July 15, 2022: Rich Birhanzel, Global Health Lead at Accenture. The Accenture Technology Vision 2022 is hot off the presses. It reveals that the “Metaverse Continuum”— a spectrum of digitally enhanced worlds, realities and business models—is redefining how the world works, operates and interacts. We see businesses racing toward a future that is very different from the one in which they were designed to operate, while technologies, such as extended reality, blockchain and edge computing, are converging to reshape human experiences. So how do we make the leap and take the lead in the metaverse?
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The internet of ownership. This is about a new distributed data layer Essentially it's the ability that we would have as individuals to take our identity and our data with us and have control over that data as we move and leverage the metaverse and other uses of data. Of course, this is something we've been after in healthcare for some time
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All right. Today, we are joined by Rich Birhanzel, Senior Managing Director global health industry lead for Accenture and rich. Welcome to the show.
Hello. It's a pleasure. Appreciate it.
I'm looking forward to this conversation. when I was a CIO at St. Joe's, I would invariably grab these decks from Accenture and some of your competitors, because what you do is you, you look out across the trends that are happening in the industry. And from year to year, I was able to sort of stitch things together. And this year's really caught my attention, meet me in the. Metaverse and you talk about the metaverse continuum. have we gotten there, I mean, are we at the point where, industry is now looking at the metaverse as something that needs to be tackled?
I think we're at the beginning of that wave. We certainly are seeing other industries outside of health start to really immerse themselves in the potential of the metaverse. And we are now starting to see some experimentation and some early Use cases around metaverse. And we think that this is gonna be a very important macro trend for our healthcare executives to understand and eventually embrace and benefit from as they evolve their organizations.
it's interesting. So let's talk, metaverse a little bit for people who are struggling with a definition, it really defines a place it's like going to the internet. Isn't it it's like you create experiences on top of it.
we think about it as two things. And the first first thing is what you just mentioned the internet of place effectively, a new experience layer, where it opens up different possibilities and channels for a user, a patient human to move beyond just browsing on the internet and being able to interact in a virtual world with clinicians with other people who are providing services with other patients with caregivers. And so that is the internet of place is creating these opportunities to expand the way that we interact with each other. The other dimension of it is also important, and that is the internet of ownership.
And this is about a new distributed data layer Essentially it's the ability that we would have as individuals to take our identity and our data with us and have control over that data as we move and leverage the metaverse and other uses of data. Of course, this is something we've been after in healthcare for some time the ability of the individual to own his or her data.
And be able to take that with them as they navigate different clinics, hospitals, experiences, but even in the metaverse as well in these virtual scenarios. So the internet of ownership is also important combined with that concept of the internet of place.
there's a bunch of people in healthcare right now saying, man, you're preaching to the choir. We'd love for our health data to follow us wherever we go. But I love in this deck that you talk about the authenticity of that data and the sophistication of the attacks are getting beyond, but I'm, I'm getting, I'm getting ahead of myself. We'll get to that when we talk about some of the elements in it you talked about a digital core. Yeah, that is required to take advantage of this. What are some of the elements of a high performing digital core that healthcare needs to look.
Well, let me talk about that in two ways, first of all, sort of the fundamentals, and we see that most health systems are already moving in, the direction of a few things that are really essential as, building blocks to do any of this one is, and really importantly, is to have a data architecture across the enterprise that defines who people are.
Be able to easily share that data across leveraging that data architecture, that modern definition of data across the enterprise. We also wanna have modern software that is stitched together by standard integrations. And then that has to be done. Ultimately in a infrastructure that it's got that has some elasticity and allows for innovation effectively cloud infrastructure, so that some of the things that we'll talk about here and what we've discussed in our report are possible.
So we have capacity and elasticity of our of our operation on the te. To be able to embrace some of this innovation. So when we go beyond that, though those sort of foundational elements, we start to get into things that are newer to many health systems, social, mobile deeper analytics and certainly cloud technologies.
And then of course, in the data realm, Data that goes beyond what we already have. Let's say in an EMR or some of the extended technologies that a typical health system would have and have a more comprehensive understanding of the person. And even of physical objects and some of the other elements of how we're going to create new experiences but what's critical. There is that foundation around data and infrastructure and integration, so that we have a foundational element from which we can introduce some of these innovations.
That the, the data layer, the experience layer, as I'm thinking about that, as we're building this out it's. I remember, I think it was one of your decks a long time ago, talked about the physical digital world and orchestrating experiences. And now we have the physical digital world and the metaverse and we're orchestrating experiences across all of these. And in order for that to really make sense for the user, the experience has to be with that health.
