A Conversation Without Borders

Among the diverse voices at the Forum were three standout attendees—one from Ghana, another from Brazil, and still another from India—all deeply committed to advancing scientific discovery and digital transformation in health, all sitting at one table coincidentally. Their presence reinforced the idea that innovation emerges not from a single system or nation but from a mosaic of lived experiences, cultural insight, and shared human purpose.

At a time when geopolitical divisions grow and xenophobic rhetoric clouds practical need, this convening of minds from across continents stands as a counterpoint: progress in medicine and public health demands openness, not isolation.

Today, two out of five HIMSS members live outside the United States, representing the tremendous growth in its international reach.

Global Minds and Shared Missions

Consider the stories behind some of the most transformative scientific breakthroughs. Dr. Tu Youyou, who drew upon traditional Chinese medicine to isolate artemisinin, reshaped malaria treatment and saved millions. Tu received the 2011 Lasker Award in clinical medicine and the 2015 Nobel Prize in Physiology or Medicine jointly with William C. Campbell and Satoshi Ōmura for her work.

Dr. Salvador Moncada, born in Honduras and later based in the UK, changed the future of cardiovascular medicine through his work on nitric oxide. And Dr. Pardis Sabeti, born in Iran and raised in the United States, played a critical role in genomic tracking during the West African Ebola outbreak. These are not anomalies—they are the natural result of cross-border learning and purpose-driven science. In recognition of his tapping into the power of collaboration to accelerate biomedical discoveries, Dr. Salvador was nominated by the President of Honduras to serve as the country’s first Ambassador to China. 

Such examples underscore a larger point: global health challenges—from infectious disease to chronic illness—cannot be solved in silos. They require knowledge sharing, inclusive research, and the integration of clinical science, population health data, and epidemiological insights gathered across geographies. HIMSS is paving the way for people and countries to come together.

Today, health information flows freely across continents. Clinical trials are increasingly multinational. Genomic datasets used to train AI models include samples from diverse populations. Epidemiological patterns—from outbreaks to noncommunicable disease trends—are informed by data from regions that span income levels and infrastructure capacity. This global interconnectedness of knowledge is not only valuable—it is vital.

Health innovation now depends as much on access to ideas and information as on access to raw data or funding. Each individual—whether a clinician, data scientist, policymaker, patient or communicator—contributes to this ecosystem through their choices within their workplace, organization, advocacy group and community. These local actions ripple outward to impact global outcomes.

When people are empowered to think boldly and act collaboratively—regardless of where they are from—their influence transcends borders. This is especially true in a world where diseases migrate, health inequities persist, and environmental factors increasingly shape population health. No one country has a monopoly on the future of medicine, and no one person is immune to illness.

Science and Technology as a Bridge

Science is not merely technical; it is relational. It is built on trust, transparency, and the willingness to share. When data is exchanged openly—on disease trends, therapeutic outcomes, or environmental health risks—it becomes a force for public good. When it is withheld or politicized, it delays solutions and costs lives.

As HIMSS convened global thinkers in a borough symbolic of reinvention, the message was clear: advancing AI in health is not just about algorithms—it’s about equity, empathy, and inclusion. Those values begin not with policy mandates but with people. Beneath sessions on technology and policies, the conversation continually returned to the reality—it’s about people working collaboratively.

Every organization has the power to foster a culture where global voices are welcomed, collaboration is incentivized, and ideas are judged not by origin but by merit. The future of health will be shaped by how willing we are to embrace human potential, wherever it begins, and work with people who can help advance human health wherever they call home.

Brooklyn as a Setting and Symbol

Brooklyn is a fitting backdrop for these conversations. A city defined by generations of immigrants—scientists, healers and visionaries—stands as a beacon for what is possible when people are welcomed, not walled off. HIMSS is hosting its APAC meeting July 16-18 in Malaysia.

The HIMSS AI in Healthcare Forum brought together technologists, clinicians, ethicists and entrepreneurs. But more than that, it reminds participants of something timeless: when diverse minds come together, knowledge is not only shared—it is elevated. When human potential is honored without prejudice, the possibilities for better health are limitless.

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AI Is Not an Add-On—It Is the Infrastructure

One of the most powerful refrains in Lawry’s address was this: Artificial Intelligence (author’s definition – “augmented implementation”) is a general-purpose technology. Like electricity or the printing press, it doesn’t simply optimize existing processes—it refines them. It changes the sector’s (and perhaps society’s) operating system. It is not “intelligent,” it’s intelligence, [as John Nosta suggests].

In the health sector, AI must be treated not as a pilot project or a staffing replacement but as core infrastructure. It’s not a department, it’s a foundation. Lawry urged leaders to go beyond adoption cycles and recognize AI’s capacity to reshape systems, relationships and responsibilities. That shift requires not just technical integration but cultural transformation. It requires integration of clinical, operational and human resource functions.

“What Does This Mean for Me?”

Clinicians aren’t resisting AI—they’re seeking relevance. Their reflective question is: “What does this mean for me?” This question is surfacing across hospitals, clinics, and systems worldwide. Health professionals are not asking for more white papers or coding walkthroughs—they want to know if their judgment, autonomy, and voice will be protected.

His message was clear: Don’t ask clinicians to adopt. Invite them to co-design. Empower them to lead alongside technologists. That is how AI earns trust and ensures value.

Elevating the Workforce Through Upskilling

Referring to McKinsey forecasts, Lawry noted that up to one-third of clinical activity—primarily administrative—can be automated. But this is not about eliminating jobs. It’s about restoring the joy of practice and aligning people with purpose. If deployed wisely, AI can liberate talent from tasks that dull passion and delay patient care. The real challenge will be forging a bridge between aspirational and operational intent.

This is possible if health systems democratize AI knowledge. Upskilling cannot remain the domain of senior executives and IT teams. The professionals most affected by AI must also be those most prepared to use and question it with confidence.

Governance Is the Bedrock of Responsibility

Too many institutions speak about responsible AI but fail to structure it. As Lawry outlined and reflected in his Responsible AI Discussion Guide shared at the Forum, governance is not an aspiration. It is a requirement.

Lawry asks three key questions to test organizational readiness:

1. Has the institution formally adopted responsible AI principles, ratified by top leadership or the board?
2. Are those principles consistently applied to all AI projects and partnerships?
3. Are AI standards written into procurement practices?
   
