The Democratization of Healthcare

An interview with John Nosta -  innovator, philosopher and futurist who specializes in healthcare and technology. John is the founder of NOSTALAB - an amorphous, self-organizing neural network dedicated to the advancement of digital health. He is also the author of HEALTH CRITICAL in Forbes. We talk about Internet of Things, big data, democratization of health and the future of healthcare.

Health is becoming a more personal and self-directed endeavor where control is being replace with collaboration.

If you look at the healthcare today, what would you point out as the biggest problem?

I don’t think is smart to point the finger at one issue as leading issue or concern. The problem is multifactorial ranging from a system that entrenched in old habits to economic drivers that fail to support innovation.  And again, it’s a complex picture that is best examined by region or country. So, I’ll go out on a limb here and suggest that “passivity” is one of the biggest problems in healthcare. What I mean here is that patient and caregivers fail to take a more active role in both wellness and care - leaving the healthcare provider to make decisions. As we shift to a more “patient-empowered” dynamic, as in traditional consumer marketing, we will see new and powerful drivers address everything from costs to allocation of services.

What means for you "innovative healthcare"? What steps do we have to take to get closer to this idea?

For me, innovation is about seeking new solutions to an existing system. This is accomplished by a host of initiatives from questioning fundamental assumptions to looking for new perspectives from other industries and thinkers. For example, medicine can learn a lot from finance and the leisure industry. Part of the magic of the digital health movement is the multiple and varied voice that converge around a problem. The solutions are often unexpected and solve problems in unconventional ways.

Health start-ups, health apps, wearables, etc. Do these trends will influence healthcare market or it's just a short hype?

I certainly don’t think it is hype! But some of the products and innovations will certainly fail. But we are at the early part of an exponential curve that offers tremendous innovations in medicine. But let’s back up a bit. For many people, health is a destination - a place to go for an appointment or test. In a funny way, it’s almost disconnected from the objection under observation. And that’s you! Health is becoming a more personal and self-directed endeavor where control (usually left to the clinician) is being replace with collaboration. And it’s this collaborative care (the clinical, the mom, the caregiver, the individual working together) that will come to change the very nature of wellness and medical care.

One of the first touch points of this is the emerging ability establish “the quantified self” and step up to a higher sense of “observation and ownership” around your body. The role of the sensor - as in motion trackers and sleep evaluation - is only the beginning. Soon, wearable technology will expand to amazing abilities to sense the very earliest stages of life-threatening conditions (cancer, heart attach, stroke) and shift this detection earlier and earlier and earlier. What results is disease detection that actually shares a border with prevention. It’s not unrealistic to have nanotechnology “robots” constantly flowing through your body searching for the very first cancer cell and destroying it long before there any substantial growth or physical manifestation.

Sensors will no longer be an optional part of our lives as we see commonly in the gym or with the weekend warrior. They will evolve to become “essential partners” that act as a “check engine light” for your body and become a ubiquitous tool for adding both life to your years and years to your life.

But here’s a word of warning. Those sensors that are commonly on our wrists will evolve to become we consume, wear as a patch or become embedded under our skin. The notion of a wristband sensor will be nothing more that a quant reflection of the early days of digital health. And that shift will happen much quicker than you think.

It also might be better to define a “tracker” as less a tool to measure steps and more so as one to detect cancer when coupled with advances in nanotechnology. And this is where things get interesting. We move from athletic options (where we are now) to clinical imperatives. And it’s this shift that will catalyze the changes in digital health. Simply put, a major trend will not be acceleration of existing devices but the development of new and innovation clinical tools - not digital toys - that fundamental change the practice of medicine.

So, it is just hype? Absolutely not!

Sensors will evolve to become “essential partners” that act as a “check engine light” for our bodies.

Which of the new innovations will be "the next big thing" and why?

First off, I would never try to predict out 20 to 50 years. As we are in an exponential curve, going out that far is almost impossible. But I believe that we will see a few key changes. The role of AI in all aspects of our lives will be commonplace. And it might be better to shift from “artificial intelligence” to IA - Intelligence augmented. From cooking at home to complex surgery we will become intertwined with technology was an essential tool to process information and decide the best paths forward. And this cognitive connection will be further empowered by aspects of new interfaces from new complex visualizations to augmented and enhanced reality. I would also suggest that big data would emerge as a powerful window into humanity that will reveal new and important connections. And these connections will help power and drive everything from simple manufacturing to aspects of human evolution!

