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[00:00:00] Kimberly Boyd: Welcome to Pragmatism in Practice, a podcast from ºÚÁÏÃÅ, where we share stories of practical approaches to becoming a modern digital business. I'm your host, Kimberly Boyd. Last year, ºÚÁÏÃÅ released its first Looking Glass report which examined more than 120 technology trends, capsulated through six lenses, to help businesses understand what those trends could mean for them.

Now we've done the same analysis for the healthcare industry through the Looking Glass healthcare report. There are hundreds of ways that technology is transforming healthcare delivery, management, and patient outcomes. I have here today Scott Davies, Tech Principal based in the UK, who will help us dive into the key trends that are likely to have the biggest impact on healthcare, and should be prioritized for organizations' modernization budgets. Welcome to Pragmatism in Practice, Scott.

[00:00:49] Scott Davies: Thank you. Nice to be here.

[00:00:51] Kimberly: This is the opportunity for us to learn a bit more about healthcare trends and technology, and also for us to get acquainted with one another. To get us started, I would love for you to tell us a bit more about you, your role, and why you're passionate about transforming the healthcare sector.

[00:01:19] Scott: Great. Thank you. My name's Scott Davies, I'm responsible for technology and insights for our public sector clients in the UK. I've actually just spent the last couple of years being focused on supporting our healthcare clients, and look at how they can use technology to deliver better patient outcomes. I think the time's right now to change the way we look at healthcare sector, and how we put the patient back at the center, both in terms of addressing their needs and in putting them in control of their data, and how it is used to rebuild patient trust and empower them to make better decisions about their own health in a more proactive way.

[00:01:55] Kimberly: Well, that makes a lot of sense. I think all consumers now are interested in having a little bit more control and are a little more knowledgeable about data and perhaps their rights around it, so this is definitely a space I think that's ripe for opportunity. Scott, can you tell us a little bit more about why this is a report that people should pay attention to? Why this report is important for the future of healthcare delivery?

[00:02:24] Scott: I think it offers a lot of insight into the problem areas of healthcare. Then it looks through a set of technology lenses at the trends and opportunities we see for innovation in that space. For example, one of our core focus lenses was artificial intelligence and machine learning, and how that could be used to enhance healthcare provision. The overall theme, though, is really a convergence of trends and key enablers in different technology areas that come together to create something that's quite unique and quite game-changing.

Traditionally, healthcare organizations have had to make decisions based on a partial view of patient data, based on only what they have in their own systems because the interoperability between these systems has always been problematic. I think by putting the patient at the center, there's an opportunity again to actually create something that represents a bit more of a holistic view of the patient through the systems that are far more interoperable.

[00:03:20] Kimberly: Why is it now? Is it just the perfect storm of capabilities and technology, or having this moment in time where they're all aligning that's allowing us to break through that interoperability that's previously existed?

[00:03:37] Scott: I think that's really interesting. That's something that you can look at from a number of different angles. I think the first thing is our expectations have changed. I think previous generations' interactions with healthcare were very different and not proactive. People tended to go and see a physician when they were not well, rather than interact with healthcare when they are already well and fit and able. I think our expectations have changed. I think as well, the way we consume the services that healthcare providers have has changed as well.

In the past, perhaps there were only one or two big suppliers in that space, and now with the emergence of startups and a lot smaller companies and innovators, perhaps that healthcare system landscape is made up now of 20 or 30 different providers. Perhaps there's one that does genealogy research, or one that is a specialist in cancer care. There are things that would've traditionally been provided through one or two routes, and now actually, we even shop around. We choose one against the other.

[00:04:50] Kimberly: Yes. It's not even the technology trends, it's the general market trends, the move towards wellness. The fact that there's more choice, it's the combination of all those things coming together right now?

[00:05:03] Scott: Precisely. Precisely, I think that's exactly what's happened.

[00:05:06] Kimberly: Curious too, is there a choice? Is there-- I know we sit on the opposite side of the Atlantic Ocean, and we definitely have choice here. Is that the case too if you're in a country like the United Kingdom where there's the NHS so there's still people shopping around in terms of healthcare services?

[00:05:26] Scott: That's really interesting. As you're saying, yes, quite rightly, in the UK, there's a national healthcare provision that everyone uses, but you can still elect to use private services as well. I think that's what a number of people do, some of which are paid for perhaps direct care, but some that are also perhaps more about wellness and fitness in particular.

[00:05:50] Kimberly: Got it. Why does this matter if I'm not a healthcare organization, if I'm not a digital leader in a healthcare organization? Why should I pay attention to this? What's exciting for the individual healthcare consumer?