   The health sector cannot afford partial answers. Most AI will arrive embedded within larger platforms—EHRs, diagnostics or billing systems. Governance alone is insufficient if the umbrella of its use doesn’t extend to vendors and embedded solutions. His cautionary guidance: policies without enforcement expose organizations to reputational and regulatory risk.

Judge AI by Outcomes, Not Headlines

It’s easy to get excited about the tech tools and early pilots. However, Lawry warned against evaluating success by the number of AI deployments. Actual value must be measured by mission alignment. That means, are outcomes improving? Are clinicians regaining time and focus? Are costs becoming more sustainable? Is ethical compliance being elevated? It is a nuts-and-bolts call-to-action.

Lawry urges organizations to treat AI not as a buzzword, but as a continuous improvement program. Like clinical quality, it requires constant evaluation and a clear connection to purpose.

Leadership Is the Deciding Factor

Perhaps the most lasting message from his keynote is that technology does not create transformation—leadership does. From boards to bedside, AI requires a mindset of clarity, courage, and consistency.

Leadership must:
– Understand what AI can—and cannot—do
– Create a culture where experimentation and transparency thrive
– Build governance, avoiding treating AI as a vendor offering

“AI value at scale is about leadership,” Lawry declared. “No algorithm, no matter how powerful, can substitute for moral clarity and institutional courage.”

A Gathering That Signals Momentum

This HIMSS AI in Healthcare Forum is a chance to compare notes and is a change-agent catalyst. It brought together visionaries and practitioners, policymakers and informaticists, engineers and ethicists. What unites them is the understanding that we are not waiting for the future—we are in it.

From HIMSS CEO Hal Wolf’s empowering opening remarks to Forum Master of Ceremonies and HIMSS Senior Director of the Personal Connected Health Alliance Rob Havasy and the powerful opening keynote by Tom Lawry, it is clear that this event is more than a “professional meeting” – it is an invitation to the possibilities of the age of AI in the health sector. But its success will not come from software, coding and flashing healthtech alone. It will arise from systems that put people at the center—patients, providers and the health ecosystem community.

AI Has No MRI: It’s All About Leadership

Tom Lawry offered more than a presentation—he provided a roadmap. One that begins not with technology but with trust. One that demands more than innovation—it requires intention.

The transformation ahead is not only technical. It is cultural, operational and profoundly human. The institutions that rise to the occasion will do much more than survive disruption. They will define the next era of healing.

AI is here. The question now is whether we are ready to use it and lead with it.

The post Why AI’s Future in the Health Sector Hinges on Leadership, Not Just Technology appeared first on Medika Life.

Top IT firms are racing to attract customers for their wearable tech advancements because of this promising future of the wearable business. Tech giants like Samsung, Apple, and Microsoft have released new products in recent years. And digital wearable health devices are showing promise in managing chronic conditions, promoting preventative healthcare, and improving patient engagement, according to research conducted in 2024.

Improvements in sensor technology, AI integration, and data analysis are also enabling more personalized and accurate health monitoring. However, there are still issues with data privacy, regulatory frameworks, and device validation that need to be resolved before these devices can reach their full potential. But today wearable devices are adding a new layer of both protection and vulnerability to our health and our health records.

When it comes to diagnosing and monitoring individuals, wearables might be useful. Worldwide health systems, like the National Health Service in England, have acknowledged the potential of wearable technology to aid with health care, and this acknowledgment has earned them a spot in the common strategic Long Term Plan. Wearables, however, are not just for patients’ specialized medical gadgets. For customers who are concerned about their health, top IT companies have started investigating wearable health devices.

With its January 2019 launch, the “NHS Long Term Plan” lays out NHS England’s goals for healthcare over the next decade, including how the organization will spend NHS funds to enhance patient care and health outcomes throughout the country.

According to a large body of research, wearables can help people take charge of their health by facilitating self-diagnosis, behavior modification, and monitoring. If the technology is to be used widely, it requires more promotion and support from providers to encourage uptake; more short-term investment to upskill employees, particularly in data analysis; and overcoming barriers to use, especially by improving device accuracy, are all factors that will contribute to greater wearable adoption and engagement.

Participatory health informatics (PHI) means considering the role of technology in assisting individuals with self-management and decision-making by also improving health literacy and the physician-patient relationship so that individuals can become more involved in the aspects of their health and care.

Historically, research in the PHI field has predominantly been based on social media and internet-based applications, with patient empowerment having been identified as the most common theme in this body of research. However, wearables are just beginning to be considered as part of PHI given recent technological advancements. Therefore, similar research is now required to examine whether wearables can empower individuals in ways similar to those regarding domains such as self-management, decision-making, and the physician-patient relationship.

And the inclusion of patient empowerment must also be calculated and addressed in a world where an almost collegial relationship is formed between patient and physician. This will be a major change from our past relationships where patients were poorly received once they began researching their illnesses on the Internet and questioned their healthcare provider. “Oh, you’ve been using Dr. Google, I see,” was a common put-down. Respect is receiving new consideration and pointing out our lapses in possible healthcare education and sensitive training toward patients must be required. Can challenging patients be acceptable, as formerly was the case?

Remote patient monitoring using wearables is becoming more important in light of the growing provider shortages that exacerbate geographically based disparities.

Where Do We Need Wearable?

One area of intense interest is related to patients with potential cardiac issues and here we note that much is yet to be accomplished for these patients. Only eight studies of the 31,12 papers retrieved from a systematic search were randomized controlled trials. The research was mostly focused on consumer-grade wearables that were modified to monitor heart failure (HF). The majority of these studies were conducted in the feasibility testing phase. Out of all the wearables that were mentioned, only two were approved by the FDA for HF RM (remote monitoring). A major obstacle to wearables’ incorporation into HF therapy is the lack of convincing evidence regarding their actual influence on HF management. This must be a concerning issue.

High expenses, low functional capacity and quality of life, and high rates of morbidity and mortality marked the complex and sometimes fatal syndrome known as heart failure. High expenses, low functional capacity and quality of life, and high rates of morbidity and mortality mark the complex and sometimes fatal syndrome known as heart failure (HF). Over 64 million individuals across the globe are impacted by HF and we do not truly know the total number because not everyone with potential HF has been identified. As a result, reducing its monetary and social impact has risen to the status of a top public health concern on an international scale. Therefore, this should be one of the aims of wearables — helping to reduce mortality.