What will the relation between patient and doctor will be like in the future?

Today, care is almost always defined by one word: Control. It’s the physician and the payer that frequently control the type and quality of care a patient receives. The future will see a shift from control to collaboration. A new and more informed patient (and caregiver) population will know more about their condition, know more about care options and place a higher value of clinical data. And the resulting dynamic will shift care to a different “equilibrium” that will do a few interesting things. The first is disruption. Physicians and patients will have to find new ground were collaboration can fit into the complex clinical equation that is already burdened with many issues. However, over time, the emergence of a “new normal” will emerge where healthcare providers and patients will both win.

What does exactly "democratization of health" mean and how will it impact healthcare?

As I have said many times in the past, control will be changed from control to collaboration. You only need look at various consumer companies to see this. From Uber to Amazon, the power of the consumer is THE define trend that define and destroy an entire industry. I think that the same will apply to medicine as patients play a more active role. But it’s also fair to suggest that this change might be less a pure democracy and more a two or three party system. The unique aspects of medicine will always require specific domain knowledge and this may (yes, I do say may) still remain under that “control” of the physician. But even that might be up for change!

Why is the confluence of health and technology so important to you?

Why health and tech? It’s a simple reason. It gives me an “unfair” advantage in life. We live in interesting times. Both health and technology are topics that are resonant to our individual lives and society as a whole. For me, and certainly many others, the ability to enjoy good health and the rich benefits associated with wellness this is a “life imperative” that always remains top of mind. We remain vigilant to diet, exercise and knowledge to help nurture and protect this vital asset.

And to help accomplish, we have now become technologically empowered with tools like the smartphone, nanotechnology, genomic analysis and many other “tools of technology” to make smarter decisions, battle disease and injury with less fight and more finesse and even, dare I say, cheat mother nature.

My interest - no obsession - over the confluence of health and technology is simply a smart longevity strategy that is brought to live by the wonder and magic of science.

The rooms in our homes will become passive laboratories that will collect data, track our motion, keep an eye on the refrigerator and collect biological samples for real-time analysis.

The Internet of Things is common topic. How big do you see it becoming?

The Internet of Things will become huge. It will be amazingly large and form a network of connectivity that will define and drive much of our life. Yet this looming monster of technology will vanish and become a passive system that is incorporated into the very fabric of our lives. Interestingly, one of the places that the IoT will thrive is in our homes. The rooms in our homes will become passive laboratories that will collect data, track our motion, keep an eye on the refrigerator and collect biological samples for real-time analysis. Our actions—from heating a room in the winter to choosing more healthy food choices—will be informed and optimized by technologies that speak together and form a collaborative network.

What is your favorite social networking site and why?

I’m a Twitter fan. And while I make very good use of other social networking sites such as Facebook and LinkedIn, I find that Twitter is an outstand tool to listen, learn and engage. From lists to hash tags, I find that Twitter helps me “take the temperature” of a concept of issue. I’ve often compared it to the Heisenberg Uncertainty Principle in physics where you can measure exact momentum or position of a particle—but not both. With Twitter, you can find exacting information as to “what’s happening now.” But as with the Uncertainty Principle, you sacrifice depth of content. And that’s where search engines like Google come in to add depth and context beyond a timely collection of 140 character tweets.

We often talk about the democratization of health and the empowerment of the individual. For many, Twitter acts in a similar way. We all get 140 characters to tell our story and then we shoot that little arrow into cyberspace. It really doesn’t matter who you are, but more importantly, it’s what you’re saying. The ability to have your voice retweeted or even to go viral is right there at the intersection of your fingertips and the keys. So please follow me @JohnNosta. I promise to provide real value and engagement!

Why are you optimistic about the future?

I’m an optimist by nature. But I think that an optimistic outlook has a bit of magic that built right in. I believe that a positive outlook takes us down a decision tree path that builds a path to success. If I take the “no road” I’ll often end up at a dead end or follow options that are defined by negativity or pessimism. And this applies all aspects of life from business of relationships.

But there’s another equally important aspect of my optimism and that’s the factual reality of science. It’s my business, to stay close to innovations in digital health and I often have a first-hand looks at ideas, prototypes, data and results that aren’t in the public domain. And what I see puts a smile on my face and drives a jubilant sense of optimism that is not only irresistible - it’s infectious!

15th October 2015 (Artur Olesch). Image: designed by freepik.com