It, it can't be, oh, I went, I went digital today or I went physical today. It meant it's I engaged with St. Joseph health and the experience was my data was there. I saw my physicians being tracked by my physicians those kinds of things. And that's, I mean, that, this is really a continuation of that concept. Isn't it of orchestrating across all those different layers.
It is. And then, and that's why this internet of ownership is such an interesting and important concept because we wanna move past. So we wanna optimize, of course, like you just described, we've been all working on optimizing. If someone's in a particular health system or has a particular health insurer that they have a an intended experience and and across that, that feels the same.
Now we want to take that to the next level. If we have this internet of owner. And I personally control my own data and my identity, and I can decide with tokens and blockchain and all the other things will introduce who gets access to it. And when now there's the possibility to extend that experience beyond one health system or one health insurer, one clinic versus another hospital, even into wellness and have a commonality of my identity.
Of that as well as some curated experience that is being infused and informed by my data, like my preferences, how, what channels do I like to be engaged in and such. So that's really the promise of this concept of of having control over our own data and being able to take it with us as we experience different places and organizations in the healthcare. 📍
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So reg in typical format, you guys Accenture put forward for trends. And this is this just for healthcare or is this the trends that you're seeing sort of play out across industries?overall technology vision for:
All right. Let's walk through the four and specifically talk about healthcare and how, it relates. And I think I'm saying this right web me web me is, is the first trend. What is that?
Well, this is really the, when we talk metaverse this is the one that really is the prominent metaverse trend and really much of what we have been describing so far here in this idea of having the internet of place and internet of ownership what we, what we anticipate and in this web me space, or in a more broader sense, the metaverse as a platform is being able to create different sort of experiences and applications. And one of the things I think about here we've got things that range from surgical training just to use as an example, can we use virtual capabilities, virtual reality, extended reality to practice surgery on a digital twin, meaning not the actual person we're going to perform the surgery with, but a digital twin of that person so that we can an. any kind of challenges that we're going to come across when we actually perform the surgery. And then when we get into the surgery, can we leverage things like extended reality and augmented reality to actually help execute the surgery. So that's one of those more complicated applications of it.
If we were to think about something that's a little more common and typical we think. All the time we spend in the healthcare system registering or sharing our information or filling out a form and how much time we consume of valuable clinicians in doing that. Think about the times when, for example, nurses need to participate in the gathering of that information.
What a great opportunity for us to create virtualized experience where we can share that information without having to consume the time of a valuable clinician and allow them to spend more. serving patients, working with their care teams. So when we think about that we think about the collection and think about the things that we do before we get into a surgery as a patient and all the information that they wanna gather ranging from what did you eat the night before to some of the more demographic information that they might share or things like medications, allergies, all that sort of thing as we get prepped for a surgery or a particular Could be virtualized, right. Could be something that we do. In fact, it's highly scripted today. So it's something that we would expect to see evolve as an opportunity. And at the end of it, what we wanna do is solve the big problems and challenges that we have right now. Today, we have a clinical capacity issue globally, right? We have wage inflation globally. Those two things are related. And so it's expensive. We have less clinicians to serve and to provide patient access. So patient access is suffering as a result generally and globally. So this can help that. Or we have.
Expectations around customer experience, meaning patient experience or the caregiver experience. Think about how we can create new channels here that are tuned to the way people wanna interact with the health system. So web me is really that as we think about metaverse in particular as that expression of metaverse, and as we think about it in healthcare, how can we leverage that to tackle some of these challenges that we have today and over the next few years
Some of the things that just popped into my head as you were talking about. Just in terms of ideas. One is data collection, right. And we're all, we're all carrying around these computers in our hand. Yeah. and I'm using voice more and more to dictate my voicemails to go back and forth, that kinda stuff. And I could see health system start to collect information via voice a voice.
Activated form that essentially says, tell me what medications you're on. I mean, we're already doing ambient clinical ambient clinical listening. Sure. In the care setting. There's no reason why they couldn't make that form more intuitive that I could essentially just feel like I'm being interviewed by a clinician and giving that that back.
And we're talking a lot to health systems that are looking at asynchronous healthcare. As as an option to increase the touchpoints and to increase the care they're providing to the community. And I'll give you another one that's kind of out there, but I'm currently, I'm currently taking golf lessons and I'm not taking golf lessons from the pro down the street.