But digitals have a whole host of potential uses currently that include fall detection, glucose monitoring, activity monitoring (steps tracking), sleep quality, blood pressure monitoring, and potentially high-risk pregnancies.

Unaddressed Issues of Wearables

Concerns about privacy and data sharing are only two of the many hazards and difficulties linked to wearable technology. The literature has mainly addressed technological or ethical concerns, treating them as distinct domains of study; nevertheless, wearables’ potential to enhance biomedical knowledge acquisition, development, and application has received scant attention.

Three areas that have been inadequately studied include screening, detection, and prediction. Screening involves searching through datasets obtained by monitoring for particular diseases and the people linked to them. Passive sensors that monitor things like motion, steps, light, pressure, sound, etc. are typically the basis of wearables used for this purpose.

One application of wearable technology is screening for sleep apnea by tracking the wearer’s heart rate and breathing patterns while they sleep. Detection is a process that is closely connected to screening. It is common practice to employ wearables to detect conditions and notify individual users when monitoring particular conditions in populations. Detection involves looking for patterns and features in the data gathered from wearable monitoring devices that could be indicative of certain medical disorders. Once we have this data, the possibility of greater detection of issues may emerge.

It is still very difficult to predict clinical outcomes following hospital discharge. There has been little success with strategies aimed at predicting and preventing death after discharge, readmissions, and trips to the emergency department (ED). Early interventions on modifiable risk variables might minimize morbidity, death, readmissions, and emergency department visits if predictive models could be improved. Wearable technology can monitor activity levels, sleep patterns, and tachy- or bradyarrhythmias, some of the modifiable risk factors for these clinical outcomes. Wearable digital devices might make significant differences in the ability to predict future health issues.

It has been shown that using more aspects of complex data from wearable technology would most likely enhance prediction models. One study that made use of 89 Fitbit data characteristics had an 88.3 percent success rate in predicting hospital readmission. Compared to other models, theirs performed far better in predicting readmission using typical retrospective clinical data.

Are digital, non-invasive wearables a viable and important contribution to healthcare now and in the future? Unquestionably, they are providing information as a continuous monitoring system in real-time and can prevent fatalities. The cost of the devices, availability, and insurance reimbursement will undoubtedly factor into how many patients can avail themselves of this technology. Lower-income patients and those in health deserts will be less likely to have access to them.

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The global healthcare industry is responsible for two gigatons of carbon dioxide each year, which amounts to 4.4% of net emissions worldwide. Hospitals generate about five million tons of medical waste annually from everyday trash such as medical packaging and food to regulated medical waste, surgical gowns, gloves, syringes, IV bags and more.

The recent panel discussion, “Sustainability + Health Systems,” facilitated by mHealth Israel, brought together an impressive roster to discuss this issue. Panelists included:

• Dr. Reed Omary, MD, MS, is the Carol D. & Henry P. Pendergrass Professor of Radiology and Biomedical Engineering at Vanderbilt University Medical Center (VUMC) with over 25 years as a practicing interventional radiologist. Dr. Omary stepped down from his position as Chair of Radiology to make a full career pivot towards sustainable healthcare to motivate US healthcare to decarbonize their operations and adopt sustainable practices. You can follow Dr. Omary’s blog on making healthcare more sustainable: The Green Leap
• Dr. Elizabeth Morris, MD, is the Chair of the Department of Radiology at UC Davis Health, an institution with a history of commitment to sustainability. Dr. Morris approaches sustainability through the academic lens, exploring how to think holistically about planetary health within our healthcare system.
• Bert Hartog, Interim VP of Sustainability & Transformation at The Digital Medicine Society (DiMe), a professional society for the digital medicine community that focuses on driving scientific progress and broad acceptance of digital medicine to enhance public health.
• Philip Guster, Director of System Sustainability at Henry Ford Health. Philip previously worked at DTE Energy, which partnered with Henry Ford in 2021 to help the health system reduce its greenhouse gas emissions through DTE’s voluntary renewable energy program with the purchase of wind and solar energy at increasing rates over the years.

Below is a selection of insights to questions raised during the webinar. Responses have been edited for length and clarity. You can view the full panel discussion here:

https://cdn.embedly.com/widgets/media.html?src=https%3A%2F%2Fwww.youtube.com%2Fembed%2FBjCpeI45wfc&display_name=YouTube&url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DBjCpeI45wfc&image=http%3A%2F%2Fi.ytimg.com%2Fvi%2FBjCpeI45wfc%2Fhqdefault.jpg&key=a19fcc184b9711e1b4764040d3dc5c07&type=text%2Fhtml&schema=youtubeSustainability + Health Systems: U.S. and EU Perspectives Webinar

What made you decide to turn your focus towards sustainability in healthcare? And what do you see as the greatest challenges facing healthcare when it comes to sustainability?

Bert Hartog, DiMe: I’ve spent my career in clinical research, looking at clinical trials and ways to make them not only scientifically robust but also very attractive for participants to take part in, and part of that is convenience for the participants. That’s where digital health technologies can make a huge difference.

The light bulb moment for me was when I realized that many digital health solutions come from digital health devices produced for single use. At the beginning of the 2020s, 100 million devices were newly issued into the global market. I realized this is a mountain of electronic waste that nobody has given much thought to.

Everybody acknowledged that this is an underserved part of the digital health transition we see happening. It’s something that warrants attention.

Dr. Morris, UC Davis Health: When I took the job at UC Davis, I found myself in an environment highly geared towards sustainability. UC Davis is number one in the country for sustainability, and being in that environment made me start looking around at our department. As chair of radiology, which is one of the greatest contributors to greenhouse gas emissions in healthcare, I realized we need to figure out how to make our machines work more sustainably.

I am also interested in AI research, which, as Bert pointed out, is a double-edged sword. AI can help us achieve greater sustainability, but these storage systems can consume significant energy.

Sustainability is our number one problem. We need to start talking about it, communicating, and working together. It’s crucial to collaborate with industry partners to get this right. The biggest challenge is that doctors tend to be conservative. New technology often takes 16 to 20 years to gain traction, but we cannot wait that long. This issue is imminent, and we need to be nimble and act fast.

Dr. Omary, VUMC: I used to think about being green in my personal life, but I didn’t consider how to bring that mindset to my work as a physician. It felt like I was living two separate lives. The pandemic made me realize that as healthcare professionals, we have not just an opportunity, but a responsibility to step out of our medical centers and benefit our communities and nations.

