2024: A New Year with New Challenges and Hopes

The technology industry started the new year with yet another shake-up and realignment, and I hope that anyone affected will be able to find a landing place soon. The pandemic-era over-hiring and overly optimistic viewpoints of the U.S. corporate world are bound to get scaled back, and unfortunately, that adjustment is still ongoing. This column, however, is not about doom and gloom. Rather, it is about looking into the year to see what lies ahead and what we need to be excited or cautious about.

U.S. Healthcare’s Private Equity Moment

First, a recent report published in the prestigious Journal of American Medical Association (JAMA) surprised everyone from Capitol Hill to the common public. Private equity companies with deep pockets to invest in startups to real estate are increasingly gobbling up different components of healthcare delivery systems in the United States. These companies have invested $1 trillion in U.S. healthcare over the past decade (and counting). They bought primary care facilities, multispecialty clinics and hospitals across the country at “good prices” with the promise of bringing “efficiencies” and “better customer service.” Instead, as the JAMA report suggests, patient safety and quality of care were sacrificed, unnecessary tests were conducted and overall cost of care went up, not down! Well, when profit-making becomes the sole purpose of delivering healthcare, what else could be expected? In the name of “efficiency gain,” staff reductions occurred, which in turn led to reduced patient safety monitoring and an uptick in preventable complications at the hospitals. More tests were conducted so that revenue streams could be bumped up. Suddenly, a not-so-good healthcare system starts to look even worse!

This is a dangerous trend and, coupled with the continuous closure of critical access hospital facilities in rural parts of the country (owing to funding and patient shortages), could be a perfect downward spiral for worsening health outcomes in the U.S. in the coming years. This should not have happened after all. Some policy interventions, appropriate and timely enforcement of local, state or even federal government audits, could have curbed the greed of fund managers to literally experiment with the people’s health. After reports shared the light, Capitol Hill has taken notice, but the politicians need to act quickly. As we have seen with the delayed actions in Medicaid expansion, rural hospitals could not keep their doors open; delayed intervention in this matter will fail to prevent private equity firms from continuing to ruin healthcare delivery facilities. There needs to be a higher bar for taking over a healthcare delivery organization than, say, a retail company. We see that in the case of public works, so why not for healthcare?

Generative AI is Everywhere

2024 could very well be the year of generative artificial intelligence (AI) in healthcare. AI is now almost ubiquitous. One can hardly find a service in which AI is not promoted as being used in some form. The degree of sophistication of AI technology and its use cases vary. From smart targeting for sales and marketing to smarter chatbots, AI is the mantra for startups and corporate America alike. Big Tech is throwing even bigger budgets toward the infrastructure to enable expensive generative AI computations – from textual summary writing to image creation to videos. Google, Microsoft, Salesforce and Amazon are opening up their AI engines for cloud-hosted customers to use in their own software products. I have recently used Google’s image-generating AI engine to create eye-catching abstract paintings for some marketing campaigns. The best part was that I could do it in 10 minutes, using my own laptop, without additional software, and spending a minimal amount of money! Sure, it had many shortcomings that a graphic artist would have taken care of easily. But the convenience, speed and financial economy were amazing. Some companies are bringing those tri-factors into the hands of clinicians in 2024. The job of a notetaker scribe will be handed over to generative AI. The goal would be to reduce the burden of physicians to complete patient charts. Google Health recently published a blog post emphasizing this. The same approach will be extensible to radiology and pathology, given that advancement in computer vision, image analysis and pattern recognition already made those areas ripe for AI applications. Generative AI could be the cherry on top because it could nicely summarize the diagnosis or the findings from images or test results in a humanlike manner.

I do have a fair warning though. There is still a lot of hyperbole going around about AI and its immediate potential in all parts of our lives, including healthcare. Although the technology is maturing by leaps and bounds, and hundreds if not thousands of companies are jumping onto the AI bandwagon to make a fortune, a cautionary tale for all readers would be to remember the heydays of the early internet in the late 1990s. The euphoria did meet some reality moments in early 2000, and the real internet-enabled value creators actually emerged after that period. I have a sense that we might have a deja vu of this, so tread cautiously.

Further Development of Gene Rewriting and Gene Therapy Treatments

This is no longer a new frontier. CRISPR is already in use. However, 2024 could see further advancement of gene therapy-based treatment protocols for some rare diseases. In fact, there could be 17 more therapies that could see approvals in 2024 by the U.S. Food and Drug Administration and in the EU. Modifying or deleting bad genes without adverse effects is the ultimate holy grail for the human race. Someday, if we are able to alter the human genome in such a way that cancer becomes a thing of the past, how epic would that be? I am convinced that this healthcare technology could be more impactful for humanity than AI in its current form could ever be.

Don’t Forget Good Old mRNA

In this context, it is worthwhile to mention that 2024 could also see some real breakthroughs from mRNA platform makers to create new vaccines targeting diseases that were not considered as immunizable before, such as HIV, malaria, heart failure or even cancer. Those and many others are on the list of research and exploration by scientists at leading institutions in the United States and around the world. In some ways, it feels like human beings are in a dual race: a race to reproduce the cognitive conscience that is central to our brilliance in AI and devising mechanisms to overcome the diseases that nature uses to remove our species. The race is getting tighter with every passing year, and at some point, both will converge. The question that bogs my mind: Will that lead to a superhuman species that would not easily perish and be aided by the infallible power of AI? Will that power be equitably distributed? What will that mean for the world?

Well, that’s a distant philosophical thought perhaps, but the journey toward that must be exciting. It seems like 2024 is already on that path.