As we conclude our series on care automation with Dr. Ray Costantini, CEO and co-founder of Bright.md, we look toward the future and what it will take to implement care automation on a wide scale, plus examine the inclusion of genomics in patient records and how that impacts care delivery.
Intel: What challenges do you see ahead for implementing care automation solutions at scale?
Costantini: A challenge that we’ve identified is that in healthcare, IT is often managed as a cost center rather than as an innovation center. Even at great health systems, which have really strong CIOs, that often means there’s not enough IT resource availability to move forward with innovative IT projects. To help with that, we’ve worked hard to ensure that the EMR integration options for SmartExam are robust, HL7-standards based, and quick and easy to implement.
Because what we do is so unique and new, one of the key challenges that we’ve faced is helping health organizations know that a system exists. Because video-based care is what executives have seen, they are often looking for video-based products as a way to improve their convenience care offerings. Video certainly has a valuable place in health care. On the other hand, it’s pretty hard to make a sustainable business case for video in the high volume, low margin, capacity constrained areas of healthcare, like primary care. Once we have an opportunity to show physicians and healthcare executives how SmartExam works, we’ve found it to be a much easier process.
Intel: How do you see the inclusion of genomic data in a patient record impacting care delivery and our ability to automate care? With genomic data, is there a limit to the types of conditions that could have automated care workflows?
Costantini: We spend a lot of time and thought around potential areas for clinical growth, and as healthcare becomes increasingly quantified and precision driven, the number of opportunities for that growth are virtually limitless. At our core, what we’ve built isn’t constrained to being a low-acuity care platform; it’s a care automation engine, and there are a lot of exciting ways to use a tool like that. As an example, we’re already able to gather and synthesize information from multiple, disparate sources, ranging from structured EMR data to patient interview information. Adding in lab results, or genomic data or any other structured information is actually a relatively small step now that we’ve built that foundational care automation platform. We see a lot of tremendous opportunities to further support the personalized, precision diagnosis and treatment process.
Intel: Where do you see the care automation industry going in the next 3 to 5 years? By 2020 will it be common practice to get automated care for certain conditions?
Costantini: There are more than 415 million eligible primary care visits in the U.S. every year that would benefit from care automation. That’s more than $150 billion of healthcare spending. We’re also facing more than a 30 percent shortage of primary care capacity. It takes 10 years to train a new primary care provider, so even if we magically ramped up our training programs by 30 percent today, we wouldn’t see an increase until 2027. And on top of that, we’re already spending almost 20 percent of GDP on healthcare - that’s twice the OEDC average. We can’t afford not to use care automation tools to help improve provider efficiency, reduce costs, and improve the quality and value of care being delivered.