During the pandemic, we saw how events in one part of the world could impact another, seemingly unconnected part. This realization hit me during lockdown — I wanted to do everything I could to help during the pandemic and take on the larger, more complex challenge of climate change.

The more I read about it, the more I realized that climate change, like COVID, disproportionately affects those who can least tolerate it. This led me to pivot my career towards generating the most impact. In healthcare, we think about our patients, but with climate change, we suddenly have 8 billion patients to consider, including future generations.

Philip Guster, Henry Ford Health: Midway through my career, I was working for the largest utility in Michigan, one of the largest in the country. My background is in manufacturing, and then I moved to utilities, working there for 13 years. My expertise is in engineering, energy efficiency, and systems. Healthcare has large systems behind the scenes that are crucial to patient care.

At Henry Ford Health, I’ve seen the crucial role we play as a safety net hospital in Detroit’s revitalization. Our hospital has been here for over 100 years, and we’re building a new 21-story tower that will anchor Midtown Detroit. This project will change the skyline and address the health and poverty challenges in our population. Our patients expect us to lead the way in sustainability and healthcare innovation. I’m excited to be part of a team with a culture of inclusion and collaboration, and our success will depend on our partnerships.

Clinicians have a lot on their minds — patients, improving outcomes, integrating new technologies, dealing with burnout, and staying up to date with the latest research. How does sustainability even have space in your mind as a clinician?

Dr. Morris, UC Davis Health: Sustainability shouldn’t be an additional burden. It needs to be pervasive in all aspects of our work. Sustainability can make a clinician’s day better by improving efficiencies. For example, in my area, we can improve patient protocols to make them shorter and more efficient. Small initiatives like installing motion detector lights can collectively make a significant impact across the system. These small steps create a better working environment and improve patient care.

Dr. Omary, VUMC: Dr. Morris is right. We don’t want sustainability to be seen as separate from our other duties. There’s a massive staffing crisis in healthcare — two-thirds of nurses are burnt out, and roughly half of physicians, depending on their specialty, are burnt out too. One-quarter of physicians in the US are clinically depressed. If we think about these statistics, it’s clear we need to improve our work environment.

When we care for the planet, we care for our patients. For example, telehealth reduces the need for patients to travel and deal with parking, which can be stressful. Telehealth is a sustainable intervention that benefits both the environment and patient care. Measuring the carbon cost of our care algorithms is a great opportunity for research and innovation. Sustainable practices can save money, enhance workforce satisfaction, and benefit our patients.

Philip Guster, Henry Ford Health: This is my first time working with clinicians, but we’re all focused on continuous improvement. The key is making sustainability visible and part of our daily operations. Accurate data is crucial for this. For example, we’ve been working on our energy data for three years to ensure it’s accurate. This visibility can engage hospital presidents, clinicians, and staff.

We’ve made significant strides, such as reducing the use of harmful anesthetics like desflurane. From 2019 to 2023, we reduced its usage from 25 down to one. This data-driven approach can prevent greenwashing and help us track our progress accurately.

We need to continue working on reducing single-use plastics and other waste, but having concrete data like this helps keep everyone motivated and aligned with our goals.

Policy and regulation are crucial for ensuring that our efforts in sustainability and innovation have the intended impact. How is policy either helping or hindering the advancement of sustainability initiatives in health systems? And who’s learning from whom here? Is it the US learning from the EU, the EU learning from the US, or is it a little bit of both?

Bert Hartog, DiMe: The short answer is, the US is learning from Europe, Europe is learning from the US, and we’re both looking at the rest of the world for further inspiration.

The difficulty is scale. We need to transition from point solutions, proof of concept pilots, individual clinics, individual hospitals, and individual networks doing their own thing, which is good and should continue. But we need to move up to the network level where we start addressing issues at state level, country level, and region level to really have the impact we’re looking for. Every little bit helps, but we need to start transitioning from innovation into scaling. That is important, and that’s where policy can make a difference.

One example in Europe is the electronic waste resulting from digital health devices. This was the beginning of a consortium with academics, hospitals, business schools, pharma, med tech, and startups, funded by the European Commission to work on designing these technologies for recycling — be it reuse, repurpose, or any of the “Rs.” We look at incentives for people to return these devices after use, considering a behavioral science component. Downstream, we work with waste management companies so they are equipped to handle this medical waste properly, allowing for recycling and recovering rare earth materials and precious metals when the product has reached its end of life.

Dr. Morris, UC Davis Health: In my area, radiology, we have very big machines like MRI and CT machines. So there’s a lot of effort or thought put around refurbishing these machines so that we’re not just recycling them but making them better. This requires a huge amount of effort and connecting people who normally weren’t connected in the past, and creating new regulations and guidelines.

In the medical space, societies can be very strong in this area, putting out suggested guidelines for machines, for example. There’s the Energy Star program here in the US, which could impact regulations and guidelines. Building these relationships is crucial, and normally, I would never have talked to an Energy Star person until several years ago. But this is critical because we need to speak the same language and get guidelines that are used not just in the US but globally.

We look to Europe because they are usually ahead in environmental policies and ideas. For instance, in MRI, we use gadolinium, a contrast agent that gets excreted into the water. Europe is very concerned about rising levels of gadolinium, which we weren’t even measuring in the US. Now that Europe has highlighted this, we’re starting to think about it too. We can learn a lot from Europe as they often lead in these areas, and I tip my hat to them.

What is the role of innovation in accelerating the sustainability transformation? And what’s the business opportunity in it?

Dr. Omary, VUMC: There’s a lot of money being left on the table when sustainability isn’t considered. Proper sustainability practices save money by reducing waste, and those savings can be reinvested into new growth areas. Entrepreneurs have a crucial role here. They bring a finance lens that can lead to faster adoption of sustainable practices.

If we pitch sustainability as an economic benefit, we meet the needs of the audience better. Entrepreneurs also teach us how to scale and grow quickly, which is essential for expanding sustainability initiatives.

Philip Guster, Henry Ford Health: As we’re building our new campus, sustainability is a priority. At Henry Ford, we’re implementing sustainability upfront in the contracting phase. When we seek partners through RFPs, we hold them accountable for sustainability. This approach ensures that sustainability isn’t an afterthought but a core part of our projects.

