AMC Health

Lloyd Mangnall

That is a key question we have been exploring at AMC Health as we strive for disruptive innovation in real-time virtual care. Traditionally, virtual care was viewed as remote patient monitoring – where each patient’s biometric readings were collected from monitoring devices, then aggregated, analyzed, and sent to a clinician—with irregularities and trends highlighted—who ultimately decided what level of intervention a patient needed. We want to expand that passive, linear model to one where more ‘collaborative interaction with the patient occurs’—both in real time and asynchronously.

“By monitoring and engaging patients virtually, we forge a connection that is both depended on and valued”

As the world boldly marches forward into the Internet of Things (IoT) age, billions of inexpensive, disposable sensors will monitor people’s vital signs, symptoms and behaviors while they are in the hospital, an outpatient setting, at home, or anywhere else. All that new real-time informationwill be transmitted to their mobile devices, and eventually to the cloud. Billions and billions of discrete, potentially relevant clinical events will be sent to the cloud every few milliseconds. However, this deluge of real-time information will be too large and too fleetingfor merehumans aloneto process into anything meaningful. Artificial intelligence will need to process the information, correlate it, and make decisions about what’s relevant. Relevant could mean out-of-range readings, significant changes in trends or stark variances.

We are launching the first phase of this disruptive new healthcare platform, with an infrastructure that gathers and transmits much more useful quantitative and qualitative information wirelessly and presents it in a meaningful way to clinicians. Over the last year, we have been working to create what is essentially a patient engagement social network. Utilizing mobile technology, we have started to enable a more dynamic interaction with chronically ill patients, similar to what they would experience in a doctor’s office: How do you feel right now? What did you eat today? Did you take your medications? And we delve a littledeeperwith specific questions to gather information related to their disease or condition.

We are continuously enhancing the ability of patients to interact efficiently with their care team. As an example, we have all grown accustomed to websites that provide the option for live online service through chat sessions. We take it one step further by enabling the complete virtual care experience. We connect them quickly with the appropriate level of support—basic tech support, automated education, behavioral coaching, even clinical monitoring and support by registered nurses for simple patient health issues and direct connections to physicianswhen appropriate. By monitoring and engaging patients virtually, we forge a connection that is both depended on and valued. This is important because most patients with chronic illness see their doctor every 90 days. For the other 89 days, we provide the appropriate level of constant coverage. The patient is never really on their own. 

As we progress in this direction, we are working on a global healthcare platform that resembles social networking sites like Facebook and LinkedIn. Patients and clinicians could create dynamic networks of friends in health, which offer different perspectives on the same information. Patients may include their clinicians, their personal health and wellness coaches, their family and friends, and possibly even other patients who are dealing with the same condition. Clinicians will include patients, as well as consulting or referring clinicians, and possibly even researchers. Data that is being collected through the Internet of Medical Things or gathered via the highly social interaction of providing care could be posted directly to the patient’s “wall” and would be accessible to different groups depending on the patient’s authorization.  

Different members of the patient’s social care network would have relevant information available to make better decisions. A son or daughter would be able to keep track of their parent’s heart condition remotely. On another level, clinicians may be able to look across all of their patients with a specific type of cancer and identify trends, or a family could have control over its extended medical history.

Modern electronic health records are nothing more than detailed journals of health-related events that occur across a patient’s lifetime. Currently, our health information is stored in fragments buried deep within multiple monolithic EHRs. Through our approach, we will start to see that each individual’s data is no longer out of reach if you aren’t in a hospital, doctor’s office or outpatient setting.The electronic health record (EHR) will begin to look like a highly secure version of Twitter, Instagram, Facebook and LinkedIn. Plus,‘each individual could bring their information with them anywhere’ simply by inviting new friends into their dynamic network of friends.

Every great company must innovate to fundamentally differentiate itself in the marketplace, and innovation by its very definition requires invention. We are striving to purposely disrupt the status quo in healthcare and develop something truly transformative. At the heart of our work is the ability to build upon what others have done before. We are learning from the models developed by Twitter and Facebook and Amazon. They have already solved many similar problems in a different context, so we are adapting their approaches to the healthcare space. The methods that we are applying are applicable across the entire IoT landscape.

Though we are strong proponents of innovation, wherever we can, we leverage off-the-shelf components to satisfy commodity concerns. Unfortunately, many technology leaders today are overly reliant on commercial off-the-shelf technology. A lesson I’ve learned is never to accept what the vendors are pitching me outright. Everyone can buy the same commercial technology, so by default that makes everyone the same; focusing only on a specific vendor solution means doing only what everyone else is doing and omitting the critical differentiation that distinguishes you from the pack and ultimately gains market share.

We take what is already part of the open source domain and find common patterns that we can use in a new way. Innovation today comes more easily and occurs at a much faster rate. In a considerably short amount of time, we have assembled a completely new platform from open source components, frameworks, and platforms. Healthcare continues to experience rapid and sweeping change and we cannot predict with certainty what is going to happen next. We can, however, use our ability to quickly plug-and-play major componentsand continue to stay ahead in a constantly changing environment.