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Health care is in the midst of a digital revolution
And it is generating an ocean of data
There's loads of health data out there
Patient records that have been digitised, gene sequences...
...medical images, lab tests, and then of course there's the sensors that...
...we're increasingly wearing on our bodies, whether they're Fitbits...
...or ear buds or Apple watches...
...or maybe just your own mobile phone that you carry around with you
Now some of the tech companies that made those devices...
...are eyeing up the data they're collecting
Microsoft and Walgreens in a seven-year deal...
...and it includes up to 12 digital-health centres
Alphabet, the owner of Google, has made an offer to acquire Fitbit
These companies have made vast fortunes from processing...
...managing and mining data
Today they're turning those talents to health care
But will that make you feel better?
You need to record at least ten finger movements...
...and combined with those data it will give you the score
This app is designed to monitor a patient's Parkinson's disease...
...just by using the camera on a smartphone
This is a test that, traditionally, you're doing it in...
...a health-care setting in front of a neurologist
It's been created by a tech startup called Medopad
Dan Vahdat is its boss
With a phone like this, I can measure my resting heart rate
I can measure and do a test for Parkinson's, a test for Alzheimer's
Can we look at some of the population
The app tracks the patient's symptoms...
...so that doctors know when to intervene...
...rather than waiting for the patient to come to them
We think there's a new category in medicine...
...which is based on all the data that your body generates
And the whole idea and our focus is to see...
...can we find signatures that quantify your health...
...quantify different diseases you might be dealing with
These invisible footprints are called digital biomarkers
And you're leaving them wherever you go...
...through watches, wearable technology and smartphones
There are already thousands of diagnostic and monitoring applications...
...targeting a host of different conditions and diseases
Health care is all about the data
This digital-biomarker category, probably...
...it will have the biggest impact in medicine...
...because of the amount of data it's going to generate
Combined the digital biomarkers produce...
...big and potentially very valuable datasets
And that's just the tip of the iceberg
Factor in the vast volume of data already generated by health-care systems...
...in the daily effort to look after patients and populations...
...and there's the potential to improve outcomes on a far bigger scale
There's a whole bunch of things you can do...
...just with a much broader and deeper view of a patient...
...through digital-health records
You can pick up medical errors, for example...
...and you can also figure out which pathways of care are most efficient
It's only by assembling lots of patient-health data that you start to see...
...what spending is useful and what spending isn't
But in many health systems, what you find is you have pools...
...of medical data in different places. And it's not until you link these up...
...that you can really wring out the power that they have...
...to kind of give you really wonderful insights
Digitising and linking this data...
....enables patterns and trends to be spotted
But it's a big job
...and the evidence suggests that many countries have a long way to go
Health-care systems have been quite slow...
...in using modern technologies to revolutionise themselves
Some people say that they're about ten years behind other sectors
In 2017 the OECD, a group of mostly rich countries...
...judged how ready its members are for a revolution in health tech
It looked at two factors: technological readiness...
...meaning digitised records that can already be used...
...for monitoring and research...
...and policy, the extent to which governments facilitate...
...the use of the data in these digitised records
Some countries, like Slovakia, have the technology ready...
...but are held back by government lagging
Others, like Poland, have more policy in place but less technology ready
And even though many OECD members...
...have a high proportion of health datasets digitised...
...only a small percentage of them are regularly linked...
...with other sources of information
Take Singapore. Although all of its key national-health datasets are available...
...just under a third are linked, making vast quantities of data redundant
The reason most OECD country health systems don't...
...clean up their datasets, or at least that they haven't so far...
...is really that the data that exists in the health-care system...
...it's not really there for this purpose
The point of it is to look after human beings in the moment
Inefficiencies in health services, and failure to make full use...
...of digital technologies, mean that rich countries...
...are wasting up to $600bn a year
That's around 8% of current health spending...
...and more than the equivalent of the GDP of Sweden
At a time when all of the OECD health-care systems...
...are struggling under a burden of increasingly old patients...
...lower amounts of money flowing into the system
There's just not a lot of money there to do...
...the kind of digital reorganisation that is needed
Enter big tech with its massive computing power...
...and expertise in data analytics
And it is very keen to offer its services to overwhelmed health-care systems
Microsoft is providing American health-care systems with AI tools...
