Given rapid advances in AI, it’s interesting to think about what they mean for US healthcare. Healthcare is a combination of (1) compute tasks (some version of “given their symptoms, how can we help this patient”), (2) simple interventions (“take drug X once a day”), (3) basic patient care in a hospital or other care setting – take vitals, start a line, take blood sample, provide food, and (4) highly specialized procedures e.g. trauma surgery or image guided cardiovascular procedures.
1. Compute/diagnostics/monitoring tasks All text/image/audio compute tasks are ripe for automation and there will be increasing pressure to automate them (higher hospital profits, faster, potential liability for failure to use best methods/tools, improved patient outcomes). Lobbying by professional societies will slow the rate of adoption, but that’s a loosing battle and hopefully the affected fields will rethink themselves rather than focus on delaying the inevitable.
2. Simple interventions can be scaled/automated by connecting an online pharmacy with the triage or diagnostic AI. This trend is already underway, with a human doctor in the loop largely for legal/regulatory reasons. Expect lobbying for transition to a fully-automated integration of #1 and #2 based on super-human performance of the triage/diagnostic AI – if the computer-only system is better than the one with the human doctor in the loop, presumably the FDA and other regulators will cave in at some point (although this may take many years).
3. Basic patient care is here to stay in some form – it consists of many different tasks that can be hard to automate, despite e.g. Japan’s long standing robotics R&D for supporting their aging population through care robots. The main trend will be to replace tasks requiring specialized skills (such as currently provided by registered nurses (RNs) and Physician Assistants (PAs)) with tasks that can be performed by lower paid staff (such as CNAs, certified nurse aides). For example, CNAs do not normally draw blood but hospital procedural changes could normalize that, after additional training for the CNAs. Per #1, any monitoring/diagnostic tasks currently provided by RNs and PAs will be increasingly automated, based on cost/speed/scaling/liability. In parallel, medtech tools and devices that radically simplify existing patient care procedures – such as placing IV lines, taking vitals, or drawing blood – will be championed by hospital CFOs.
4. Highly specialized procedures Upon first thought, it’s hard to imagine things like heart and brain surgery being massively impacted by AI and automation. Sure, minimally invasive procedures are growing and surgeons now frequently use robots, but the basics seem solid (highly trained humans use tools to help patients). The real threat to surgeons (and opportunity for medtech investors and innovators) are tools that allow complex procedures to be completely avoided or replaced by simple procedures. A great example is the replacement of amniocentesis or CVS by non-invasive prenatal testing (NIPT). Rather than first needing to manually collect and biopsy placental cells with a long needle or catheter, equivalent genetic information can be obtained through a simple blood draw and subsequent characterization of the circulating fetal DNA. NIPT is a win for (almost) everyone, since it reduces miscarriage risk to the mom and replaces a highly specialized procedure (done by an experienced doctor with ultrasound guidance) with a vastly simpler procedure (a basic blood draw) that can be performed by a phlebotomy technician. Presumably, startups focusing on down-skilling procedures/interventions currently requiring highly trained doctors, to services that can be performed by aides or technicians, will receive much investment.
TLDR
Trends and opportunities to look out for:
- AI decision support tech that reduces costs and improves patient outcomes. AI decision support is the precursor to replacing humans due to the need to first collect human vs. computer performance data for regulatory filings, scientific publications, and marketing materials; decision support tools are a natural entry point and necessary stepping stone to full automation.
- Medtech tools/devices that allow basic patient care to be primarily provided by aides and technicians rather than RNs and PAs, since monitoring/diagnostics will be increasingly provided by computers rather than humans.
- Medtech tools/devices that dramatically down-skill (or bypass) the need for procedures/interventions currently provided by highly trained professionals. For example, tests using circulating tumor DNA reduce the need for tumor biopsies and redirect payments from doctors and hospitals to genomics/diagnostics tech companies.
Robots, Data, and Networks 