The Year in Review

By Mark Thill

Amazon on My Mind

Year-end reviews are supposed to recap events of the year just passed and glean wisdom from them. But the events of the year 2017 are forcing me to look forward at least as much as backward. That says something about the pace of change today.

In September, for example, Boston-based Day Zero Diagnostics was selected as the winner of the 2017 MedTech Innovator competition at The MedTech Conference. The company combines genome sequencing and machine learning to combat antimicrobial-resistant infections, enabling physicians to switch from broad-spectrum antibiotic therapy to a targeted antibiotic in hours rather than days. Talk about the future.

Then in October, the American Medical Association announced an online platform designed to bring physicians and health tech companies together to develop and improve healthcare technology solutions. The Physician Innovation Network is an online community where physicians can connect with companies and entrepreneurs who are seeking physician input in the development of healthcare technology products and services. Sounds like a crowdsourcing variation-on-a-theme.

And by now we all have heard about Amazon’s intent to dive into the healthcare supply chain. This fall, it was reported that the company was obtaining wholesale pharmacy licenses in states across the country.

Bots can do it
Amazon is definitely on the mind of Richard Zane, M.D., professor of emergency medicine and chief innovation officer for UCHealth in Aurora, Colo. Speaking at the 59^th Annual Meeting of the American Society of Radiation Oncology (ASTRO) in San Diego, Zane said he believes that the digital revolution – wearables, the cloud, bots – may save healthcare. It’s an industry ripe for disruption by companies such as Amazon, in terms of money spent, money wasted, and old ways of doing things that contribute little to better health, he said. Not to mention that healthcare has about the same safety profile as bungee jumping. “We kill almost 440,000 Americans a year,” he said.

Zane believes that Amazon will bring its “last mile revolution” not just to the delivery of medical devices and pharmaceuticals, but to medical care itself. It will be joined by companies like Google, whose Project Baseline is studying how wearables can redefine what a healthy and unhealthy human looks and acts like.

When you speak about the potential of wearables, you’re talking about a continuous stream of data, providing accurate, reliable information about a person’s physical and emotional state of being, Zane pointed out. That’s great. Problem is, not even the best, smartest doctor or other diagnostician can process all that information and make good on-the-spot medical decisions. But bots can, said Zane.

Imagine an automated attendant listening to an asthmatic patient’s complaint of a respiratory ailment, processing his medical history, getting a reading on current atmospheric conditions (such as pollen count, humidity, etc.), and then making a recommendation for how that patient should navigate his or her day. Maybe Alexa can help?

But if – or when – we come to rely on bots or automated systems to make diagnostic and prescriptive decisions, where does that leave tomorrow’s physician? And closer to home, will bots be making product decisions for providers? If so, what will be the role of the sales rep or the contracting executive? And will we – gulp – need journalists to make sense of it all?

Yes, it’s safe to say that Zane has Amazon on his mind. So should we all.