A view from the Center

Deloitte's Life Sciences & Health Care Blog

Homo ex machina

‘Temet Nosce’ or know thyself.

This is what The Oracle tells Neo when they first meet in The Matrix. Who we are and how we learn is a combination of our biology and our personal experiences. The plasticity of our minds and our genes make us individual persons in the world. Our individual mind and experiences are hard to offset. Sometimes we make decisions counter to our long-term wants because the wiring of our minds and our conditioned responses. Often it seems as if we are a slave to our desires and incapable of realizing our long-term goals. Would knowing myself better help me make better decisions?

Let me give you an example. As someone who has struggled with my weight, I would like nothing more than to make only healthy, evidence-based decisions when it comes to diet and exercise. But sometimes I don’t. A few months ago, I decided I needed to tip the scales in my battle against my desires. I downloaded a weight loss app, started counting steps and continued a lifelong practice of mindfulness, all in an effort to override those short-term desires and work toward my long-term goals. And I, like Oprah, lost 26 pounds over several months (both of us eating bread)!

Most of us struggle in one way or another with some sort of addiction, desire, impulse or emotion — by just being human — and understand all too well what it means to be enslaved to the biological machine. The awesome thing is now we seem to have digital tools to help set us free.

While walking (miles according to fitness tracker) at the HIMSS16 conference, something dawned on me. Many of the enterprise health IT software solutions that I saw at the conference and have spent most of my professional life with would do little to help me with obesity and to prevent me from developing diabetes. They are very helpful if I end up sick in a hospital but have little to do with preventing me from getting there. The consumer-centric technology counting my steps or my mobile solution helping me become aware of what I am eating might just do it.

What I did find fascinating at the conference was the emergence of cognitive or machine-based learning solutions. With the vast amounts of data for machines to learn from, I began to imagine a future where machines could nudge me into healthier behaviors, help me be more aware of my actions, and possibly allow me to live a healthier life. Now that machines are learning from our data, we may not need a spouse, daughter, care manager, or physician to remind us to be healthy. Perhaps a machine will help us engage ourselves.

Better living enabled through computing

Think about how often we turn to digital tools for data. Our wearable devices and sensors tell us how close we’ve come to our fitness goals. Our mobile apps help us log meals and calorie intake. I can download health data from my fitness tracker, watch my heart rate with my smartwatch, and double-check calories on mobile fitness app.

These devices provide tons of data—but very little insight. Cognitive computing bridges that gap. Cognitive computing includes self-learning systems that use data mining, pattern recognition and natural language processing similar to the way the human brain works.  At Deloitte, we’ve begun to explore ways of leveraging these technologies to help identify the key behavioral and lifestyle issues most relevant to a person’s health. It can be used to monitor our health in real-time, and provide us with the most appropriate tools to encourage in the moment choices that support our long-term goals.

Here’s how: Self-learning cognitive systems digest structured data (facts in the form of rows and columns) and unstructured information (natural language, tweets, blogs and images) and draw conclusions from them just as the human brain does. They can take clinical guidelines and medical literature, as well as all of our self-generated data, and merge it with our past medical history, genetic variants, personal preferences, and the results of previous behaviors and choices. After quick analysis, the end result is advice that is contextualized and wholly unique to us. This is a concept we’ve begun to call precision wellness.

Cognitive computing could unlock behavioral triggers that lead to poor physical health and chronic disease, allowing for the emergence of a new human being—one who is no longer at the mercy of biology alone. We can use tools that better align our long-term goals with our immediate desires and then we ourselves, not a machine, can become what we want to be. Though a weight loss digital tool may not be a cognitive computer, it gives me the nudges that I wouldn’t have on my own. For me, embracing mindfulness and using my weight loss program app has helped to level the playing field between my long-term goals and immediate desires and steered me to make healthier choices in the moment. Can you imagine if all the cues were personalized and unique to the nudges I need when I need them?

Why now?

  • Moving away from fee-for-service: The health care industry is moving toward a value-based construct and away from episodic-based reimbursement models. These changes encourage providers to engage with patients in new ways and provide financial incentives to stay healthy and out of the hospital. When promoting wellness, providers are well aware of the importance of what happens outside the clinic or hospital walls.
  • Exponential technologies: Cloud, mobile, digital, cognitive computing, robotics, genomics and virtual reality now make it possible to connect and learn from our patterns in ways we couldn’t before. Today we can leverage machine-based learning not only for precision medicine biologically but also for precision wellness psychologically. There is more data than ever before driven by EHR, social media and the use of apps and wearable devices. There are new tools to harness this data to help both providers encourage and patients adopt healthy habits.

I already had the raw data necessary to make healthy choices, but I still needed help — personalized nudges to push me in the right direction. For me, homo ex machina is not just the world where Neo says, “I know Kung Fu,” but the world where Kung Fu Panda says, “There is no secret ingredient. It’s just you.”

Author bio

Dr. Dhar is a principal with Monitor Deloitte, the strategy practice of Deloitte Consulting LLP and the National Therapeutic Area Transformation Integrated Solutions Leader for Deloitte Consulting LLP. He is responsible for developing integrated capabilities that bring together market leading ecosystem solutions, exponential technologies, data, and analytics, to transform health care. Dr. Dhar received his MD from the University of Illinois and MBA from the University of Chicago.