[00:06:30] Scott: That's good. I think, as an individual, if we start there, we're all patients and as patients being put back in control of access to our data and how that data is used, both for our own care but also to help provide positive outcomes for others is really useful, and there's a massive emergence now of a trend towards personal data stores. Where you and I have almost you can put your hands around your own data and hold onto it and work out how that's shared and how that's accessed by other people.

I think that's firstly it from an individual perspective. I think then for organizations that are not healthcare organizations, I think there are also a lot of parallel opportunities, where putting their own customers in that kind of position, where they put them back at the center would help build better trust and engagement from that audience. Then the other angle for those other types of organizations on data is the amount of data that's being generated and consumed, processed, and needs to be understood across that is very similar, and that will be the same for lots of organizations.

[00:07:46] Kimberly: It's interesting what you mentioned the opportunity that's here or nearly here as a patient or a consumer of healthcare where we can have more control of our data. I'm starting to feel that just a fraction with the pandemic and having to show your vaccination records everywhere you go. There's not like one easy source for that, and I can definitely see and feel it in real-time, but I would love not just to have my vaccination records. I would love to have all of them in a one-stop shop.

How far away do you think we are from something like that? Is that something that almost becomes infrastructure like the internet, or is that something that one of these leading healthcare organizations will step to the forefront and create a solution for?

[00:08:36] Scott: I think you're right. I think the trend definitely that way. I think there will be a one-stop-shop, but whether it'll be in the hands of a particular supplier or not, I think is up for debate. I think we'll definitely get very close to our own personal data stores, where I can choose to share that data and that will be more seamless across settings, that will definitely happen. I think that's definitely what we're going to see in the next couple of years. I don't think there'll be one big player that emerges though and owns that because of that fear about how that data's being used, even when that's a state.

[00:09:15] Kimberly: Absolutely. I can imagine, I think we've read books and seen movies about all the nefarious uses of data out there, so while there's lots of opportunity, there's probably an equal amount of risk and security that that needs to be considered as well. Talking still a little bit more, maybe from wearing the hat of the healthcare consumer, I know one of the trends that is touched on in the looking glass report is really about the rise of wearables.

I'm sitting here with my apple watch on. I check it to make sure I'm moving around at least the minimum around these days as I'm sitting in the middle of winter. Really, remote monitoring devices have been around for quite some time, but it seems like they've really taken off as of the last few years. What's changing or anticipated to change when it comes to wearables?

[00:10:16] Scott: I think the first thing there is our own desire for data. We're really interested about how far we've gone, how much we've exerted ourselves, whether that's normal, or were we doing better, this feel-good factor that we get from looking at it, completing the rings, and all those other things that go with it. I think there's definitely that and the desire to be more in control of our own health care, like "What am I going to do to improve my health?" That kind of angle, so that I can make better wellbeing or better informed choices about diet, activity, and all sorts of angles.

I think that's the first bit. I think the other angle, obviously, is the relationship that you and I have with our healthcare providers. I think there's great opportunities there for them to have better serve us in a more timely way with the right level of support, healthcare interventions, and information because of that data being more real-time.

[00:11:23] Kimberly: I just came from my annual physical, so I could see a future where my physician was like, "Let's just check your wearable and tell me if you're truthful and saying you exercise four or five days a week," which maybe scares me, [chuckles] but it's probably good for the quality and veracity of my health data in the long run.

[00:11:47] Scott: I think that's really interesting. I don't know if it happens in the US, but in the UK now, there are some insurers and company-provided health schemes who actually reward you for sharing and improving your health scores and things through fitness devices.

[00:12:09] Kimberly: Absolutely. I've seen some of that as well. I think it's not completely widespread yet, but it's interesting. We've talked a lot about data, but it's also, for some of these healthcare organizations, almost putting on their retail or their consumer goods hat and saying, how can we gamify this? How can we make the customer experience when it comes to healthcare data more appealing so people can maximize? Both on the provider end and the consumer end, it's definitely converging.

[00:12:43] Scott: I think it gives a really interesting provider angle as well. I think we talked at the start of this about perhaps our engagement historically with healthcare has been, "I feel unwell, therefore I'm going to go and see somebody," rather than almost a continuous dialogue through wearables and the data that they provide, and somebody saying, "Hang on, Scott, that doesn't look right for you." Rather than, obviously, it can be far more dangerous and far more costly to actually treat something that's happened rather than prevent it from happening. I think that's quite interesting.

[00:13:24] Kimberly: Yes, exactly. We maintain our cars, we maintain our homes, why don't we maintain ourselves like we do the inanimate objects in our life?

