Dennis Schmuland, MD, FAAFP

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While you're reading this opening sentence, AI is quietly disrupting the practice of medicine as we know it. 

In fact, AI is about to do what we hoped to see technology do in the last decade for the health industry: Empower organizations and clinicians to improve the health, outcomes, and experience of care for more people in less time and at lower cost. It's happening now in fits and starts, but, eventually, as AI becomes invisibly woven into the fabric of our work and lives, the practice of medicine will become astonishingly more efficient, effective, and, ironically-more human. 

And that's good news for the U.S. health industry that's known for its overachievement in inefficiency and consumer unfriendliness.

It's also good news for clinicians that are legitimately skeptical of highfalutin promises of new technologies. They're skeptical because their experiences with EHRs have left them feeling hindered more than helped by computers. Some studies have shown that up to half of their day is now spent facing a computer screen instead of patients. 

AI, (think of it as a mostly invisible machines with human-like abilities to perceive, read, speak, and learn, and analyze), is wildly different from any technology we’ve experienced before. 

Why? First, because AI is more like us. It can sense, converse, work, and act for us, on our behalf.  In contrast, the EHR is more like a complex tool that requires special training and repetitive use to build the skills required to master the tool.  The more you use it, of course, the more adept at it you become, and the more good things you can do with the tool.  But the learning curve is long and painful. Thankfully, AI is almost the exact opposite. It requires almost no training to use because it can adapt to the way we think and work.

Second, AI delivers a big advantage over EHRs. AI doesn't just work on our behalf.  It works on our behalf without getting in our way like the keyboards and displays that EHRs require.  That’s because AI hardware is usually hidden in the cloud, out of sight.  So, there’s no hardware to get between the patient and clinician

Lastly, unlike humans, AI works tirelessly, instantly, and can analyze thousands of data points at the same time. This means that AI can work on behalf of clinicians behind the scenes, vastly expanding their capacity to act. This frees them to do more important things, like direct patient care, sleeping, or even working at improving their work-life balance. 

To be sure, AI will never get a chance to earn its keep unless health organizations and clinicians choose to adopt it. Fortunately, health organizations will rapidly adopt it because, with operating cost growth overtaking revenue growth, it won’t be long before they won’t be able to afford to operate without it.  And, unlike past technologies that took years to see any results, AI will prove its value almost instantly by finding its way into existing workflows. And don’t worry about clinicians adopting AI. When clinicians experience AI that amplifies their productivity and expands their capacity to act, they'll want more of it, not less.

editorial advisor, is chief health strategy officer, Microsoft US Health & Life Sciences.

Articles

Artificial intelligence is about to do what we hoped to see technology do in the last decade for the health industry: Empower organizations and clinicians to improve the health, outcomes, and experience of care for more people in less time and at lower cost.

Three Reasons AI is ‘Wildly Different’ than Other Healthcare Technologies  

	One of the more interesting findings in the 2018 Managed Care Technology Survey that caught my eye relates to your predictions regarding healthcare technology investments.

	When I compared the 2018 findings to the 2017 findings, it’s clear that healthcare organizations continue to invest more in tech. In the 2017 survey (which also took place during the fourth quarter of 2016), when you asked how many planned to invest more in technology in 2017 than in 2016, nearly 50% said they did. When asked the similar question in the 2018 survey (which took place during the fourth quarter of 2017), more than 40% predicted they’d invest more in technology in 2018 than they did in 2017.

	Chief information officers and chief transformation officers looking to drive digital transformation in their organizations are no longer asking, “How do we drive EHR adoption and show an ROI on our EHR investment?” but rather, “How can we create new value and business designs by blurring the digital and physical worlds of business, people, and things with exponential technologies, 

	A December 2017 Deloitte Insights paper predicts the manifestation of exponential technologies within the next 36 to 60 months.  The report, for example, references artificial general intelligence, which it defines as an advanced version of artificial intelligence that would have capabilities similar to what we call “gut instinct,” which allows us to perceive and interpret information on the spot. What’s unique about exponential technologies, and most exciting for the health industry, is that they’ll empower, not burden, organizations and clinicians protesting that they’re serving their EHRs more than their EHRs are serving them.