We understand there are incremental costs, but having the option to choose sustainable solutions and holding vendors accountable for innovation is crucial. It’s about integrating sustainability into every phase, from contracting to the materials we use in construction.

Bert Hartog, DiMe: In clinical research, which is the prelude to clinical care, we have an opportunity to scale sustainability benefits exponentially. We’ve started quantifying the environmental impact of clinical trials to establish a baseline and identify what good looks like. By understanding these metrics, we can address logistics, utilities, and packaging without compromising patient safety or scientific integrity.

For example, remote monitoring in clinical trials can reduce carbon footprints by 20%. If we multiply this impact across millions of instances, the benefits are substantial. Offering remote options for assessments and trials can significantly reduce environmental impact. More companies are becoming interested in this approach as they see the data proving its effectiveness.

How do we ensure these efforts and technologies are accessible and equitable to all communities, marginalized populations, and developing countries? How do we address these disparities?

Dr. Morris, UC Davis Health: It’s only recently that healthcare systems have started to address inequities and systemic racist policies. It’s crucial that we factor in these disparities completely to ensure we don’t leave behind marginalized communities.

As we scale up initiatives globally, particularly in lower and middle-income countries, we have the opportunity to improve healthcare access. For example, in our area, we’re investing in vans to reach remote communities, utilizing telehealth for primary care, and establishing clinics in rural areas. Shared best practices and collaboration are essential to make healthcare accessible for everyone, although I don’t have a perfect solution yet.

Bert Hartog, DiMe: Sustainability can be a byproduct of changing practices. Initiatives like hospital-at-home and telehealth not only improve access to care but also contribute to sustainability. Equity means reaching those populations who currently lack routine access to healthcare due to various barriers. By embedding sustainability in different practices, we can address both access and environmental concerns simultaneously.

Dr. Omary, VUMC: The transition to green technologies allows us to redesign systems with an equity lens. Sustainability and equity can go hand in hand, offering win-win solutions.

What gives you hope for healthcare’s ability to make the needed changes?

Dr. Omary, VUMC: What gives me hope is knowing that younger generations prioritize climate change, making it a top issue facing humanity. This mindset shift will lead to a workforce that’s committed to sustainability. When healthcare professionals see themselves as part of climate solutions, it gives me hope.

Bert Hartog, DiMe: What gives me hope is the blurring of traditional boundaries and the interconnectedness of the world. With knowledge sharing and collective efforts, we can address systemic issues and scale up solutions globally.

Philip Guster, Henry Ford Health: From a Henry Ford perspective, executive support for sustainability initiatives is encouraging. Top-level commitment ensures that sustainability is integrated into our practices from the ground up. It’s a significant shift from when production was the sole focus, and it gives me hope for our future.

Dr. Morris, UC Davis Health: Leadership plays a vital role, and I’m hopeful to see leaders across industries prioritize sustainability. There’s a growing market for green initiatives, which further drives change. It’s reassuring to know that sustainability is becoming a best business practice.

A Hopeful Future for Sustainable Health Systems

Following this conversation, three points stood out to me.

First, everyone has a role to play in making healthcare more sustainable. Clinicians can ensure their areas of health are optimizing resources to ensure their most efficient use (and reuse). Making practice more sustainable can bring an economic benefit. Optimizing costs means funds can be reinvested in other areas of care.

Second, professionals from other industries — the energy sector, materials industry, or waste management — can also “work in healthcare,” enabling the sustainable transformation of healthcare systems.

Finally, often what is good for patients can also be good for the environment. Remote care and telehealth can make care more accessible, equitable and convenient to patients while having an impact on emissions reduction related to transportation to and from healthcare institutions.

As health leaders continue to drive the integration of sustainability into every aspect of healthcare, from clinical practices to large-scale infrastructure projects, we begin to reveal a hopeful future for the global healthcare industry. Leveraging technology, fostering interdisciplinary collaborations, and prioritizing equity will enable healthcare systems to address climate change and improve health outcomes globally.

The post Sustainability + Health Systems: US and EU Perspectives appeared first on Medika Life.

Additionally, in a recent AT&T survey, business leaders in healthcare reached a similar conclusion. The survey found that the lack of a unified strategy was the dominant challenge in digital transformation. This strategic obstacle was five times greater than commonly cited examples, such as “required expertise,” and about 10 times greater than an “ROI justification” for the expense. In other words, organizations may have the resources to drive change, but fail to have a coherent strategy to implement digital transformation.

Even when organizations can overcome these hurdles, one major challenge remains: focus and prioritization. In many boardrooms, executives are debating overwhelming lists of potential generative AI investments, only to deem them incomplete or outdated given the dizzying pace of innovation. These protracted debates are a waste of precious organizational energy—and time.

The Rudderless Ship: A Metaphor for Healthcare’s Digital Journey

The complexity and lack of strategic coherence in healthcare’s digital transformation can be likened to a ship without a rudder. It may be powered by the finest engines and loaded with the most sophisticated technology, but without a rudder to steer, the vessel is aimless, unable to reach its desired destination. The healthcare industry is a vessel brimming with technological promise but adrift in a sea of strategic ambiguity.  And this path is complicated by the turbulent currents of cost, reimbursement, adoption and clinical validation.

The Philosophical Imperative of Innovation

The path forward is critical, but innovation is the fruit of strategic thinking, and this critical process and path can be a significant obstacle in driving critical improvements to our healthcare systems. It’s not merely a matter of technology or investment; it’s a profound philosophical challenge that requires an integration of ethics, creativity, and humanistic understanding.

In the world of healthcare, where lives are at stake, the diffusion of innovation into complex systems is more than a commercial or technological endeavor—it’s a moral and societal one. An approach that intertwines technology, AI, and human empathy is essential for aligning the path of innovation with the needs of patients and the healthcare community.

Navigating the Sea of Change

Navigating the intricate waters of healthcare digital adoption requires more than cutting-edge technology. It requires a compass of strategic wisdom, a rudder of cohesive planning, and the winds of philosophical insight to guide the way.

As the rate of technological change accelerates, a well-defined, unified strategy for digital transformation is not merely a wise business decision; it is an imperative for healthcare’s future. Innovation is not just the tool but the very art of reimagining what healthcare can be. This is the odyssey we must embark upon—an imperative that transcends technology to explore the profound interconnections between the human spirit, the art of healing, and the science of the future.

