The inefficiencies of the system itself are on full display during the pandemic — where testing is hard to come by, diagnoses and treatments are reactive rather than proactive, and many people do not get the care they need, when they need it.
Adrian Aoun, CEO and founder of Forward, a tech-driven healthcare startup, told Karen Webster that it’s possible to build a completely new healthcare ecosystem, beginning with primary care — and the overhaul needs to leverage data and artificial intelligence (AI).
Along the way, he said, healthcare can be transformed from a service to a product — with standardized levels of quality, and accessible to pretty much everybody.
The need for a systems-based approach to healthcare is especially critical, he said, as there are 7.6 billion people on the planet. Fewer than 2 billion of them, according to Aoun, have access to quality healthcare.
“If you truly want to scale healthcare out to as many people as need it, you have no choice but to take healthcare from being a service to being a product, which means relying less and less on humans and doctors doing everything, toward relying more and more on like sensors and algorithms,” he said.
The executive, who founded Alphabet’s Sidewalk Labs subsidiary, told Webster, there are common challenges across transportation, healthcare and education in the drive toward efficiency and inclusion. Tech development and deployment has been piecemeal.
Tackling Systems Problems
“You very quickly realize that these are all system problems, and you don’t get to just focus on one little part and ignore the rest,” he said.
For a real-world example, he said, consider flying cars. We think those marvels of airborne transportation are the wave of the future, but turns out they’ve been around for decades, courtesy of Disney.
“Go to Disneyland,” he said, “and hop on a tram and there’s no driver right now.”
That’s because the engineering and development teams at the famed entertainment company thought about the entire system, from cars to roads to safety barriers, and of course the onboarding process itself.
Turn those same principles to healthcare, he said, and thus far technology has usually been approached purely from a mindset that values data — but not context.
Forward’s goal is to focus on primary care needs. Advanced technologies can create a primary healthcare ecosystem that then becomes the hub for the spokes of other healthcare services.
To get a sense of the technology disconnect, he noted that, while speaking to Webster, he was wearing a ring that measures heart rate variability, body temperature and other vital signs.
But, while it may be interesting to wake up from one day to the next and realize your temperature may fluctuate from time to time, those isolated data points are useless.
The information on its own offers little value.
As Aoun said, transforming healthcare is not about solving point problems — healthcare is a “systems problem” that needs a continuum of information and data flow, yes, but also context.
The Apple Watch may take heart rate of its wearers every 15 minutes, but there’s no doctor on the receiving end of that data to interpret it and perhaps put it to good use, finding out, for example if an individual is pre-diabetic.
Nowhere is the systems-based approach to healthcare more starkly illuminated than in the present day, where the coronavirus is running rampant.
A positive diagnosis for the dreaded virus needs context; that context comes against the backdrop where there are a few hundreds of thousands of hospital beds in the U.S. and only around 90,000 intensive care unit (ICU) beds, said Aoun. Both numbers come up frightfully short when considering that as many as 1 million people might die in the U.S. of COVID-19, according to some forecasts.
An app-driven approach can help coalesce the systems approach to healthcare, said Aoun.
He said that Forward offers an app focused on the coronavirus, which asks a bunch of questions of its user to ascertain whether they are high risk and should be tested for the virus.
Aoun added that there are also sensors delivered to the home that can monitor blood pressure, temperature and other signs to monitor other factors related to possible coronavirus infections. In-home visits collect blood and urine draws. In-office visits to Forward’s offices feature body scanners and live video displays that show data, measurements and metrics in context, discussing ailments and treatments.
“We're trying to create the kind of end-to-end system that allows us to go from, ‘You're worried to you've been assessed, you've been diagnosed, you've been cared for all the way back to you’re healthy,’” said Aoun. “That’s the systems approach that frankly just doesn't seem to occur very much in the world right now … once you have a hundred clues or a thousand clues or a million clues, you really can start to piece together a very clear image of what's going on.”
Asked by Webster about the profile of a typical Forward member, Aoun said that the average age of an individual is 41, but the continuum spans people in their 20s all the way through octogenarians. The pricing structure is $149 a month. Forward, he said, has a network of specialists (all full-time employees), and if need be will coordinate care outside of its network, which can then use the individual’s health insurance plan to cover more serious situations.
“Our goal,” he told Webster, “is to create the first ‘at scale’ healthcare system.”