The Future of Healthcare Could Be In Rural India

In my last post, I talked about using big data to improve patient outcomes by providing better diagnoses and treatment suggestions, an idea made popular by Vinod Khosla. Despite the great potential for this technology to improve lives as well as cut costs, the unfortunate truth is that most healthcare systems likely just aren’t ready for it. There three main reasons why this might be:

Necessity

There is a saying that goes “only when humanity is at the brink of destruction, are people willed to change”. While this might be an overdramaticization, the idea goes without saying that we are not at this dire point in healthcare. Across the developed nations, for the most part, people are fairly healthy and receive treatment when they need it. I haven’t been to the doctor yet this year but do I feel healthy? Yeah. Maybe I am just a lobster in a boiling pot, but its easy to get complacent when my friends and family aren’t dropping dead from the Black Plague by the cartload. We are indeed becoming more health conscious, but until the water starts boiling, advanced medical technology is a nice-to-have, not a necessity for survival.¹

Regulation

We are reaching a point in the United States where the current legislation governing healthcare administration is unbearable. Regulation constricts what kind of care citizens can receive and what kind of data doctors and patients have access to. Since the essential component of a medical decision engine is the data itself, it cannot come to be without improved open-data initiatives and better integration between EMR systems. Google knows everything about my life on the Internet, but its tough today for my doctor to know everything about my health, even if the data was out there.

Complexity

A medical decision engine using machine learning algorithms needs a lot of data to work – that’s why open data initiatives are so important. Naturally, as early versions of this technology are introduced and gathering data for the first time, they will not be very good, which is why engineers and doctors will have to work together to hard-code some of the capabilities in the beginning. Instead of using complex algorithms do make a diagnosis and treatment suggestion, it would use simple logic. The problem is that a lot of the illnesses people have in the developed world are too complex and nuanced to be successfully diagnosed and treated with a decision tree. Compare the diagnosis/treatment of heart disease (the leading cause of death in the US) with influenza (a significant killer in India).

So this is why we can’t have nice things: we are complacent, over-regulated, and our problems are too complicated.²

Fortunately (just for the sake of the advancement of technology, it is actually quite unfortunate), there are parts of the world that have both the burning need and regulatory flexibility to make medical decision engine technology a real possibility – India, Africa, and Asia. It is my belief that in the very near future we could start to see futuristic health technologies implemented in the slums of Rajastan before they hit the wealthy suburbs of San Francisco.

Despite having some of the greatest doctors in the world, the health situation in India (which I will focus on for now) is dire. Many people live in extreme poverty, have poor living conditions, are malnourished and have limited access to medical professionals. One of the leading causes of death is from diarrheal diseases – a minor illness in the United States. Clearly, India is in desperate need of better care and the effect that even small improvements could make a huge impact. Additionally, the barrier of entry is much lower than it is in the US because of fewer regulations.

Let’s step back summarize:

Need Effect Barriers
US Low Medium High
India High High Low

Awesome. India is ripe for Vinod Khosla’s medical decision engine. And there are already rumblings laying the infrastructure today. Google is currently testing out blimps that carry wireless signals to remote regions of Africa, Asia, and India and there has been talk about pairing that with cheap smart phones.

Fast-forward and imagine a new India where the Red Cross pays annual visits to villages and slums to equip individuals with Google phones that access blimp-distributed internet and train them on how to use the medical decision engine to serve their community. Foreign philanthropists could fund this endeavor to create monetary incentives for the trained villagers to continue using the technology.

Bill Gates recently published a blog called Why I’m Going to India where he discusses the amazing potential for India to overcome its problems utilizing new advancements in science and technology. I couldn’t agree more that the opportunity in India is abounding and that it will be ground zero in the adoption the latest and greatest health technology.

¹  I will nod to the notion that we are getting to this point with the healthcare system itself (rather than our physical health). We need to find cheaper alternatives to the current model, and technology has proven to be an enabler in this respect time and time again.

²  More complicated than the third world rather.

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