I'm taking golf lessons from somebody who's four or five hours away. And I take this app, I set it up. I video my swing. And it's in this app I hit send. And that, that video goes to that pro that pro then looks at, it puts me next to Rory McElroy or whoever's going to do, and then gives me feedback. And that comes back to me.
I mean, these, these are things we could do very easily today. When we think of the metaverse though really the, sky's the limit, I mean, there could be a, different way of reimagining it is the. Is the internet technology there for the metaverse today, or are we gonna see that evolve over the next couple of years?
so I'd say generally the, yeah the technology is there now, the access to that technology is variable. And so that's one of the things we have to see as. an improvement, especially for those of us in healthcare. We think about health equity all the time. And what we wanna avoid here is by moving down this line on innovation that we create even more disparity because we create a technical barrier to participate in some of this innovation.
So we're very careful about thinking about that, whether it's a data point or even just a hardware point, right. And access to certain capabilities, as simple as for example, a VR headset. Not everybody has one. And so it's gonna be hard to participate in virtual reality if we can't find a way for that to to be extended to people, I would like to pick up for a moment on your voice idea, which is a really good one.
And come back to this idea of the internet of ownership, because the further ex a further extension of that is imagine if you were walking around with effectively a dig, a digital token, And you have control over it. And when you decide you need to go to an urgent care, for example, and instead of them having to go ask you for all that information, or you having to even type it in at home or at the place that you go to, you just provide access to the digital token and it populates what they need to know.
Because it is your address hasn't changed many of your vitals haven't changed your allergies, haven't changed and all that your medical history hasn't changed. Imagine if we could skip past those inefficiencies and also. Accuracy. Think about how much accuracy comes with having a single source of truth for your allergies or your medical history or some of your channel preferences right.
Of how you like to be engaged. So that's what the real promise is in here. Not only efficiency, but also we're now confident, right? That we're not gonna have a different answer over here than we might have had over here, because it might have filled out the form differently.
Yeah, we have a hard stop in 10 minutes, otherwise you and I would talk for the next hour on these topics, cuz this is, this is good stuff.
the things we could do with the phone, I mean, again, more ideas just popped into my head. One of the things we're gonna get into the next three, but one of the things, when we talk about health equities, And this is just my little, my little rant for a second. Here is I used to work at the Catholic health systems.
At one point the sisters came to me and said I think you're pushing us past the people we're trying to help. And and essentially we did the research and found out a majority of 'em did have phones and so phones. Yeah. And, and so we had technologies for just straight phones or mobile phones, but phones.
And then we had. Obviously we had smartphone technology, but the case I made to the sisters that really resonated with them is we shouldn't use the fact that we need to be creative and imaginative of how we're gonna reach that population with holding us back in creating new solutions, because maybe the solution is giving VR headsets to a population so that they can interact and so I want, I wanna continue to push and then solve the individual problems on access the way I think we can solve it,
I think sometimes we can create some of these utilities and they don't all have to be the immersive 3d experience. That can be an option. Many of these things that we're talking about as improvements could also be rendered in effectively a 2d experience, but it's still creating sort of different Lev different different levels of efficiency and engagement. So I think there are some things that we can do creatively.
What also. I think we're gonna talk about this as we move toward the unreal. The thing we also have to be thoughtful about is as we move towards synthetic things like synthetic data, being able to augment or replicate real world data sets very cautious about that we're not creating unintended consequence as it relates to the the creation of those data sets.
And particularly when we think about How, how synthetic data could become. So similar to real world data that we wanna be able to have the kind of controls in place so that we don't have the misuse of that data set. So there's another example of health equity and just making sure that as we unlock this ability to discover more quickly and innovate more quickly. We don't have any unintended consequences we're of the same mindset that we should press forward with innovation. But I think it's, if we start from the beginning with caution and thoughtfulness from the start, then our hope is that we can avoid getting into scenarios where we have those sort of unintended consequences.
Do these strategies build on each other or can we start talking about the unreal and then go back to the programmable.
Yeah, let's go ahead and we'll keep talking about the unreal. And the unreal is a little bit self explanatory in the, in the sense of what we decided to call it. As we think about the advances in artificial intelligence and the ability to create synthetic data, we think about. What's really important to train AI models and machine learning is volumes of data, right? Being able to have a whole bunch of experiences and data. Well, when we can create broader and bigger data sets that are like real world data, without having to be constrained by real world data, we can advance AI and machine learning at a much faster pace.