[00:13:36] Scott: I think certainly it's part of-- We're all aging. As you age, I think on a day-to-day basis, you probably accept a lot of the changes and don't really notice them, but actually, to have somebody or something actually prompt you and say, "This isn't as good as last year."

[00:13:58] Kimberly:ÌýSpeaking of adding up data and looking at it over different periods of time, it's not as though healthcare hasn't always been an industry that's rife with data. It's been a part of it really ever since its inception. Can you talk a little bit about what some of the new tools are, or what some of the ways that the industry is really thinking about and revolutionizing how data is captured and used?

[00:14:53] Scott: Yes, certainly. We've progressed a lot, I think, in terms of artificial intelligence and machine learning over the last couple of years and the way that we approach interpreting and analyzing data. We've also taken a step back actually, and actually looked at the outcomes that have been provided by tools like artificial intelligence and machine learning, and actually said, "How did it get to that answer?"

One of the things that we at ºÚÁÏÃÅ have been promoting is explainable machine learning or artificial intelligence, systems that can actually display their reasoning about why they're offering an insight.

I think we're now at that stage where we can start to do that a lot better. That and the emergence of more real-time analytics tools, that can help derive insights over larger amounts of data, be that through the scale, the things like public cloud provide, or by more efficient computing, I think it's certainly more reachable now. You can certainly get handheld devices that can do image recognition. You can do it on your phone, you can point Google, for example, using your phone animate objects around, and it'll tell you what they are, and it'll tell you history about them. That certainly wasn't achievable three, four, five years ago.

[00:16:23] Kimberly: I think your point around the explaining the why behind it is especially important in the healthcare industry, right? I think it's not something you necessarily just want to blindly take an answer for. Technology can advance and enhance things a lot for us, but AI doesn't necessarily always get things right. The fact that they can have that added piece of the equation to say, "This is why," especially when people are making decisions when it comes to health, I think is incredibly important. Sounds like it's striking that right balance between enhancing with technology but not at the expense or a shortcut when it comes to care.Ìý

[00:17:13] Scott: Yes. I think the other thing about that as well is we talk a bit about it in the report is looking at things like averages in things like healthcare can actually be harmful sometimes, because activity on a daily basis for you may be very different from activity on a daily basis for me. Actually, we shouldn't always compare or average across lots of people because that might not be right. I think there's opportunities now with the technology because we can process the data far better, because we can make it far more personalized, we can actually say, "Hang on, Scott, this isn't normal for you, not normal for a male of your age and ethnicity and background. It's just not normal for you."

I think as we build up this data over time, and we actually we're able to process it more and actually get more insights, we can actually offer more personalized healthcare, which I think is a really exciting area.

[00:18:13] Kimberly: Absolutely, right? We're already in the age of personalization, but especially when it comes to healthcare, people have very unique sets of personal circumstances. Having the access to that data I think allows providers to get really granular and really create solutions for individuals, which I think is probably not something we've had before. It typically has been maybe the law of averages and patterns, which works to a degree but this really just opens up a whole new area of opportunity.

[00:18:57] Scott: Think about you going to your provider and having a discussion about your goals and then coming out with a recommendation or a set of plans that will help you get there. That's a very different thing.

[00:19:11] Kimberly: Almost like, I equate it to, if you go to a personal trainer and say, "This is what I want to accomplish." It's a mindset shift I think for the entire healthcare industry because I think people probably on the consumer side have been more passive. All this change I think allows people to be a little more proactive and say, "This is what I want to achieve. Here's my information. How can you help me build a solution or build a path to get there?" That's a really big shift, I think.

A theme I keep hearing through the course of our discussion too is really healthcare is becoming much more similar to consumer than it ever has been before. I think it's a little bit, literally they used to dole out the medicine and now it's more of a personalized experience.

[00:20:09] Scott: I was just going to say, I think that's interesting as well. If I look at my parents' generation, if a doctor gave them some medicine to take, they would take it and would keep taking it without question until they were told to stop or until they ran out of medicine, we are far more questioning now about what's this for? What are the side effects, why should I take it even almost challenging back because it is a far richer picture and we're far more educated in terms of how we take care of our own health. We want to know more about what we've been asked to do.

[00:20:49] Kimberly: I think that ties back to a bit when you were talking about the AI as well and the use of it in giving the recommendation but giving the explanation of it. It's great that we have that capability, but I also think that's a demand that we're starting to see from more informed healthcare consumers. We've talked a little bit too about there's a variety of tools that are revolutionizing but then there's also augmentation tools. Is there anything else that executives should be aware of or keeping an eye out for in this really shift being more proactive and preventative in the healthcare industry?