	This is very good news for the industry because, under value-based care payment models, true North for value creation is now the quadruple aim: better heath, better care experience, lower costs, and improving the productivity and work experience of clinicians. And recentering the industry’s core value proposition around the quadruple aim means that technology must now do more than improve experiences, outcomes, or even safety 

.  But this requires health systems to deploy three exponential technology platforms that I like to refer to as “human empowerment platforms:” intelligence, engagement, and collaboration platforms that will pick-up where EHRs have left off and drive real-life experience and cost structure transformation for consumers, payer, and providers.  EHRs have gotten the job of data digitization, revenue maximization, and compliance reporting done.  But, in the process, EHRs have exacted an immense burden on the productivity of clinicians and care teams.  In contrast to EHRs, these three human empowerment platforms will improve clinician productivity and impact because, by design, they’ll amplify human effort and ingenuity. 

 is needed to empower the organization to redesign their business and clinical processes and work on behalf of clinicians to scale their productivity, expertise, reach, and leadership. 

is needed to empower organizations to deliver unobtrusive interactions to consumers during the 5,000 hours between office visits to improve care outcomes, promote healthier living, and accelerate recovery. 

 is needed to empower organizations to digitize care teamwork and extend care coordination efforts into the medical neighborhood to reduce the need for care and improve population health.

	What’s particularly exciting is that, for the first time in history, every sector in the healthcare industry-provider, payer, and pharma-now has a business imperative do deliver services or products that achieve the quadruple aim.  When innovative health systems begin to harness exponential technologies to empower their organizations, clinicians, and consumers to amplify human effort and transform their experience and cost structures, we will see the kind of real life digital transformation that’s been long overdue.

 editorial advisor and chief health strategy officer, U.S. health and life sciences, Microsoft Corporation.
	 

Why healthcare organizations will invest more in tech this year

SchmulandAs the chief health strategy officer of a global software company, one of the most frequently asked questions I get from executives and health professionals is, "What do you think are best technology solutions in the market today?"

	For the past decade my answer has been, "It's the solutions delivering the right 

to the right person at the right time and place."  In the volume economy era when autonomous providers were paid for procedures, tests, treatments, and length of stay and were the prevailing decision makers, the primary role of technology was organizing and presenting information to clinician decision makers.  That era produced the current bumper crop of technology solutions we have today: electronic health records (EHRs) and health information exchanges.

 Ten things healthcare executives should know about 'the cloud'

	But we're now operating in a consumer-centric, outcome economy where technology has to take on a much bigger and challenging role than organizing and presenting information to decision makers.  Now it must help us bend the cost curve. And to do that, technology has to 

 the people best positioned to bend the cost curve: health professionals and consumers.

	Health professionals can bend the cost curve if technology can empower them to improve the safety, speed, outcomes and coordination of care.  Consumers can bend the cost curve if technology can empower them to live healthier, better self-manage their conditions, and minimize the functional and cost impact of chronic disease-all driving up demand, complexity and costs. 

	But to empower people, technology has to do more than connect them to

people, teams, insights, and complex processes

 both within and beyond their four walls-and automate as many portions of those processes as possible.  It also needs to help 

 those processes in a way that improves the outcomes and experience of care at a lower cost.

	So today my response to the "best technology solution" question is to apply the "non-techie" empowerment test.  Passing it requires answering "yes" to two simple questions:

	Passing the non-techie empowerment test requires answering "yes" to these questions:

1. Does the technology empower health professionals and teams to get more of the right things done and coordinate getting the right things done with other team members anywhere, in less time and with less effort? 

Almost any technology can eventually get the job done with enough brute human willpower, time and energy behind it.  But, most solutions in-market today exact an immense burden on users' productivity and time in the process of getting the job done, thereby erasing the benefits.   The technology that delivers the greatest value helps empower users and teams to get the right things done in less time and with less effort-without burdening them.  

	2. Can you find a large mass of non-techie health professionals who refuse to practice without the technology solution? 

Why is it so important to ask non-techie users?  Because techie users are so inspired by technology-and technically gifted-that they'll invest the time and creativity, even during their private lives, to tinker and concoct workarounds to make non-empowering technology solutions work for them.  For non-techie users, the bar is much higher-technology needs to "just work," not make them work more. 

 Using data analytics to effectively manage populations

	Unfortunately, despite the recent surge in EHR and portal adoption, many experts have concluded that the current generation of technology solutions is burdening health professionals at least as much as, if not more than, it is empowering them. Productivity has declined and safety and practice variability haven't budged at all over the last five years.  Clem McDonald, MD, a world leader in EHR research, recently remarked that the records and reports within EHRs now have so much information in them that they’ve become “endless and mindless.”  And some experts even argue that the current crop of solutions may have complicated care more than simplified it as the 

 recently reported in its list of 10 deadly tech hazards in hospitals for 2015. 

