The Health Industry Braces for a Revolution at Work

CRISPR-Gas9 is a revolutionary gene-editing technique that has scored breakthroughs in combating muscular dystrophy in lab mice. It could be a game changer in the prevention of disease in humans.

If it makes the leap to clinical use, says the Economist, “human genetic engineering will truly have come of age.”

So why did this biotech achievement pop up as a topic in a conference on modelling the future of work? It underlines the blend of boundless promise and health-leadership challenges that spin out of technology breakthroughs like CRISPR.

Jason W. Fischer Interim Division Head, Division of Emergency Medicine, The Hospital for Sick Children Associate Professor of Pediatrics, University of Toronto

“We are in a golden age of medicine,” said Jason Fischer, a pediatrician and technology champion at Toronto’s Hospital for Sick Children, speaking at the DeGroote School of Business’s Digital Leadership Summit. “We are just ripe for disruption. You’re waiting for something to fall that will change everything.”

But like any field on the edge of disruption, healthcare is also bracing itself for upheaval in the model of work. Summit speakers described the road ahead – for physicians to be grounded in informatics and data science, for medical schools to teach the new digital technologies in addition to traditional medicine, and for organizations to hire people as much for their algorithmic understanding as for their medical talent.

It also means mastering the skills of leadership in an environment where “people” reporting to you are not always people. “Some of your employees frankly may have to be robots,” said Kathy Woods, a partner and national lead for Deloitte’s leadership consulting practice in Canada – speaking at the technology and health panel, sponsored by the Health Leadership Academy, a collaborative effort of McMaster’s Michael G. DeGroote School of Business, Michael G. DeGroote School of Medicine and Faculty of Health Science.

This power of disruption will only intensify as healthcare professionals combine different technologies, such as blending

Kathy Woods | Partner and National Lead, Deloitte Leadership, Deloitte Canada

CRISPR with the power of artificial intelligence, the world of intelligent machines which is already altering the landscape of modern medicine.

For Fischer, the pairing of AI and CRISPR means that the life-lengthening predictions of science fiction may not be so far-fetched. “We often miss the power of convergence, putting these technologies together and seeing what they can do.”

Yet for young people entering the profession today, there is not nearly enough training in what their future jobs will look like, said Fischer, recently appointed Physician Information Technology Lead for SickKids’ Project Horizon, described as “an opportunity to imagine and plan for the future of pediatric healthcare.”

In their training and residency, young doctors’ heads are immersed in books about anatomy, physiology and medical science – all essential grounding — but not how to interact with the new technologies. At SickKids, he said, new doctors are being encouraged to gain digital skills and become prepared for this shift – which will gather force as machine learning and virtual reality become standard tools.

Not everyone adapts equally. Kathy Woods made the point that in the wake of all the digital advances, leaders must deal with how the workforce “feels” around the cascade of change. Bosses need to think about leading employees who are not located next door, but are still hungry for a lot of personal interaction. “As leaders we really need to step up,” she said.

John Dalla Costa | CEO, Centre for Ethical Orientation

As John Dalla Costa, a consultant on ethics and governance (who teaches in the Health Leadership Academy’s Emerging Health Leaders Program) reflected, it is the challenge of being interconnected while you are physically remote. Indeed, the entire conference underlined this paradox of hyper-connection and disconnection.

Woods sees three huge shifts looming in the healthcare work environment: We are already in the midst of a vast cognitive shift that breeds ambiguity and complexity. We also need to be ready for a behavioural shift with new forms of interaction — how we relate to each other – and that has to be reflected the storytelling of leaders.

The third and most important shift is emotional, and with that comes new ethical and engagement challenges. Leaders have to be confident and comfortable that they don’t have all the answers, having probably never worked in areas where their employees — human and machine – are operating.  They must move to a new level of authenticity, which is “important on steroids,” she said, and it connects directly to the maintenance of trust.

The good news is that in the healthcare system, the technological changes could make an impact in dramatically positive ways — for example, in the ability of stressed-out medical practitioners to focus once more on bedside manner.

Fischer pointed out that in the medical system, people have been “running, and running, and running” to keep up with the insistent demands, at a cost of their empathy and emotional intelligence. But it is possible, he said, for new AI diagnostic techniques — plus improved operational changes such as better flows of work — to redirect attention to the patient environment. His hope is that the new generation of health professionals will grow up with less fear about disruption and losing jobs and more hope to augment the quality of jobs.

He sees potential for disruption, for example, in the fact that 30 per cent of the people who come in the door of hospital emergency rooms are looking for reassurance – for example, the parents’ anxiety that their young daughter’s fever is okay. That reassurance could possibly come through the use of a validated AI “chat bot” that could mean less stress on the emergency room.

No one in the healthcare panel predicted a reversal of Canada’s single payer healthcare system but they acknowledged that there is an appetite for innovation, which suggests opportunity for the private sector and nimble entrepreneurs. Economics is a prime factor, the realization that we can’t maintain public healthcare spending at current levels.

The appetite also reflects the growing activism of patients and the increasing need to see them as consumers of the healthcare system – a realization that was one of the dominant themes of the conference. The emerging generation of young consumers has grown up on the service offerings of Best Buy and Amazon, and won’t be satisfied with lower quality service from their healthcare.

This shift of emphasis means looking at hiring in a different way. Indeed, someone with skills in the hospitality industry or in retail may be better equipped to run an emergency department than someone with a medical background. Or online shoe vendor Zappos might have clues for learning how to move patients effectively through the system.

Kathy Woods said the new age of technological change will require a more sophisticated approach to hiring talent. We will still need specialized medical capabilities but what about the other skills? Jobs will be different in the future, but organizations still have to identify core capabilities that cut across the various activities and learn how they can be hired. Employers have to figure out what work can be automated; how much can be outsourced; and how much is to be configured differently. From that analysis, they can pull out the essence of whom they have to hire.

Marwan Sati | Vice President, R&D, Merge Healthcare

She said the upward curve of technology is steep, but the realities in the world of work are still lagging, and the public policy gap is scary.  As well, there is a need to get the relevant research data out into the public sphere.

The healthcare conversation unfolded as a striking paradox – a future with infinite promise tinged with the vulnerable feelings of the people who must adapt to it. Marwan

Sati, an IBM researcher working with the fabled Watson computer, acknowledged he is one of the disruptors. Watson, for example, can read the 3,000 research papers written on oncology every year, turning them into a tool for understanding rather than an amorphous swamp of undigestible information.

The computer can also detect melanoma from the transmission of a picture of a mole on the skin, or screen for Alzheimer’s disease through a scan of the eye – or allow radiologists can cope with the flood of images that come across their screens.

But despite the blinding – and positive — force of such innovation, there still exists a sense of fearfulness that the new world of work will be a scary place. The antidote, speakers agreed, is for leaders to develop a stronger narrative to communicate realistic hope in the face of an uncertain world.

Some fear is only natural, said futurist Bob Johansen, a distinguished fellow of the Institute for the Future.  ‘If you are not just a little frightened about this future, you’re not paying attention.”

Gordon Pitts is the Business Writer in Residence at the DeGroote School of Business.