Four Great Change Waves in Healthcare, A Ton of Wreckage and One More GenAI 'Oh No!, You did it again' (+Ukraine)

This morning, I was undumbing myself on quantum dots and theranostics (yes a real word). Specifically how they will have so much positive impact, especially with the emerging field of theranostics, which includes faster, earlier, more precise, and fewer side effects treatments for cancers. What's not to love about that?

Yes, I needed help with all of that. So, I used two GenAI platforms in parallel, Perplexity and Gemini. I caught one of them fabricating complex answers. I will show you that at the end.

Four Great Change Waves Beginning Now in Healthcare

1. All of AI - starting with high buzz GenAI, some healthcare institutions will start broadly adopting AI . GenAI impact will accelerate as solutions are developed that submerge the tech, the prompt engineering needs and provide simple timely value to everyone and every part of the healthcare ecosystem. GenAI is really about smart process design with clever, right time, right place knowledge/insight/precision augmentation. It is about platforms to leverage cumulative know how, IQ, smarts CrowdSmart.ai . The more you feed that with data the better. Architect that purposefully for cost structure AND quality AND patient outcomes and you crush the competition. John Sviokla (HBS), Saurabha Bhatnagar, MD , Ryan Vega MD, MSHA and I are writing a separate deeper dive article on that to be published IRL. But GenAI is not eough. Huge advances in hyperspeed/hyperscale AI ( Ocient ), Agentic/Embodied AI and Federated AI ( Pediatric Moonshot ) will be essential areas of transformation. Tech platforms to ingest, manage and leverage all the data allow quick if-this-then-that solution construction will accelerrate the winners ( VANTIQ ). Yes this wave is well underway.
2. Cross Field Bonanza (with AI) - AI is driving massive progress in drug discovery, robotics, photonic sensorization, material science, computational neurobiology, synthetic biology etc etc. There is a looming boom in cross discipline impacts into healthcare. The ability to do the bioengineering to coat quantum dots to do simultaneous diagnostic and therpaeutic work (find the cancer, kill the cancer) so they have higher efficacy/less negative biological response is an example of cross field bonazas. Another is AI in robotics tied to edge compute and super low latency networks enables machine augmented surgery/procedures. Again this is cost structure AND quality AND patient outcomes all improving.
3. Precision/Personalization/Prevention - Humans have 30 trillion cells and 35 trillion microbes. Statistically we clearly are all different. Increased precision and personalization from AI plus the new clever targeted therapies and procedures will have huge impact. Paradoxically increased precision/personalization in an AI world can also be via a lower cost structure.Bigger than that though is digital patient intelligence over time and knowldge from mass aggregation of data will help us drive healthcare to be precise, preventative ,predictive and prolonged which as anyone who has every looked at any production shop knows that is much cheaper and better than the alternative. The icing on that cake is all domains can adopt what I call evolutionary intelligence. That is using this ocean of digital primary material to continually discover, learn and improve. GenAI and RAG based systems will of course play a huge part but architecting your eneterprise design for evolutionary intelligence has to be purposeful. Superior intelligent agility might over time time be the only sustainable competitive advanatge among top performers.
4. Bending Space Time and Making Money- I do highly recommend watching the Dune films but this is not that. As we become more immersed in this digital infused ecosystem model the high level design can be AI/digital first and geography agnostic in part becasue we have super fat bandwidth , super fast, compute at the edge networks (like 5G). That means everything from a realy expensive GE cancer scanner to the hopsital itself to the mobile health vehicles can be designed to optimize both cost and quality of outcomes. The GE cancer scanner should have 20 remote cheap input layers and the expensive core can sit anywhere. Digital output on a patient incident can automagically be routed to the right AI and human experts in the right parallized and integrative set of processes.The inequality of equipment and availability of care by geo-economic sector is appaling from a human and a cost structure perspective. It is an opportunity. It is also important from a national competitiveness perspective as poor health outcomes are a drain on the economy/competitivenss. Also that design for GE Healthcare is at least 2X more lucrative. What is the hospital in that scenario? Surely it isn't a giant centralized concrete box. The mobile health vehicles stop being just desperate triage transport boxes and become more of a solution integrated into the network. In a congsted urban environment how hard would it be to briefly turn all lights red at an intersection and land a Lilium drone with two EMS pro's with a mobile powered stretcher (get Dean Kamen to design/build that). Stroke and trauma are two good examples where minutes matter. Extending the golden hour on the battlefield matters. The 'hospital' should in many cases extend into the home and the workplace. A difibrilator on the wall is nice but that integrated into a digital informed AI agent on your phone that is linked to the professional ecosystem is better. A lot of this has early green shoots emerging. Look at things like Dreamscape Learn amd Medivis and what they can become in this world.A great Assamese friend of mine is alive because when he had a heart attack at work and the suggestion was get him a chair and a bottle of water he said "$#@%! that, get me an ambulance'. Lucky.