	The time is now for every ecosystem stakeholder to require the technology solution vendor community to bring proof that their solutions pass the non-techie empowerment test.  That's because only technology solutions that are empowering and easy to use by all will gain the broad-based adoption necessary to transform care delivery and population health at the scale needed to bend the cost curve.

Dennis Schmuland is the chief health strategy officer at 

Technology that passes the non-techie empowerment test can empower your employees.  Passing the test requires answering "yes" to these two simple questions.

Plans, providers: Ask these 2 questions when evaluating technology

For healthcare in general, and payers in particular, leveraging technology to save money requires a disciplined focus on technologies that digitize and improve business processes, especially those processes that are the most costly and labor-intense.   

Digitizing and automating several people-driven processes could not only save operational costs but give health plans the competitive edge they need to grow market share and revenue. They include: 

Most commonly, redundancies in payer organizations happen between common business applications that may serve slightly different purposes but share common features.   

Your employees are your most valuable asset, and ensuring that they're working at their peak productivity can help drive cost savings. By taking advantage of innovative technology tools to digitize and commoditize the processes that are driven by people, executives can lower costs and even gain market share by amplifying the impact of people and teams rather than replacing them. 

Back-end systems must be better connected with familiar, front-end software to increase ease of use. Simply making sure all users can easily access software and systems-and that they are using best practices-can boost productivity.  

Implementing ways to automate tedious, manual tasks, such as authoring and sharing documents, can also boost productivity. Automation will decrease the time it takes to process claims, review records and make payments, which results in cost savings and increased customer satisfaction.   

Operational expenses are a fact of life, but payers that take a careful look at operational processes that are particularly labor intense will be in a better position competitively.  

Take stock of your existing personnel and staff, and assess whether increasing their internal skills with training, further education and e-learning might be a better use of funds and deliver greater ROI. 

In the short term, there are a number of "green" business initiatives that are not only good for the environment, but also can deliver almost instant cost savings. Slashing travel and expense budgets can be a start, and an investment in a teleconferencing and/or Web conferencing solution can help drive costs down further.   

A virtualization solution, for hardware or servers, can lower costs associated with equipment, electricity and space. With a low total cost of ownership, a virtualization solution can help IT departments maximize their return on investment and cost savings across the enterprise.  

Compliance is one of the single biggest challenges facing payers today, and with even more stringent rules in the pipeline, you need to address any bottlenecks or outdated workflow processes that may hinder regulatory compliance.  

Investing in enterprise search, database, security and reporting tools can dramatically reduce the complexity of analyzing and reporting company information for various financial and compliance purposes.  

It's a lot to take in. But by leveraging the technology you might already have, it's possible to drive increased cost savings. 			

MHE Editorial Advisor Dennis Schmuland, MD, is Microsoft's national director, U.S. Health Plan Industry Solutions. 

Your competitive edge can come from digitizing and automating labor-intensive processes to gain efficiencies

Achieve near-term productivity gains

Today, healthcare payers and providers endlessly wrestle with three alligators-rising costs, inconsistent quality, and the uninsured. These alligators seem to grow larger and stronger with every passing year. 

Granted, consumers need far better information than they have today to make value-based decisions, but better information alone won't drain the swamp. That's because, in the context of reducing disease prevalence, information itself is only valuable to the extent that it enables sustainable behavior changes among consumers.  

We need to first recognize that self-service portals must begin to adapt to consumers' daily life, their preferences, and their online interactions. Health plans and providers, instead of passively waiting for consumers to adapt their lifestyles to member service portals, need to exploit a new generation of direct-to-consumer channels and software agents that will, digitally, go where consumers go.  

Second, health plans and providers will need to activate consumers to change their health habits by equipping consumers with personal health enablement software to promote incremental behavior changes in the direction of better self-management and better health habits. Personal health enablement software will need to: 

Draining the healthcare swamp will require more than just providing consumers information, it will also require an industrywide effort to equip them with personal technologies that adapt to their daily digital experiences.   

Dennis Schmuland, MD, MF, FAAFP, is National Director, Health Plan Industry Solutions, Microsoft Corporation. 