Article by Vinod Khosla:
"Healthcare today is broken. It’s the result of approaching
medicine according to practice and tradition, rather than real science
primed by objective data, and unencumbered with the conflicts of
interest that lead to suboptimal results. Doctors today are doing the
best they can given the current system, but we should embrace the new
opportunities ahead of us.
Technology will reinvent healthcare as we know it. It is inevitable
that, in the future, the majority of physicians’ diagnostic,
prescription and administrative work, which over time may approach
80-percent of total doctor time, will be replaced by smart hardware and
software. Healthcare will become more scientific and more consistent,
delivering better-quality care with inexpensive data-gathering
techniques, continual monitoring, more rigorous science and more
available and ubiquitous information leading to personalized patient
insight. Many new findings will be outside the reach of most physicians
because of the volume of data and the unique holistic insights that data
will provide about a patient’s very complex condition. Hundreds of
thousands or even millions of data points may go into diagnosing a
condition and monitoring the progress of a therapy or prescription, well
beyond the capability of any human to adequately consider.
This evolution from an entirely human-based healthcare system to an
increasingly automated system will take time, and there are many ways in
which it can happen. Today’s traditional approaches will get better as
new approaches, and even new medicine, will be invented. The remaining
20-percent of physicians’ work will be AMPLIFIED, making them even more
effective. Doctors will be able to operate at substantially improved
levels of expertise in multiple domains, and they also will be able to
handle many more patients. The primary care physician and maybe even the
nurse practitioner may be able to operate at the level of six
specialists handling six areas of care for one patient with multiple
comorbidities in a more coordinated and comprehensive manner without
inter-specialist conflicts. This transition will affect each group of
actors in the current system differently. Some constituencies will be
affected favorably in some dimensions and worse in others, but the net
benefit will be substantially positive for society and individual
patients but it is likely that a focus on science, data, and
personalization will lead to plenty of unintended benefits that we
cannot anticipate today. Nurses will be made much more capable by
technology, often replacing the functions only doctors perform today.
New medical insights, including ones we cannot yet envision, will be
commonplace, and the practices we follow will be substantially better
validated by more rigorous scientific methods.
My statements are not forecasts that the hospital burn unit or
emergency department will run without any humans on staff. Though the
early changes will appear underwhelming and clumsy, by 2025 they will
seem obvious, inevitable and well beyond the changes we might envision
today. Expect today’s expert doctors to think these changes are
implausible when they are asked about this possibility, and expect the
classic response of “human judgment will not be replaced by technology”
from people who are not qualified to judge what software technology in
2030 might be capable of. Of course, the possibility also exists that a
much more cooperative system leveraging both humans and technological
systems in their respective strengths may also evolve, as proposed in
the book Race Against the Machine, but the core functions necessary for
complex diagnoses will more than likely be driven by machine judgment
instead of human judgment.
The transition will happen in fits and starts along different
pathways with many course corrections, steps backward and mistakes as we
figure out the best approach. Given the importance of having clarity on
what I hypothesize as my forecasts, I want to be clear that they are
only directional guesses rather than precise predictions. Further,
though many different disciplines will contribute to the innovation in
medicine like biological research or new device development, I am mostly
concerned with the contributions of digital health technologies to
medical innovation. This should not be underemphasized, as these
contributions, though potentially the most significant, are also the
most variable, and hardest to predict in direction, timelines and
scope..."
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