By seizing the helm and steering with intention and insight, healthcare can find its way. The question that looms is not only if we have the technological capability but whether we have the philosophical depth and the human wisdom to chart the course. Only then can we truly transform healthcare and reach the shores of a new era.

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The concept of rest has been an important aspect of human history, both in terms of religious traditions and in contemporary society. In the Judeo-Christian tradition, the seventh day is regarded as a day of rest, symbolizing the completion of creation and the appreciation of its beauty.

However, in today’s world, with technology enabling us to work around the clock, the idea of taking time to pause and reflect is often lost. Perhaps it’s time to explore the philosophical implications of the concept of rest and how it can help us put our lives and technological achievements into perspective.

In the book of Genesis, after creating the universe and all its inhabitants, God looked at his creation and saw that it was good. He then rested on the seventh day, not because he was tired or needed to recover, but to reflect on his creation and appreciate its beauty. This concept of rest is not just about physical relaxation, but also about taking time to appreciate and reflect on the good that has been accomplished. In the modern world, however, the pace of human accomplishment is almost continuous, and there is no time for such reflection.

And God saw every thing that he had made, and, behold, it was very good. And the evening and the morning were the sixth day.  Genesis 1:31

The technological advancements of the modern age have made our lives faster and more efficient, but they have also made it more challenging to slow down and reflect. With constant access to the internet, social media, and work emails, it can be challenging to disconnect and take a moment to appreciate what has been achieved. This constant connection to technology has led to a world that is always on, always working, and always striving for more. However, this constant striving can also lead to burnout, a lack of perspective and a vapid existence.

The bible, in Exodus, commands us to take a pause and reflect. This pause is not just about resting physically but also about taking the time to appreciate what has been accomplished and put it into perspective. In our modern world, this pause can be difficult to achieve, but it is essential for our well-being and for understanding the impact of our technological advancements.

The Greek word “schole” has given rise to the word “school,” but it has a deeper meaning that goes beyond the traditional idea of a place of learning. “Schole” can be interpreted as “restful learning,” which emphasizes the importance of taking time to breathe, contemplate, and discuss what one is learning. The idea is to create an environment where learning is not just about acquiring knowledge, but also about fostering a deeper understanding of oneself and the world.

This concept of rest—or disconnect—is not just about taking a break from work but also about taking time to appreciate the good in life. It is about taking a moment to appreciate the beauty of nature, the people around us, and the technological advancements that have made our lives easier. Taking the time to reflect on our achievements and put them into perspective is crucial for our mental and emotional well-being. It can help us gain a sense of gratitude and see the bigger picture of our lives and technological advancements.  This shift or separation allows us to move from being a participant to an observer, facilitating a new perspective on the world. And, as a function of this perspective, it enables us to evaluate innovation and technology from a more comprehensive viewpoint, taking into account the impact of our actions on the larger system.

The concept of rest is an essential aspect of the human experience, both from a religious and contemporary perspective. In our fast-paced, technology-driven world, it can be challenging to slow down and take time to appreciate the good in life. However, taking the time to reflect and put our achievements into perspective is crucial for our mental and emotional well-being. We can all benefit from taking a moment to rest and appreciate the beauty of the world and the technological advancements that have made our lives easier.

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At-home monitoring, digital health advances, technology, and 5G can play a crucial role in driving the transformation of cardiac rehabilitation and improving patient outcomes. These technologies can provide patients with greater access to healthcare services and support, enable remote monitoring, and facilitate more personalized care. In recent years, there has been a growing interest in home-based cardiac rehabilitation (HBCR) programs as an alternative to traditional facility-based cardiac rehabilitation (CR) programs.  This methodology offers many potential advantages for both patient and clinician.

Remote monitoring: Digital health advances and at-home monitoring devices can allow healthcare providers to remotely monitor patients’ vital signs, medication adherence, and other health metrics. This can enable early detection of complications and prompt interventions, reducing the risk of adverse events and improving patient outcomes.

Personalized care: With the help of digital health tools, healthcare providers can tailor cardiac rehabilitation programs to individual patients’ needs, preferences, and medical histories. This can improve patient engagement and adherence to the program and increase the chances of successful outcomes.

Telehealth: Telehealth technologies, enabled by 5G networks, can facilitate remote consultations between patients and healthcare providers, eliminating the need for in-person visits. This can improve access to healthcare services for patients who live in remote or underserved areas or who have mobility issues.

Wearables: Wearable devices such as smartwatches and fitness trackers can help patients monitor their activity levels, heart rate, and other health metrics. This data can be shared with healthcare providers, enabling them to track patients’ progress and adjust their rehabilitation programs accordingly.

Health apps: Mobile health apps can provide patients with access to educational resources, medication reminders, and other support tools. They can also enable patients to track their progress, set goals, and receive feedback and encouragement from their healthcare providers.

The comfort of home. The home environment can facilitate lifestyle modifications within a patient’s own comfort zone and provide direct family support

A new study has advanced the discussion on home care and the potential role of digital health. In a large and comprehensive clinical trial conducted at the San Francisco Veterans Health Administration compared the mortality rates of patients who participated in HBCR versus those who did not. The study included 1120 patients who were referred and eligible for outpatient CR between 2013 and 2018. Of these patients, 490 chose to participate in HBCR, while 630 chose to attend facility-based CR or did not participate in CR at all.

The results of the study showed that patients who participated in HBCR had a 36% lower hazard of mortality compared to those who did not participate in any CR program. During the median follow-up of 4.2 years, 185 patients (17%) died, and mortality was significantly lower among the HBCR participants (12%) compared to the nonparticipants (20%).

HBCR programs typically involve telephonic coaching and motivational interviewing sessions over a 12-week period, allowing patients to participate in rehabilitation from the comfort of their homes.  In addition, participants received equipment on an as‐needed basis, including resistance bands, a scale, a blood pressure cuff, a pedometer, a heart rate monitoring device, an exercise peddler or stationary bike, and a dietary video. 

This type of program is particularly beneficial for patients who cannot attend traditional CR programs due to various reasons, such as transportation issues, lack of access to facilities, or personal preferences.