And so think, for example about the leveraging of patient data sets to use in research or. Training or some other applications we can use that realistic data to advance that more quickly. Cuz it will have the same sort of statistical property that we would've seen in the real world data.
But we, but what's good about it is that we protect confidentiality and privacy because it's not real, right. We're not, we don't have the same sort of constraint because it's synthetic. So What we also wanna do though, as we develop that is to accommodate improvement in diversity to counter any sort of bias in the data. And in that way, synthetic data can be better than real world data because it can be more rounded out and, and sort of by design account for any sort of bias that might be in a real world data set.
it's interesting in this area of AI, we're seeing different models emerge here. So we have model that came out of Facebook, which is now being applied to healthcare where essentially the model trains itself. Right. So especially in imaging, so it takes the image, it breaks it into 24 squares and then it grays out half of 'em and then says what do you think it is? It sort of recreates it and goes, oh, I was right. I was wrong and it can train itself a lot quicker. I can do that with voice. Can do that , with, with data sets that are pretty constant. So video's pretty constant. Voice is pretty. Or can be constant in that, in that regard. So we have these models that are training themselves and then learning.
And then we're also having physicians. I mean, not being hired to do this, but physicians just in the normal course of their work going. Yeah, that's right. Yeah. That, yeah, that patient fell. No, that patient didn't fall. Right. So as the, video's trying to figure out if they fell or not, and it says, Hey, this patient fell, they can come back and confirm yeah.
That patient fell. And so the model model gets smarter faster, but in that, in that scenario, You guys talk in this area about Providence policy, people and purpose. I want to touch on a couple of those, cause I, I we're gonna run out of time. So Providence is blockchain has gotten a bad rap in healthcare.
It's, it's a little slow and it was going to solve everything and right. But this is one of those areas where it does that model of not blockchain itself, but the model of blockchain. Is authenticity to the data. Doesn't it.
Perfect. Perfect example. Yes. And it's so important when you're using when you're applying synthetic data to understand it may not be real, but is it authentic and where did it come from?
Right. And so that we understand that lineage and you're right. The ability to sort of Track effectively the history of that data in a blockchain like model is a really great application of, of the potential. Of blockchain.
Yeah. And policy's gonna become so important. One of the things you guys drive home in this, now I'm gonna go to the programmable world. One of the things you drive home in this is that we're gonna have to set policies and we're gonna have to set policies not on the fly, but as we go, cuz we don't know what we don't know yet. So there's, there's a whole host of things that health systems should have AI policy making groups in place that are determining programmable world. What's the programmable world about?
So programmable world, if we think about the physical world, just to, to use that application whether we're in. A care delivery room of some sort, maybe we're in a step down unit at a hospital after surgery or something. The idea of this, which we've already seen some invention here, of course, on things like sensing movement, sensing temperature, but imagine taking that to a an, an extension and a broader effectively an extreme think about how.
We could change the color of the walls based on sensing the mood of the patient. We could change the temperature in the room, driven by intelligence, without the intervention of anybody on the staff. We can have, and the the evolution of smart beds and the beds, not only being able to adjust their, the how, whether they're flat or they're putting putting the feet up or the head up. But also being able to do sense things like temperature, sense, things like moisture, right in the bed. So that, and alert the care team around those things. So as you think about it's the taking those one application here is the material right?
Taking that application. Of smart, essentially embedded intelligence and applying it into the physical world that we have. Another example would be some of these clothing innovations that are coming, where you wear the clothing and the clothing effectively has the ability through IoT to sense some of your vital signs as an example.
So your wearing shirt, that shirt allows you that shirt is telling. you Everything you need to know or telling a clinician, everything they need to know about the progression of vitals. So this is, I have a few more minutes by the way, cause I don't wanna rush you. So I'm I'm good.
So you're sensing, I'm trying to move fast here, but the, so this is really stitching together, all that. And I'm talking to health systems that have all these IoT devices at this point, but it's instead of point solutions, it's thinking about them holistically in terms of delivering care and and really easing the clinician burden and the patient experience while they're while they're on the campus. But not only while they're on campus, but also out of the home, because we're seeing hospital at home initiatives really take off as well.
Yeah. And we can see here, that will be key here is that we're gonna, they're gonna generate a whole lot more data as we see innovation in this space. So back to the earlier conversations that we've had here we're gonna need to be able to then pull that data in, into a place where the person the person who's taking care of that person, their physician whoever has access to that virtual data.
