Why, given decades of innovation, hasn’t technology made more of a difference in how we access and receive healthcare?
This is the pressing question behind a important new book, Health Tech: Rebooting Society’s Software, Hardware and Mindset, published by Routledge this fall and penned by futurist Trond Undheim (full disclosure, he now works with me at Tulip, the frontline operations platform). Through case studies and close readings, Undheim deftly shows how constant progress with analytics, edge technologies, and digital healthcare apps has been stifled by a lack of focus on implementing these innovations into the healthcare system.
NEWPORT BEACH, CA – JUNE 20: Dr. Robert Louis, a neurosurgeon at Hoag Memorial Hospital Presbyterian … [+]
To get the benefits of digital health, Undheim argues, we need to act now.
The bulk of the book is dedicated to contextualizing the current state of technology in healthcare. Undheim starts by providing a historical portrait of a stagnating industry, borne out by detailed organizational histories, and earnest attention paid to contingents that many authors would quickly write-off (anti-vaxxers). By the time the core argument of the book lands in chapter 9—that healthcare is in need of a broadscale, international, citizen-participatory ‘system reboot’—the reader is nodding along. By this point, Undheim has so carefully laid out the various actors, agents, and levers of change that if feels obvious when he suggests that, to reduce bottlenecks, technology needs to be more accessible, written in low-code and no-code which does not take a programming genius to tweak and adapt to new healthcare challenges as they arise. I concur, of course, given that Tulip, the scale-up company I co-founded out of MIT, builds on empowering frontline industrial workers in much the same way. As he points out, “AI alone cannot transform anything, AI-hype cannot either. People can” because […] the sum of all tremendously interesting e-health applications could fail to transform the healthcare system”.
Key barriers to this kind of broadscale transformation are interoperability (Chapter 6), and the lack of self-service technologies. In example after example, Undheim shows how health tech still depends on scarce expertise, especially in developing economies. So what does an alternative look like? The key aspect is that it “can be operated by locals with little training”. This argument is more controversial than it may sound, and Undheim catalogues fierce disagreements over what designates an “appropriate technology.” Technologies can be advanced but they must have a clever user interface, one that means that those adapting it to hospitals, in the field, and in primary care offices, should not have to be trained developers. The window for transformation is closing, as established healthcare actors (and big tech players) are jostling for position, and the outcome may not favor cross-vendor interoperability and no-code interfaces.
I find it interesting that Undheim, as a former civil servant himself, has some faith in the government to grasp the situation before it’s too late, yet does not leave the responsibility purely with regulators. We all have to do our part in the reboot, he writes, and spells out ways each of us can contribute: questioning status quo through citizen activism for health equity, engaging in standards-compliant interoperability efforts within industry, fostering low-cost, no-code solutions in global health, procuring new health tech that has these usability characteristics even in wealthy healthcare states, challenging national solutions if the global solutions are better, and more.
Having much the same conviction that technology must be made with humans in mind, not just to awe technologists, I heartily recommend you read Health Tech: Rebooting Society’s Software, Hardware and Mindset to consider its main argument: that we (not just healthcare professionals) need to “rebuild healthcare from the edge and up”, making use of edge technologies, but in a way that is not taxing on already scarce resources such as technologists working in healthcare. My own experience bringing human-centered technologies to market has convinced me that technology is a force for good only when it speaks directly to people, lets them explore its potential without much fuss, and allows those who use it to adapt it to their own needs. That is not where healthcare is today and making it so will not happen automatically, regardless of our decade of progress with data, analytics and edge devices. However, rebooting society’s software and hardware might be easier than rebooting mindsets.