...to analyse health data relating to surgery outcomes and cancer therapies
Google is working with Ascension, one of the largest American health firms...
...to create an online tool so that its doctors can more easily search patient data
And in the UK, Google has been working with the Royal Free...
...a London Hospital, to identify patients who are most at risk...
...of falling seriously ill in hospital
When big-tech companies work with hospitals....
...you can start to see the potential for some really big wins
But at the same time, there are also risks
Just because a tech company says that...
...it can do amazing things with your data...
...it doesn't mean that it's going to work
Health systems really have to think hard about...
...patient privacy and security of the data
For example, Google got into hot water when the Royal Free...
...shared patient data with it in a way that it shouldn't have done
This tension goes beyond big tech's access to existing patient data
The aspirations of some of these companies continue to grow...
...fuelled in part by their ability to collect health data directly from the public
It's now the private sector trying to show the government how to do it
Amazon finally making that big foray into the health-care industry...
...announcing earlier its partnership with Berkshire Hathaway and JPMorgan...
...to form a health-care company
Apple is using the Research app on its iPhone and Watch...
...to conduct medical studies with academic institutions
The ambitions of Verily, Google's sister company, seem even greater
Its goal is to become the central repository for health data worldwide...
...a kind of medical Google Maps
If you think about Google Maps, it was an effort...
...to really understand all of the roads, not just in your backyard...
...but really in the whole world
And in many ways health care has some similarities
We have to understand the system but also as a patient...
...you have to understand your health at a very deep level
And so when we think about projects, for example like Project Baseline...
...where we're trying to map human health...
...this is going to be a new ground truth to understand...
...comprehensive health data
Project Baseline analyses health data...
...to discover clues that can predict disease...
...creating a research platform that Verily hopes will enhance clinical care
Camilo Barcenas is one of its volunteers...
...paid to undergo a broad range of tests over a four-year period
There are a lot of reasons why to do this
I've got two children and one of the ways I've thought about it...
...if something happens to me in the next five years...
...then there will be this real-time log of information about me
The first test is call the forced vital capacity
What we are measuring is how much air you can take in...
...and how fast you can blast it out
Deep, deep, deep, deep, blast it out...
...blow, blow, blow, keep going, keep going, don't stop
Deep breath in
Many of these tests would be familiar to anyone who has had a health check
The difference is what Verily does with the results
The data the company is collecting...
...clinical, behavioural, psychological and even molecular...
...will be analysed in an effort to build a comprehensive baseline of good health
This data will be anything from genomics to patients' experiences
But having this information hopefully will do two main things
One, it helps us as a community to create...
...an infrastructure to actually handle all that data
And then secondarily, the idea is to try to look for signals...
...of changes in health before disease actually happens
The end result could be an invaluable asset for humanity...
...but also a pretty valuable one to license...
...in the multi-trillion dollar health-care market
It's this mix of idealism and opportunity that makes many people uneasy
Especially when the prospect is raised of these same companies...
...having access to the data in their own medical records
The issue that all of the tech companies face...
...is that they're now, so big and so prevalent...
...that they've kind of taken on this negative, scary connotation
The idea that any of them might have my patient data...
...does not play well with the public
A survey from 2019 looked at how willing Americans are...
...to share their information
It found that unsurprisingly people are most happy...
...to share health data with their doctor
...but far less willing to share with pharmaceutical companies...
...or the government
And least of all with tech companies
Privacy is contextual. It's about the expectations...
...that the user has over the data that they provide
And in a health-care context, what it usually means is that...
...I'm happy to share this with my doctor...
...but I'm not happy to share this with advertising companies...
...that my doctor wants to make a bit of money on the side...
...from by selling my patient profile to them
Health systems and governments eyeing the benefits of...
...partnering with big tech have a delicate balance to strike
To reap the rewards they'll need to ease public fears...
...about what happens to their data
That means taking the lead to ensure patient privacy is protected...
...and demanding greater transparency about the use of data
There are potentially huge rewards for health systems...
...that welcome technology companies in
They can improve care. They can save lives. They can save money
You also need to think about what happens if tech companies...
...aren't welcomed; are the health systems...
...going to develop this technology for themselves?
And if they don't, what is the cost in human life...
...to those things not happening?
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Is big tech good for your health? | The Economist

42 Folder Collection
李柏毅 published on July 16, 2020
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