“Get to the cloud. Run to the cloud!”

Unlike others, Eric Schmidt doesn’t fully buy into the vision of artificial intelligence replacing doctors. In fact, if he were sick, he’d want a human calling the shots, but one who had the latest technologies at their disposal to help with their decision-making: “I want a human in the loop for things that are life-critical [..]. I want them to use computers (but) be in charge,” the Technical Advisor and Former Executive Chairman of Alphabet Inc., told the audience in his keynote address at the HIMSS 2018 conference in Las Vegas.

Sascha Keutel

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Schmidt outlined his vision of the future in healthcare: physician would engage in a patient visit, assisted by a form of technology – a virtual assistant- that would “listen to the conversation, provide advice in his or her ear, and fill out the transcript for the doctor.” Such technology would also relieve the physicians of a lot of paperwork, while simultaneously providing the data needed to fuel population health management and other key goals of healthcare leaders. “This technology – everything I just described – is buildable today or in the next few years,” Schmidt said.

The power of predictive analytics

In the next few years progress should be made in “neural networks and reinforcement learning. The explosion of networks. If you take data, and feed it into auto machine learning, it will automatically feed you information,” Schmidt said. Machine learning applies in diagnostics, genomics and medical imaging – the last Schmidt called “largely a solved problem.”

However, “the really powerful stuff, right at the edge of what I do, is prediction. It’s one thing to be able to classify; it’s another thing to predict the next step in an outcome.” And why is that aspect so important? “We have physicians within our company who believe that if these algorithms for prediction work, we can predict outcomes in the ER, for example, 18 to 24 hours earlier than any other observation system,” Schmidt pointed out. “We can’t predict our own fates, but machines can. That’s what I want as I age: I want the computer and all this work I’ve done over my whole career to make sure that I have a healthy life.”

Schmidt listed the automation of electrocardiograms and atrial fibrillation determinations as examples of how predictive technology could be successful in healthcare. For the latter, doctors currently use a complicated scale developed over years of experience. “We can do so much better than that,” he said. “The mortality benefit – if we just put [predictive technology] into any one of these systems and do the proper historical analysis – in terms of lives saved, is probably comparable to a new drug, but far, far cheaper.”

What’s preventing progress?

Schmidt called the healthcare ecosystem as still being stuck in the “stone age,” given its reliance on ancient technology such as fax machines and pagers. To combat that, he urged the attendees to hire more engineers and to move to the cloud as that could open the door to much more efficient care. “Get to the cloud. Run to the cloud,” he told attendees. “Don’t stop, don’t walk, don’t think about it – just run. Take an airplane, fly to the cloud, whatever metaphor you care about.”

Furthermore, Schmidt described the healthcare industry “conservative beyond where it should be,” complaining that it’s moving too slowly, which he explained with its overly cautious nature. “Most of you sit in institutions that have proprietary data centers that have some sort of logic about them,” Schmidt said. “Most of that logic may have been true five or 10 years ago, but it isn’t today. We now have cloud technology available, from Google and others, that’s much safer than your data center, much more compliant than your data center. I’d prefer you choose ours, but choose any over zero.”

Another reason such innovations aren’t happening as fast as he’d liked is because, while the technology is available, a “‘killer app’ – something that causes all the data and information to become rationalized” – is currently lacking, Schmidt said. Here he referred to technologies that in the past changed the landscape of computing forever – like the internet, email and smartphones.

Schmidt conceded that foundational work would have to be done to bring all the technologies together and make the next technological advances because healthcare is “really hard, it’s really humbling, and it’s complicated. But if we all work together, we can really save lives at a level that’s unimaginable.”


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