Stop disrupting healthcare

Digital technologies are disrupting healthcare. Startups are shaping the future of healthcare. Patients are now empowered. The revolution has come. Digital health is a hot topic now. We often use big words to underline the importance of the upcoming changes. The consequences are already destructive.

Words have the potential to create a state of urgency, to convince, to motivate. People need grand visions to make significant and important changes. Martin Luther King’s speech, “I have a dream,” had a massive impact on society in the early 60s. Today’s leaders also use words to inspire.

But when the process of change has started, it’s time to get to work instead of repeating the same phrases. Some of the overused expressions create hype and unrealistic hopes that can’t be fulfilled. They force unprepared reforms that crash into reality. In healthcare, the results of this “push” strategy are dramatic: EHR led to doctors’ frustration, now the hype around AI is creating unrealistic expectations.

I’ve been attending numerous conferences and following the discussions on digital health. It’s time to change our narrative in digital health. Here is my list of the overused words that we should all avoid:

disruptive, disruption Disruptive technologies. They are coming. Like the Death Star in Star Wars or the White Walker in Game of Thrones. The new order will replace the old one. Disruption means “a major disturbance, something that changes plans or interrupts some event or process.” Healthcare

won’t be disrupted, it will be supported and augmented by innovative technologies. If you want to explore “disruptive healthcare technologies,” Google will show you over 90,000,000 results.

revolution Healthcare, get ready! There will be suffering and many victims. Paternalistic medicine will be defeated forever. Better times come. Revolution is “a forcible overthrow of a government or social order, in favor of a new system.” What will this utterly new system look like? Who are the winners, and who are the losers? Digital health is about transformation, evolution, but not a revolution. There are some exceptions in medicine when “revolution” is the right word. For example, when the science won the battle against bacteria once Alexander Fleming discovered antibiotics.

potentially AI will potentially save many lives. AI can potentially improve patients outcomes. VR can possibly help to reduce pain. Apps can likely support patients with chronic diseases. Instead of predicting the future, we should rather show what apps, VR, AR, AI, and other technologies already CAN and DO. Enough studies and examples are showing the benefits of digital technologies.

interoperability If you want to sound like an expert, you should include this word in your dictionary – it sounds complicated and professional. Without diminishing the importance of interoperability, this word is too often used as an excuse, reasoning that „digitalization is a big challenge.” When it comes to digital health, we used to focus too much on technical aspects, while forgetting about social determinants. I think that a far more significant challenge now is to manage the change process.

e-health This word means „healthcare services provided electronically via the Internet.” This term is very often misused. It the broader meaning, „digital health” is always a better choice.

exponential technologies 1-2-4-8-16. Exponential growth means that something doubles in capability or performance in each subsequent period. Now, technologies like AI, VR, robotics, and machine learning, for example, are also exponential. I agree this word sounds simply intriguing and better than synonyms like “aggressive,” “expanding,” or even “epidemic.” Isn’t it better to name modern technologies instead of using this kind of mysterious word?

mind-shift The digitalization of healthcare requires, first of all, a new mindset. We tend to think in an old way. But now it’s time to change our attitudes and think progressively. People are different, grow, and live in different environments, have different experiences and opinions. I would say that we have to “convince” rather than “plant a new attitude in people’s minds.” Anyway, saying “we need a new mind-shift” means both everything and nothing.

democratization I understand the concept of the „democratization of healthcare” and fully support it. I also agree digitalization can be an enabler of positive changes. But healthcare doesn’t need democratization. Healthcare is not an authoritarian regime. Healthcare needs more equity and equality, has to be accessible and affordable, transparent, and fair.

patient empowerment Patients are the best experts of their own health - they should have the possibility to protect their health, and co-decide with their doctor on the therapy options. However, having access to data stored in electronic health records doesn’t guarantee the “empowerment of the patient.” Many other issues must be included: health and digital health literacy or patients’ needs (some prefer external help). Linking “digitalization in healthcare” directly with “patients’ empowerment” is a huge misconception.

AI/Robots won’t replace doctors I agree, they won’t. I’ve heard this declaration recently at every digital health conference. But is it the most relevant issue we should be talking about now? I’m aware it is always repeated to gain doctors’ trust. But, in fact, I also agree with Eric Topol that AI will restore medicine. We should discuss how AI can make healthcare more precise, help patients, support doctors and eliminate medical errors, and speed up the development of new drugs. Using the argument that AI can’t replace doctors makes the discussion negative (focusing on threats), instead of positive (focusing on opportunities). 