New Technologies Are Here, Ready or Not

I recently gave a talk at the Columbia University School of Public Health. As a guest speaker for Dr. Francois Simon’s Executive Health MBA class, I wasn’t sure what to expect from the audience. The majority of the students in the class were physicians at various health institutions. The topic was “TeleHealth”—a rather vague term with a lot of room for interpretation.

To set the tone, I started with the story of the invention of the game of chess as told wonderfully in the book “The Second Machine Age” by Erik Brynjolfsson and Andrew McAfee. It tells the story of the farmer who brought his invention to his King who in turn was so impressed that he offered the farmer any reward he wanted. The farmer asked only for rice. The amount would be determined by placing a single grain on the first square in the chessboard, 2 grains in the second, 4 in the 3rd, and so on, doubling with every square. The King laughed and agreed, unaware of the exponential power of doubling.

brendan telehealth

For those of us allergic to math, I’ll spoil it for you. Just before the 7th row in the chessboard, you’ll have more rice than the entire world has ever produced in a year. The fable reminds us of the compounding power of information technology. Innovation builds on itself.


And in healthcare, we’re just entering the second half of the chessboard, where each new innovation will be more disruptive than the entire first half combined.

rice on chessboard

The funny part is, for the physician students in that class, it was difficult for them to see outside the frustrations they currently experience as doctors. When talking about Apple’s HealthKit, and the potential for our everyday data to become incorporated into electronic health records (EHRs), one physician in the class noted: “So more work for us? Who’s accountable for that data? No way we have the time.” And she’s right. We’re at this weird spot in the disruption curve where new general purpose technologies have been introduced (i.e., EHRs), but productivity hasn’t necessarily improved. The same thing happened with electricity when owners of steam-powered factories simply replaced their steam engines with electric ones, but didn’t rethink their entire factory layout and manufacturing process. It took 30 years for productivity in the US to increase after electricity. It took 10 years for the Internet to work its magic.


So we revisited the physician’s concern. If something’s being added to her plate, what comes off? Perhaps naively, I threw out “What about diagnosis?” The doctors in the room all laughed like the king from the rice story at the outrageousness of the idea. IBM’s supercomputer, Watson, may have beaten the world’s best Jeopardy players, but no way could it ever diagnose a sick patient accurately. Or could it?

It turned into a great debate on the future of medicine and, more importantly for the students in the class, the changing role of a physician. What happens when a second-half-of-the-chessboard technology like Scanadu potentially supplants a primary care physician altogether?

– Brendan Gallagher, EVP, Experience Strategy & Innovation