Healthcare Forecast: Stay home; treatment will come to you
Remote medicine, artificial intelligence, personalized medicine, wearable devices, remote monitoring devices (IoT) and more – technology is completely changing the face of medicine, and the change is profound, affecting the way both patients and physicians behave. We had a chat with Moshe Klaiman, CEO of Matrix Medika, and Moti Chiko, CEO of 2BSecure@Matrix, about the latest trends in healthcare technology.
The ‘big bang’ of Corona has propelled us forward by a decade, bringing about significant changes in all areas, but perhaps in the healthcare sector most of all. The need to find solutions for monitoring the epidemic, the burden on hospitals, and social distancing are just some of the factors that have increased the need for advanced technologies to enable remote monitoring, rapid data analysis, and the carrying out of medical procedures by digital means, which has led to tremendous growth in digital health.
We spoke with Moshe Klaiman – CEO of Matrix Medika, which provides end-to-end services for technology companies in the healthcare field – about disruptive innovation, and what awaits us in the coming years.
“The growth of the digital healthcare industry is expected to continue into the post-Corona era,” says Moshe. “Already today, the combination of in-person and online services has become an integral part of the health system, and every new venture being established must have an integrated digital component. This trend is only getting stronger. To illustrate the point, according to one IQVIA report, in 2020 more than 90,000 digital healthcare apps were added to app stores, an average of 250 new apps a day. Research company Global Market Insights estimates that the digital healthcare field, which in 2020 was worth about $141 billion, will triple in value to $427 billion in 2027. Digital technologies are here to stay, because they address the major medical challenges of our time, such as the shortage of medical manpower, the increase in life expectancy, and of course the ability to provide a better response to illness, faster drug and vaccine development, and early detection and prevention.”
Remote medicine/ telemedicine – Putting the patient in the driver’s seat and moving the center of treatment into homes
The dramatic change that digital health is bringing about in the healthcare system is very timely. The increase in life expectancy has accelerated the increase in chronic morbidity worldwide, with chronic patients, most of them elderly, being the main consumers of health services. But the healthcare system in its current structure is not really prepared to treat chronic patients, and the result is that it has become over-burdened, which threatens its ability to function effectively. Nowadays, if we do not feel well, we go to the doctor, make an appointment with a specialist, undergo tests, ask the specialist to decipher the results, and then get the treatment – a long, cumbersome and tedious process. With the help of technology, a movement towards the patient is beginning, which will fundamentally change this process.
The patient is gradually becoming an ‘at-home patient’; their interactions with the doctor are conducted digitally in part, and they take over some of the responsibility for managing their own illness. This changes the traditional patient-physician relationship and the healthcare system itself, which in the future will need to be much more involved in health and not just illness, providing support and education about sleep, nutrition, drinking and exercise, as well as medication. The goal is to actively keep chronic patients, and indeed the rest of us, in a healthy state, instead of just reacting when patients become ill.
According to Moshe, we are not there yet, but we are closer than ever. “Already today, technologies for remote treatment – big data, artificial intelligence, IoT and more – make possible virtual visits to the doctor, remote monitoring of patients’ health, the performance of tests from home using modern equipment, and more. For example, the Nonagon system – which we were partners in developing, up to and including the regulatory approval stage – aims to achieve an 80% reduction in congestion at community clinics through the use of an app and a remote testing device, which enable patients to get real-time medical services (diagnosis, referral or prescription) by a qualified doctor.
“IoT technology is also gaining momentum. For example, if you have a smartwatch, your doctor can access information like blood pressure, heart rate, sleep hours and more on a regular basis, and assess how they change over time. The watch can also send alerts to the doctor about a fall, a drastic change in blood pressure, etc. In the United States, there are virtual hospitals, where the patients all remain at home. Nurses sit in front of a screen, and if something happens, they alert the doctor. By the way, with the deployment of 5G communications networks in Israel, a very significant barrier to telemedicine will be removed – we will have an advanced surfing experience at speeds we have not had before, and stable connections. This will significantly improve the telemedicine experience.
“As mentioned, some of the tasks involved in process management and the treatment itself are being transferred to the patient. We are getting used to managing our health independently, and already expect the system to give us the tools to do it correctly. Almost without us noticing, the patient is moving into the driver’s seat. Against this background, it is not surprising that almost half of all applications currently developed in the field of medicine are designed to help patients with chronic diseases manage their disease. According to the IQVIA report mentioned above, the percentage of applications that help us manage our health status has increased from 28% in 2015 to 47% in 2020. We have to understand that today’s patients are, to all intents and purposes, ‘medical consumers’. They conduct extensive research, consult on social networks, and consume a lot of information – some of which is correct, much of which is not, which is another matter in itself. (The way in which misinformation undermines our trust in the healthcare system is a different issue altogether.)”
Use of artificial intelligence for diagnostic and preventive medicine purposes
“It’s no secret that there is a great burden on doctors in the healthcare system,” says Moshe. “Doctors have an average of 7 minutes to dedicate to each patient, which puts them under huge pressure, creating a significant need for tools that can partially automate the work of the doctor and medical staff. At the same time, with the transition to digital that was prompted by Corona, we have accumulated a huge amount of data, and in order for it to have meaning, we need ways to make it smart, capable of easing the burden on the health system and improving the ability to diagnose and predict diseases. The use of artificial intelligence for the purposes of automation, diagnostics and preventive medicine is almost self-evident.”
