Year-end review reveals many positive developments around the globe in healthcare industry

In the last few articles I tried to put the spotlight on new developments in healthcare around the world. As we are getting closer to the end of 2019, I am energized to see positive movements in the healthcare analytics and health information technology space continuing worldwide. Let’s look at what is happening at home first.

New Presidential Executive Order

A recently issued Presidential Executive Order has asked the Centers for Medicare and Medicaid (CMS) to improve the value-based insurance design payment model by embracing new technologies that would save healthcare costs and improve the quality of care. In addition, the order also asked CMS to reduce time lag between the U.S. Food and Drug Administration’s approval of new technologies and CMS coverage for these technologies.

An executive order may not necessarily drive long-lasting policy changes, but it could act as a catalyst for some meaningful changes in CMS reimbursement models as we get closer to the presidential election next year. CMS might deliver on some of the promises outlined in the order. We can also expect that in order to increase access to care for Medicare beneficiaries, burdensome licensure requirements might be removed, fostering models such as telehealth or telemedicine across state borders.

Using telehealth or telemedicine platforms as an adjunct to in-person care delivery is still not common and certainly not happening at scale outside of the Veterans Administration. This technology needs a governmental push and a creative incentive model along with much-needed policy changes to become part of the mainstream healthcare delivery. This is important because when this kind of technology-enabled delivery becomes mainstream, it improves data collection both in volume as well as in frequency. That in turn opens up the door for all other technologies that depend on a volume of data. Eliminating healthcare data silos puts other countries such as the United Kingdom at an advantageous position when it comes to developing meaningful solutions with artificial intelligence. More on that later in this article.

Providers Building Partnership with Payers

Some provider organizations have reached out to payers for their support to expand this model by showing positive cost savings and quality improvement outcomes. The Henry Ford at Home program in Michigan reduced rehospitalizations by about 45% during the first half of 2019 compared to the same time period in 2018, with a monthly readmission rate dropping as low as 7% using telemedicine and remote patient monitoring technologies. Will the payer community outside of Medicare take notice and move forward with an incentive-based payment structure to promote adoption?

Even after two decades of its adoption within the Veterans Administration, the skepticism about the efficacy of such technologies still exists. Will CMS be able to design policies that would incentivize all payers to embrace it? Will the president’s executive order move the needle and catalyze usage of digital technology for Medicare and Medicaid? Time will tell.

Artificial Intelligence for Health Outcome Challenge

CMS, however, is leveraging its Innovation Center program to test new technologies. They have recently launched an Artificial Intelligence for Health Outcome challenge with a total reward of $1.65 million to encourage innovators to design systems that can improve care quality, coordination and cost efficiency. Since the challenge was announced, about 300 launch stage applications were submitted. As a result, CMS is now taking its time to review all submissions to make sure they do justice to the aspiring companies. Final awardees will be announced in September of 2020.

The response to the challenge demonstrates the enthusiasm that exists within the technology industry to bring AI to healthcare. From natural language processing chatbots that set up appointments for patients without human intervention to sophisticated machine learning algorithms to detect cancer, analytical tools are continuously being built by startups around the country, and venture capital companies are pouring money into those companies.

The use cases are still a bit “experimental,” however. While cancer diagnosis has progressed significantly in the last few years, enabling early detection of the disease, the delivery of cancer-fighting drugs still lags. Azra Raza, M.D., a renowned oncologist from the Columbia University Medical Center, recently mentioned in a Freaknomics radio program that for certain types of cancers, the drugs used today are still the same as those used in late 1970s, and oncologists generally treat cancer patients pretty much the same way. Will AI be able to make a dent in new cancer drug discovery?

U.K. Forges Ahead with AI for Healthcare

The United Kingdom’s National Health Service (NHS), the central organization that manages all public healthcare delivery and payment, recently announced plans to establish an AI lab to tackle the country’s healthcare challenges with funding of about $300 million. According to the NHS, the lab will work to bring together academics, specialists and tech companies to address “some of the biggest challenges in health and care.” The health secretary stated that this funding will provide an opportunity to attract global talent and bring the country to a leadership position in AI for healthcare, especially in targeted areas such as automating routine work in cancer treatment, eye diseases and a range of other conditions.

Similar initiatives are also being considered in France and Germany, both of which are also gaining momentum to become AI-for-healthcare hubs in the European Union. In Africa, where traditional healthcare is scarce in many places and many countries are reeling from various humanitarian crises, AI is becoming a great tool for delivering healthcare and diagnostics at scale. Companies such as miloHealth AI Lab, Ubenwa and Retina-AI are pushing the boundaries with deep learning and convolutional neural networks.

Overall, these developments are good news for healthcare technology professionals both in the United States and abroad. Technology-enabled healthcare is the only future state that we can expect in the coming decade. To be a part of that future, I hope the Presidential Executive Order will push the largest payer of the country, the federal government, to open up more projects for technology deployment at scale, including AI in non-commercial healthcare sectors along with revamping governmental policies to support such initiatives. This should be a bipartisan issue, so hopefully politics would not impede the progress.