital music, movies, phones and so on. Other high risk industries (e.g. flying a plane) rely largely on data algorithms with people controlling them.
3) DNA testing has dropped to sub $1,000 levels. 23andMe sequences a third of the genome for $100 (though they have stopped offering health related genetic reports after the FDA sent them a letter). It is expected that DNA testing will drop to pennies and doctors will routinely prescribe it. Separately, 1 million gene expression data sets are available as publicly accessible repositories.
4) Every 50 years, there’s a revolutionary change in healthcare – germ theory to advances in medication. It is expected that the biggest change now is that medicine will become a data science.
5) Several medical devices are increasingly Internet-enabled – e.g. GE’s V-scan ‘shows’ the heart instead of a stethoscope, Scanadu’s upcoming Scout measures a variety of vital signs remotely.
6) Autonomous vehicles (drones) are expected to deliver drugs and other goods remotely (see Matternet). It’s possible to build a basic quadcopter with a camera for $100-200.
7) Patients are increasingly quantifying themselves and comparing their data with others. Example Crohnology is a social network for Crohn’s Disease patients.
8) Artificial Intelligence is becoming a reality. IBM’s Watson has been training itself at Kettering Cancer Institute. IBM has made Watson available as an API that can be used by other applications. AI-based Google car (I sat in the first version in 2012) actually works quite well!
9) Most patients will have access to an Internet-enabled smart phone or tablet device and it’ll connect from everywhere. Patients will possibly even ‘wear’ a computing device.
10) Most doctors are performing some form of data-enabled, evidence-based medicine (e.g. boom in lab tests) instead of practicing on gut-feel.
Questions to consider for ambulatory surgery centers
1) Could ambulatory surgery centers expand the ownership of the medical problem from episodic care to the source of the medical problem? For e.g. ASCs focusing on screening for colon cancer can go upstream and identify why its patients are getting colon cancer.
2) Through the aid of EHR data and virtual care, can consults pre-and-post surgery be done remotely? Could new patients be screened virtually, thereby expanding outreach by 10x or more? Outside of the insurance reimbursement model, are there other ways to monetize this? (See American Well that partners with insurances).
3) What would an ASC’s impact on its area of care be if it were to collect and document data from its expanded virtual care model?
4) What would an ongoing multi-variant analysis from different sources with abnormalities reveal for the ASC’s patient population?
5) What role do bio/ genetic markers play in the ASC’s medical area of question? Example, for eye care.
6) Is there a correlation between location and the types of patients seen at the surgery center?
7) What insights could an ASC gain if a large portion of its patients were connected to each other online?
8) What if the EHR was implemented for delivery of healthcare itself in the future and not just as a means of digital storage and quality control?