Health systems already understand this. According to a survey of senior decision-makers in health organizations conducted by Intel, in 2018 37% said that the organization they work for had adopted or planned to adopt artificial intelligence; in 2020, just before the Corona outbreak, this figure climbed to 45%; and after Corona began to spread, it jumped to 84%. There is a lot of confidence in AI technology, with the majority of decision-makers saying that within two years they will rely on artificial intelligence in the processing of medical records (two-thirds), and for diagnostic analysis (62%).
“Sometimes there is a gap between design and actual execution, between technological innovation and the maturity of the market,” says Moshe. “One such example is the case of machine learning algorithms that help physicians analyze the results of imaging tests, such as CT and X-rays. Start-ups that have been declared promising, with innovative technology, did not succeed, because they were not able to offer a sustainable business model (the question is always – who pays?). Another example, and one of the best known and most fascinating in the field, is Watson – artificial intelligence technology developed by IBM, and used by physicians as a medical diagnostic assistant. (See this interesting article in The New York Times).
“But, there are also other examples of companies that are succeeding both technologically and commercially, for example viz.ai for strokes, Aidoc for detection and triage, pulmonary embolism and strokes, iMedis for radiology (to which we made a small contribution), and more. I believe, this will continue to be a prominent trend in the coming years, because the need for automation solutions is very great, even if in the early stages artificial intelligence in health will have to learn to walk before it starts running (for example, initially being limited to more basic uses than diagnostics). One of the big challenges lies in where this area meets regulations. After all, a large part of the technological developments described above are based on access to data – sensitive medical data, which is protected by law – and regulations around its use are very complex, which brings me to the next issue.”
The digital acceleration and technological advances in the fields of artificial intelligence will only increase the acute need for information and cyber security
Along with the many benefits of the digital health revolution, it also exposes the healthcare system to far more cyberattacks than ever before. The recent attacks on Hillel Yaffe Medical Center and the Mor Medical Institute gave us a particularly vivid and painful illustration of this. During an emergency discussion in the Knesset’s Health Committee, which took place following these attacks, a representative of the Ministry of Health, Reuven Eliyahu, revealed that the Ministry of Health stops about 100,000 cyberattacks on medical institutions every month. Beyond the damage caused to medical institutions, patients are also harmed. For example, in the attack on the Mor Medical Institute, personal details of thousands of patients were published.
“According to a study conducted this year, in which health apps were tested in app stores, about 88% of health apps can collect data, and in some cases can even share users’ data,” says Moshe, “When you think that we’re talking about sensitive medical data, you start to get some idea of the great complexity of managing and protecting such information, as well as the complexity of the regulatory standards that need to be considered.
“And I haven’t even mentioned yet the different formats of information systems used by organizations, or the need to synchronize between the different systems of hospitals, health funds and more. FHIR® (Fast Healthcare Interoperability Resources) is a hot example of how significant this challenge is, which we will have to consider in the coming year. FHIR® is a protocol that aims to create uniformity between healthcare systems in the US, and is expected to come into effect by the end of 2023. This means that systems that do not communicate with FHIR® will not be able to work in the US.”
We asked Moti Chiko, CEO of 2BSecure@Matrix, to expand on the unique challenges that characterize cyberspace in the field of health, especially against the backdrop of the digital health revolution. He told us:
“The unique characteristics of the healthcare system, together with the complexity and innovation of the digital health world, enable attackers to intensify the impact of the harm they can cause to these systems. Following the digital revolution, many populations now have easy access to healthcare systems and, aside from the obvious value to the public, this exposes these sensitive systems to a much greater extent than before. The openness of the systems to users, the extensive information available in the systems, cloud data storage – all these factors and more will increase the need for security solutions at the highest level. Today, there are technological solutions to all the threats, and the field continues to develop. In the next few years, many resources will be devoted to developing solutions to improve existing defense systems.
“The real technological challenge, in my opinion, will be in maintaining and preserving the level of security over time, as well as the ability of corporate cyber units to share information between them, consolidate and bring into uniformity the threat space, and monitor everything from one point. Otherwise, we will witness advanced technology which provides a platform for patient care, but at the same time is threatened on a regular basis and struggles to defend itself against frequent attacks.
“At a conference on the subject, held at the IMed Center for Medical Innovation and Entrepreneurship at the Ichilov Medical Center in November 2021, Prof. Ronni Gamzu announced the establishment of a special emergency program for enterprises in the worlds of cyber defense for health systems. As I see it, any solution should be holistic, and take into account technological innovation in the fields of digital, data, cyber and the cloud, as part of the same system, the same ecosystem.”
“In conclusion, technology is causing dramatic changes in the field of health, and much more could be said about the issue, beyond the scope of this article,” says Moshe. “We’re experiencing the contribution of technology to our lives faster than anything we have experienced in the past. We are lucky to live in an age where change is happening right before our eyes.”