[00:21:43] Scott: Yes, I think one of those big areas is about how, is about how we maximize the time that clinicians and clinical staff have and how we make better use of that time. That means a couple of things. That means smoother workflows, it also means systems that interoperate better, but it also means systems that can help those folks perform their task better.

For example, we see tools emerging like natural language processing that can help the clinicians or clinical staff summarize text and things like that. They'll look at a whole paragraph or two of text and say, "I think this is about this, this, and this. Is that right?" Doing that allows the clinical staff to engage and actually say, "Yes, it is about this, this, and this. That's not a bad summary," or, "It's about this, this, but also this," and that helps save them time. It helps them with contact switching. It helps them perhaps think about the decisions they're about to make.

We talk a lot about how we support those people to make better use of their times instead of copy and pasting things between systems, spending their times trying to understand how the system works rather than what the workflow they're trying to accomplish is. You know, when they're sat there with a patient in front of them, their objective is to look after that patient, it should be the quickest way to that.

[00:23:25] Kimberly: I can say for my sample size of one that I've definitely noticedÌý more automation being used in my interactions with healthcare providers.Ìý Which before it was a lot of handwriting, and I was like how is this still happening in which it might seem like a little thing, but when people are starting to use those tools, it then enables all the other things that we were talking about or at least enables them to happen more quickly. So I've definitely felt some of those changes firsthand.

[00:24:06] Scott: I think another interesting thing we're starting to see is ways people are using technology better to engage those people who don't normally engage with healthcare. I think we've seen some emergence of systems that do things like they'll send you an SMS message to say, "Hey, you are due a vaccination. It's free." "I've got appointments Monday at three, four, or Tuesday at five, which would you like?" They're reducing the barrier for that person to engage with healthcare provision, so instantly, they pick A, B, or C, send a text message back. "Okay, you're booked in for three o'clock on Wednesday." They haven't had to contact their healthcare provider, sit on the phone line for ages, find a computer to use, try and remember their passwords. It's happened in a more interactive fashion that's actually made it easier.

[00:25:14] Kimberly: I think besides these lenses and these trends, we can perhaps add an additional lens of the pandemic to thank for prompting some of these things. I don't know why it took a global pandemic for us to make those changes, but if it has and it's prompting people with automatic appointments and reaching those people that we haven't before, that's a little bit of a silver lining probably that we can take out of the past few years.

[00:26:00] Scott: Yes. It's made a significant change. If you look back, telemedicine and stuff that is more than 20-years-old yet has never really come to the levels we're now seeing, and that last advancement, that last step has just been two years.

[00:26:15] Kimberly: Yes, absolutely.

[00:26:16] Scott: Yes, I agree with you. I think it's a real positive that's come out of a horrible situation.

[00:26:22] Kimberly: Although I do have to chuckle when it comes to telemedicine. My husband early last year did his first virtual doctor's appointment and he was still sitting on the Zoom for 20 minutes waiting for the doctor to show up. We've still not figured out how to make doctors on time [chuckles] for their appointments. Some things never changed, but at least he was able to do it from the comfort of his own home versus a waiting room. The good news is there's still room for growth.Ìý

Well, Scott, one final question here for you today. I know the Looking Glass report obviously talks about trends, and what we have to anticipate and look forward to in the coming year and years in the healthcare space, but is there any single prediction for 2022 that you're particularly interested or excited about and feel like that can come to fruition this year for us?

[00:27:33] Scott: Wow, that's a tough question. I think that if I had to pick, I would say it's the emergence of personal data stores and actually putting us a bit more in control of our own privacy and being able to decide how, when, and what is shared.

[00:27:51] Kimberly: Scott, we've talked a lot about some of the different trends, the use of data, the use of technology. Is there really anything else that is worthwhile to mention that executives should be aware of in this revolution of preventative healthcare?

[00:28:07] Scott: I think there's much more to uncover such as creating opportunities to improve the accessibility, inclusivity, and equality of healthcare service and the healthcare service provision, and making that sustainable. Creating the right infrastructure to support it and those ecosystems around them, but also as well, thinking about the implications as maybe hostile technology and that's all in the report.

[00:28:32] Kimberly: Well, Scott, we can certainly see how the future of healthcare will be smarter. Thanks so much for your insights today, and thanks to our audience for joining us for this episode of Pragmatism in Practice. To learn more about this topic, please download the Looking Glass healthcare report from our website. If you enjoyed this conversation, check out our past episode on creative artificial intelligence found at thoughtworks.com/podcasts. Take a listen, and if you enjoy the show, help spread the word by rating us on your podcast platform.