The Wreckage in Healthcare

No one wakes up in the morning and says 'Man, I really hope I get a huge dose of change and instability today'.

But huge change is coming for healthcare, and many leaders are bad at managing that. The bad, bottom quartile leaders for sure but also leaders of successful teams.

Expert knife fighting teams take pride in how good they have become in the knife fight competition over the years and have the rewards to prove it. They have ignored and looked down upon that new gun stuff that is being talked about. Then they show up at the competition and find out it is no longer a knife fight, it is a gun fight. That ends badly.

I would suggest Kodak was that. Ninety percent of the car companies in 1912 were that. By 1930 they were all defunct. Companies that put billions of dollars into terrestrial comms networks and ignore the satellite gang are probably the same. Military and economic history is full of great, failed teams that were perfectly prepared for the last war.

Part of the issue is leadership vision, lack of smart situational awareness/context, and a lack of intelligent strategy refresh mechanics. The other part is that even if you get all of that, this sort of change is detailed, complex, architecturally nuanced and just plain hard.

Take the best cricket team and explain/convince them the world around them has changed and fire them up about the new environment, which is all about playing rugby. Take those motivated great athletes and put them on the rugby pitch, and guess what happens. Sure, you can fire most of the cricket players and hire rugby pro's but in a market where you are really successful, how realistic is that really? Also, the real world is harder and more complex than the Toby metaphor world.

Quick Ukraine Sidebar

I wrote an optmistic LinkedIn piece two years ago about Reinventing in Ukraine versus Rebuilding including some of this about healthcare. When Ukraine wins. Mykhailo Fedorov

Unprovoked invasion, intentionally flying drones into apartment buildings, playgrounds, churches, raping and pillaging villages, kidnapping thousands of children, kidnapping thousands of children (yes I wrote that twice) plus 30k soldiers dead and 40k civilians dead/injured including thousands of children deserves our attention, support and being fervently in the fight.

Also in the self interest bucket the amount of money we will have to pour into defense if Ukraine falls to Russia is 3X the cost of action now and 3X for 30 years.

Here in the US we shoud certainly be capable of helping the fight AND doing real work at the southern border AND doing great work in space AND leadng in AI AND leading in Fusion development AND leaping ahead in material science, biotechnology, healthcare, education AND food supply.

This is the United States ...it is the country of AND not the country of 'Or'.

Thank you both for reading this far ;-)

P.S. GenAI did it again. I was running Perplexity and Gemini in parallel on the Quantum Dot learning, and it cited five scientists doing Quantum Dot research in the areas of cancer, regenerative medicine, precision medicine, and systems biology. I asked for the location of their labs, and it said that was not available. I suggested it may have made up those scientists—the first at the top of the list was Dr. John Smith.

This is the response I got back (from Perplexity):

I apologize for the oversight. Upon reevaluation, it appears that the researchers mentioned in the previous responses were indeed fictional and not based on real individuals conducting research in the field of Quantum Dots (QDs) and theranostics. If you have any further questions or need accurate information on a different topic, please feel free to ask. Thank you for bringing this to my attention.

#innovation #genai #ai #ukraine #changeleadership #healthcare #healthcare innovation #ukraine

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