So we'll want that data integration. Ability to be dynamic and the sharing and the understanding of that insight is important as well as sort of the sensing technology that's driving home, these new, new insights. Ultimately, what we, what we're looking to do in this space is the physical world around us can be part of our care and part of the wellness, right? It comes an extension of it. And so there's real opportunity here. Really exciting things that we could imagine.
This is one of the reasons I love these decks is cuz they get me thinking of what's possible in the various care settings and reaching out to people, computing the impossible.
We've talked about quantum computing for years, but it's a lot closer than it's been. And even if it's not, we have all sorts of other computing capabilities and data sets that we didn't have before. We're now able to and I think that the vaccine and record time is sort. Indicative of this, we're able to do things we haven't done before because computing has really advanced
absolutely. And again, we think about the ability to process against large data sets previously. At a pace that we previously couldn't do. And of course, your example in vaccines is a great one. And even in the future, as we think about the combination of the things we talked about with synthetic data and the ability to really anticipate what all the all the concerns are with, let's say some virus that occurs down the road and in the future, and being able to anticipate and leverage that data.
To look at things like, and anticipate different characteristics of a person. Maybe their genetic history as an example, and what, and how that might interact with the future virus as we learn and discover more about the virus. So as we think about clinical trials research and those sorts of things, we've already seen some of that benefit and we would expect that to continue, but even over in the health insurance world, then we, we talk about this a little bit.
If you think about the ability to really go deeper and be more in a, and be able to anticipate on things like fraud and waste and abuse in the app, in the execution of healthcare we have the ability, I think, to leverage that data and that new compute capability. To anticipate and be more proactive around where those things might occur and then leverage those things to really make a difference. So application both in the care delivery side, certainly the clinical research side and the, and Dr. And and such, and then even in the health insurance side.
All right. Closing question, and that is. how do house system leaders take these concepts that are established in this document and run with them or walk with them or get comfortable with them? I guess there's, there's an awful lot here that would indicate that we could be looking at a very different healthcare delivery paradigm three to five years from now.
Yeah. Well, so there. I'll say just three really practical things that I would share. And then some a few specific actions they could take.
And I imagine many already do you know, some, if not all of these things, I would encourage healthcare executives to engage with the ecosystem. What I mean by that are technology companies and services companies that are in this space that are looking ahead technology companies that are investing ahead.
And talk to them, right. Hear from them not one, but several of them. Right. Be able to embrace that community in a dynamic way. So that you can kind of hear what's coming and start to think about that application. Certainly participation in consortiums, which of course many, many, many healthcare organizations do today, but we might seek.
Additional consortiums formed within the industry around things like blockchain and, and quantum computing and some of the other topics around metaverse that we talked about today. And then lastly, and this will get into the kind of specific steps, consider some focused talent in the organization on emerging tech.
So think about having a, a futurist view. Inside the organization. So think of, as we think about skills to have on the team, as we go forward, it's helpful, right? To have someone on the team that is not having to be focused on the day to day, but is looking ahead and helping to, to set set the course.
So back to that, so three things, strategy, technology and skills. I touched on skills, right? Having some folks that are able to look ahead some skills on the team back to the strategy. Starting to look at things like this and other perspectives on metaverse and some of these concepts, we talked today and starting to think about them first in the problems of today, right?
We talked about clinician capacity and patient access. We know that patient experience is a hot topic, has been for a while. As you think about challenges like that today, how can these emerging technologies. Help solve for some of those things. So start to get down the road on high level strategy around here are the things that are coming.
How can they help me solve the problems that I see now, and I might see in the next couple of years, and then lastly technology, we talked earlier about having that foundational. The foundation to embrace some of this a reflection on, do you have the foundation to be able to embrace all of this?
How far along are you with social mobile analytics cloud and ultimately your data architecture? Because those will be really important to be able to embrace the concepts that we've talked about here.
I'm a reminder of the story of bill gates back in the day when the internet was sort of coming up and all of a sudden he went off to his retreat and he came back and he wrote a letter to his entire team. He was like, drop everything. The Internet's real and. We're missing the boat. And I sort of think that same way. And I've heard people talk about the metaverse in that same way. It's like, it's, it's not going to crash on us tomorrow, but it is something that is going to change the way we interact.
With the internet today, and it could be the next evolution of how business is done and how healthcare is done. And with the, with that possibility being out there, it's definitely something that that leaders need to be aware of and weighed into. And so great conversation. Rich, thank you again for your time.
Yeah, I appreciate the opportunity to talk about this. Thank you for 📍 your time.
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