Although this study has limitations, it suggests that HBCR may provide a viable and effective alternative to traditional facility-based CR programs. This finding is particularly relevant in the context of the COVID-19 pandemic, which has disrupted access to healthcare services, including CR programs. HBCR programs may offer a safe and effective option for patients to continue their cardiac rehabilitation without the need for in-person visits. Future studies can build upon these insights and incorporate advancing digital health monitoring devices for added data capture and to support analytics that drive frequent physician and patient feedback.

At-home monitoring, digital health advances, technology, and 5G can play a key role in transforming cardiac rehabilitation and improving patient outcomes. These technologies can enable remote monitoring, personalized care, telehealth, wearables, and health apps, among other benefits. By harnessing these tools, healthcare providers can provide patients with more accessible, convenient, and effective cardiac rehabilitation programs, ultimately saving lives.  But more importantly, current clinical data validate this concept and offer a life-saving path, accessible, and patient-friendly path for care.

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The United States has an effective, inclusive and diverse transplant system that saves thousands of lives every year. It has taken decades to get us to this point, made possible due to the gifts of generous donors and their courageous families and the meticulous coordination that takes place every day between patients, physicians, hospitals, organ procurement professionals and volunteers.

As the Chief Medical Officer at United Network for Organ Sharing (UNOS) and the former medical director of major university-based kidney and transplant programs, I have the unique experience of knowing what this lifesaving system looks like up close.

What is UNOS?

UNOS powers the nation’s organ donation and transplant system. We hold the federal contract to serve as the Organ Procurement and Transplantation Network (OPTN), established by Congress in 1986, which also requires that a private, nonprofit organization oversee the transplant system, with decision-making authority given to patients and medical professionals.

UNOS built, maintains and upgrades the nation’s computerized national waitlists of organ transplant candidates. We also built the secure technological infrastructure that makes it possible to offer donor organs to patients in need. In collaboration with transplant professionals and many other stakeholders, we establish policies that allocate organs to waitlisted patients. Patients, physicians, surgeons and others discuss and develop policies in an effort to allocate donor organs equitably and efficiently. Finally, we work with transplant centers and organ procurement organizations to drive improvements and bolster performance.

This extensive national infrastructure and the people who power it are committed on a single purpose: to ensure that patients can receive the gift of life from a generous organ donor.

The Generous Donor

Organ donors are most commonly patients in hospitals who, due to severe injury or illness, have been declared brain dead but whose organs may remain viable for transplant. It’s important to remember that less than 1% of people die in a way that makes organ donation possible.

Physicians exhaust every available option to save a patient’s life. However, if the patient passes away, other lives may be saved through organ donation. At that point, the hospital contacts their local Organ Procurement Organization (OPO), one of 56 regional nonprofits that assess, collect and transport donated organs. OPO staff are trained to counsel families during one of the most difficult moments of their lives.

If the deceased patient is a registered organ donor, the OPO works with the family so they understand the donation process. If the patient was not registered as an organ donor, the OPO staff will offer the family the option to donate.

We should not underestimate the importance of this decision and the strength and courage required by a family during such an emotional time. This decision is transformational – a single donor can save up to eight lives.

Making the Match

After the OPO confirms donation consent, their staff determine if a deceased donor’s organs are viable for transplant. If so, they enter the patient’s medical information into the UNOS database. It generates a list of best match candidates based on a variety of clinical factors, including blood type, body size, severity of illness, distance from the donor hospital and time on the waitlist. 

Currently, more than 100,000 patients are on the national waiting lists, the majority of whom are waiting for a kidney transplant. Potential transplant recipients are placed on the transplant waiting lists after being referred and evaluated at a transplant hospital.

While popular culture has trained us to think otherwise, no patient has a fixed position on the national waitlist; in fact, a patient’s place on it can change over time. It’s more accurate to think of the waitlist as a pool of candidates, awaiting the organ that best fits their unique genetic and medical profile.

Once the UNOS system has produced a list of candidates who best match the available donor organs, the OPO contacts the transplant hospitals of matched patients, once again using UNOS’ computer systems.

A Race against Time

After an organ has been accepted by the patient and their doctors, time is of the essence; organs can be preserved outside the body for only a short time – often just a few hours. The organs are then respectfully recovered from the generous donor.

The OPO arranges to transport the donated organ to the transplant hospital. Once the medical team transplants the organ, a life can be saved, quality of life can be improved and a donor’s legacy can be honored. Recovery from a transplant differs from patient to patient, but each include life-long medications and lifestyle changes.

This complex, lifesaving process, with its many moving parts and medical, logistical and geographic requirements, happens every day. It is successfully replicated across the country seven days a week, 24 hours a day, 365 days a year.

A Lifesaving Goal

We are proud of the results. We have now surpassed over 1 million transplants in the United States since the nation’s first successful transplant in 1954. In 2022 alone, over 42,800 transplants were performed – more than any other year. Our transplant system continues to set lifesaving records thanks to generous donors, their courageous families and the hard work and dedication of those who make up this diverse and thriving national system.

Understanding how the system works, the people who make it possible, the lives saved and the donors honored is essential to advancing our shared goal of driving continuous system improvement to save as many lives as possible.

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It’s happening now. And healthcare is at the center of this revolution of care driven by technology, the empowered consumer, and dimensionalized  by retail to drive both services and the creation of a new and more optimal user experience. The many and varied digital health tools that are available today—blood glucose monitoring to advanced analytics—can add an expanded dimension to the utility and convenience that redefine fundamental aspects of care.

Technology with a human touch.

Technological advances are providing unparalleled opportunities for medicine and digital health, giving rise to new capabilities which are making it possible to deliver personalized medicine and preventive care at unprecedented levels. Wearable devices such as fitness trackers can provide real-time data about users’ health, allowing doctors to monitor their progress or identify potential issues before they become serious problems. Together, devices with AI-based insights become greater than the sum of the parts and make drive essential clinical utility

Further, the power of technology, including advanced analytics and artificial intelligence, will enable clinical stakeholders to operate at expanded levels of competence. The roles of the nurse, pharmacist, and other HCPs will expand to tackle pressing human issues including fatigue and burnout.

Humanity with a technology edge.

At the heart of this transformation is the user experience, or perhaps better articulated as a human experience. By making technology more user-friendly and intuitive, healthcare providers can make it easier for patients to access the care they need and to understand the information they are provided with. This can help to reduce anxiety and improve overall satisfaction with the healthcare experience. Additionally, this can help to reduce errors and improve the accuracy and reliability of medical information, which can ultimately lead to better outcomes for patients. By using devices such as wearables and telemedicine, patients can get the care they need without having to leave home. Additionally, designing healthcare facilities with a focus on comfort and accessibility can also help make the experience more human-centered. And by providing compassionate, personalized care and support, we can ensure that each person is treated with dignity and respect.

