*The content is brought to you in partnership with Discovery Health
By Chris Bateman
The explosion in digital healthcare innovation will within the next few years reduce doctorsâ workloads and overall healthcare costs five-fold, speed up diagnoses by the same margin and totally reinvent the way medicine is practiced, saving billions of rand.
This was said by Dr Jonathan Broomberg, CEO of Discovery Health, in a presentation to journalists in Johannesburg last week on how the digital revolution is transforming medicine. He said new technology could empower patients to take responsibility for their health and enable doctors and caregivers to intervene almost instantly via individual wearable (or ingestible) automatic devices that monitored and transmitted in real time anything from the gut biome, heart-rate, stress and insulin levels, to the amount of movement or its absence. Algorithms enabling âmachine learnings,â already allowed computers to crunch this tsunami of streamed data into accurate diagnoses within seconds, supporting doctors to personalise and speed-up treatment. These data-rich innovations, led by non-healthcare companies like Google and Amazon, would enable clinicians to discover patterns and causes of diseases, plus predict longevity, in ways, ââwe have no idea about todayâ.
The approach of most modern doctors was a far cry from universal treatment based on medical textbooks where everybody was treated the same way a mere 10 years ago. The digital revolution and its attendant device-connectivity was already decreasing preventable hospital admissions, predicting health and resulting in early interventions when warning signs appeared. Broomberg gave the example of sensors installed in an elderly personâs bed, toilet, fridge and front door (besides wearables and/or âingestiblesâ), enabling a connected caregiver to monitor anything unusual.
Impact of Mayo Clinic heart app
The cutting-edge Mayo Clinic, based in the United States, was already producing research on a wearable app for heart failure patients that had reduced such hospital admissions by 40%. Discovery Health was using its own Vitality member data (300Â 000 active members) to predict a patientsâ probability of developing new chronic condition or progressing to a worse disease stage, while financially incentivising doctors to consult for longer – and improve their own lifestyles. Â Active Vitality members were shown to have an 11% lower mortality risk, while those who did five workouts per week had a 35% lower risk of death, according to the data. A Google-inspired algorithm developed by Stanford University could today diagnose a skin melanoma (cancerous or pre-cancerous) from a single photograph- with the same accuracy as a certified dermatologist, taking about 15 seconds instead of the usual 15-minute face-to-face consultation.
Discovery Healthâs HealthID digital platform, in place for four years, enables the sharing of patient data (with patient permission), between physicians and funders and would shortly incorporate ââHealthTapââ which uses artificial intelligence to provide relevant answers to patient questions. Elaborating, Broomberg said the same network in the United States covered 105Â 000 doctors across 141 specialities and incorporated five billion healthcare questions, developed over seven years. Complemented by an artificial intelligence algorithm, it fired incremental questions at a user and, based on their answers, gave a diagnosis-likelihood as a percentage. This virtual consultation could then be taken to a doctor for assessment, in most cases speeding up final diagnosis and shortening consultations. Fast becoming the most popular form of medical advice world-wide, virtual consultation comprised 80% of patients first medical contact in both Israel and parts of the USA, Broomberg added. Discovery Healthâs swiftest-growing digital innovation, the SmartPlan, (40,000 members), pointed patients at a dataset of GPs, specialists and hospitals who had shown themselves to be more efficient, with better outcomes. The claims cost within these networks had come down by 28%. A patient ratings tool also allowed members to rate the healthcare services they received and was already resulting in some hospital scores improving, especially where they fed data back to their staff. Â When it came to the controversial question of patient access to clinical notes, Discovery Healthâs position was that the data belonged to the member (patient). The use of this was governed by an explicit agreement between the patient, doctors and the funder. âWe think the more data thatâs available to patients, doctors and funders the better,â Broomberg said.
CMS moving with the times
Significantly, the Council for Medical Schemes, (CMS), last year gave permission to medical aids to use certain behavioural data in deciding whether to pay for Prescribed Minimum Benefits (PMBâs).
Explained Broomberg; âIf youâre a serious non-complier (as in not taking medicines), or donât take your insulin meds for eight months out of ten we can take you off â but we certainly wonât discriminate against anyone for something they have no control overâ.
The Discovery Health CEO said cyber-innovation in industry had completely disrupted business models, citing the Uber taxi industry and AirBnB. âA while back it cost a million dollars to buy a New York taxi medallion (conditionally allowing the owner of landmark vehicles to operate). Today the medallion is worth a third of thatâ. Air Bed and Breakfast started with a couple of conference delegates buying air mattresses and putting them on the floor of their spacious flat to accommodate fellow delegates. Today it was a massive business that threatened the hotel industry.
Broomberg said investment in digital healthcare in the United States came to R56.9 billion last year alone, with genomics and DNA sequencing getting the lionâs share at R5.5 billion. Discovery Health has announced plans to begin genome testing in partnership with global DNA sequencing leader, Dr Craig Venter in the USA, enabling members to send saliva samples for analysis in order to quantify their genetic susceptibility to a wide range of diseases. Not yet approved locally, this technology will enable members to adjust their lifestyles accordingly or take early preventative measures to reduce their risk. The HealthID app already had data-share consent from half of Discovery Healthâs 1.2 million members, with 2000 doctors using it every day â the aim for ubiquity being 4,000 members. The company had yet to capture the doctorâs clinical notes and hospital records but had loaded pathology reports and some radiology reports. Capturing the full patient record was the next step in âbringing the industry togetherâ to streamline efficient and integrated care.