Today, there’s an interesting example of emerging technology call GPT-3 (short for “Generative Pre-trained Transformer 3”).  GPT-3 works by training a large neural network on a dataset of human-generated text, such as books, articles, and websites. The neural network is designed to predict the next word in a sequence of words, given the context of the previous words. As the model is trained, it “learns” the patterns and structures of the language and can generate new text that follows those patterns.

There are several potential applications for GPT-3 in the field of medicine. For example, the model could be used to generate medical reports, summarizing patient information and test results for physicians and other medical professionals. Additionally, GPT-3 could potentially be used to improve natural language processing (NLP) systems for electronic health records (EHRs), allowing physicians and other HCPs to more easily search and analyze patient data. NLP systems that can understand and extract information and could help improve the efficiency and accuracy of medical decision-making. And perhaps most remarkable is the ease of use of these platforms.

The convergence of these areas of innovation—human and technological—is leading to fundamental changes in the way healthcare is delivered, with the potential for transformative effects on patient outcomes and cost savings. The cooperative engagement of man and machine is becoming less a “force fit” and more a “create dance” that celebrates this new relationship.

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On the one hand, we have incredible science, technologies, drugs, devices and providers. On the other hand, we have a truly dysfunctional healthcare delivery system.

America has exceptionally well-educated and well-trained providers committed to your care.

America is the envy of the world for its biomedical research prowess uncovering the basic science of human biology, funded largely by the government via the National Institutes of Health and conducted across the county in universities and medical schools.

The pharmaceutical and biotechnology industries continuously bring forth lifesaving and disease-altering medications.

The medical device industry is incredibly innovative and entrepreneurial. The makers of diagnostic equipment such as CT scans and handheld ultrasounds are equally productive. 

Consider these examples: The science of genomics is revolutionizing medical care in profound ways, such as producing targeted cancer drugs, predicting later onset of cardiac disease, offering prognostic data to guide cancer treatment, rapidly identifying bacteria and its antibiotic susceptibility, indicating whether a drug will work in a specific person and determining if a drug will cause a side effect in that person. 

The pharmaceutical industry has brought us statins to reduce cholesterol, drugs to prevent blood clotting and effective means to control high blood pressure. The rapid development of multiple vaccines and treatments against Covid-19 has been an incredible tour de force.

The device industry has created a potpourri of new approaches that have transformed, for example, cardiac care, including angioplasty, stents, pacemakers and intra-cardiac defibrillators. We even have the ability to replace the aortic valve without major heart surgery. 

Organs can be imaged noninvasively in incredible anatomic detail while also showing their inner cellular workings. The operating room is equipped with devices that make surgery less invasive, more effective and much safer.

Simulation technology has completely changed how trainees learn the basics of procedures from the simple, such as drawing blood, to the complex, such as laparoscopic surgery and cardiac catheterization. Robots are assisting surgeons in open heart and prostate surgery and are integral to today’s large hospital pharmacies and central sterile supply systems.

We may be on the verge of using genetically modified animal organs transplanted to humans for heart, lungs and kidneys.

The electronic medical record allows rapid access to information at any time and place, helps the physician to select the correct medication and dose and speeds up prescription transfer to the patient’s local pharmacy.

Radiology and pathology images can be sent via the Internet to a distant site for interpretation by a specific expert. A video of an ongoing surgical procedure can be evaluated by a distant authority in real time to give advice to the operating surgeon, such as in a battlefield situation far from home. And some surgery can even be done distantly via robotic controls.

We can be appropriately awed, proud and pleased about what is available for our care but to a large degree, we don’t fully benefit because —

We have a very dysfunctional health care delivery system. It is highly flawed and just does not work well.

Image from Peterson KFF Health System Tracker

America spends nearly 20 percent of its Gross Domestic Product on medical care, which is double that of the average of 9.9% for the other 34 economically-developed countries (such as Canada, Britain, France, Germany and Japan) in the Organization for Economic Cooperation and Development. On a per capita basis, America spent ~$12,000 on health as of 2020, which is more than twice the average of the other countries and well above Switzerland, the second highest country in expenditures, at ~$7000.

Despite these expenditures, our lifespans are somewhat shorter with Japan and Hong Kong at the top of the charts averaging 85 years and the United States ranked at number 46 with an average of 79 years and falling somewhat in the past few years. This decline is not for lack of medical advances but is rooted in the social determinants of despair and disease and the linked epidemics of obesity and type 2 diabetes.

There are thousands of preventable hospital deaths each year, and there are ~100,000 deaths due to hospital-acquired infections.

On a direct personal basis, you experience the dysfunction personally in many venues. You pay a high price for your health insurance yet you get only 15 minutes with the doctor. You are frustrated, perhaps angry and the doctor is equally frustrated and increasingly burned out. Tests and procedures are way overutilized. Trips to the ER and admissions to the hospital are much greater than necessary. Plus, these incredible technologies and lifesaving drugs are often used in ways or settings in which the marginal benefit barely, if at all, exceeds the marginal cost.

This is not an enviable record.

A report from the National Research Council and Institute of Medicine, summarized in the Journal of the American Medical Association, found “the health outcomes [of the United States] are generally worse than those of other wealthy nations. People in the United States experience higher rates of disease and injury and die earlier than people in other countries. Although this health disadvantage has been increasing for decades, its scale is only now becoming more apparent.”

Although there is better control of high blood pressure and cholesterol and there are lower cancer and stroke mortality rates, U.S. citizens have a lower life expectancy, higher infant mortality, higher rates of premature birth and thus lower birth weights, a higher incidence of HIV-AIDS, the highest prevalence of obesity and diabetes and the second highest rate of death from coronary artery disease, among other ills. To repeat, this is not an enviable record, especially given the level of expenditures. 

In sum, the paradox is that America has the providers, the science, the drugs, the diagnostics and the devices needed for outstanding patient care. But the delivery of care is dysfunctional at best and far too expensive. You are not getting the full potential of care that could and should be available and you are paying too much for what you do get.

In the articles to follow, I will delve into the what’s and why’s of this predicament along with practical approaches to improvement. Please join me.

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