When it comes to the future of health, it seems that cows (yes, cows!) might be a couple hoof-steps ahead of people. While visiting relatives in Ireland last month, we stopped at a small dairy farm about 90 miles outside of Belfast. What I saw in the barn that afternoon lines up surprisingly well with Deloitte’s vision for the future of health where always-on sensors detect potential health problems long before symptoms surface. The farm also offered a glimpse into the future of work where automation takes over tedious tasks previously performed by people.
Fergal and Aisling have 70+ cows, a bull named Billy, and a robotic system that lets cows milk themselves…day or night. Each cow wears a radio-frequency identification (RFID)-equipped collar that triggers the milking station’s metal gate to swing open whenever she is ready to be milked. Sensors in the collar also count each cow’s steps, analyze their chewing (a healthy cow might chew more than eight hours a day), and continually assess their activity level. A cow that isn’t active, or not constantly chewing, might not be feeling well. Algorithms also analyze milk in real-time—checking white blood cells, temperature, butterfat levels, and quality. Any fluctuations could indicate the early stages of a health issue. The system can also determine when a cow is ovulating, which means hormone therapies aren’t needed to stimulate ovulation for breeding.
Adam Griffin, senior farm management support advisor at Lely North America (the Dutch company behind the robotic milking system), says the system collects about 120 different data points on each cow every day. Software turns the raw data into daily reports for the farmer. “Cows can hide symptoms fairly well until they’re actually very sick,” he says. “Once that happens, aggressive treatment might be needed.” Cows can usually overcome an illness on their own, but fighting an illness can negatively impact milk production, he adds.
Many dairy farms still send milk samples off to a lab for analysis. In the past, the farmer would have received the results in the mail. While lab results are typically available electronically, it might still take a couple of days before they’re available. By then, early and easily treatable health problems might have grown worse. Fergal says the robot can identify a sick cow at least two days before visible signs appear.
Invisible always-on sensors could be key to prevention
People have more complicated lives and different health needs than cows. However, in the future, we expect similar always-on sensors will spot potential health issues—and allow us to take steps to address them—before we start to feel sick. Today, wearable devices that track our steps, sleep patterns, and even heart rate have been integrated into our lives in ways we couldn’t have imagined just a few years ago. We expect this trend will accelerate. The next generation of sensors, for example, could move us from wearable devices to invisible, always-on sensors that are embedded in devices that surround us.
Many medical technology companies are already beginning to incorporate always-on biosensors and software into devices that can generate, gather, and share data. Advanced cognitive technologies could be developed to analyze a significantly large set of parameters and create personalized insights into a consumer’s health. The availability of data and personalized artificial intelligence (AI) can enable precision well-being and real-time micro-interventions that allow us to stay a step ahead of illness and far ahead of catastrophic disease.
Consider this: Consumers can already use a smartphone to adjust the thermostat, set alarms, and turn on lights in their homes. Cycle that forward to a home equipped with remote-monitoring biosensors. The home bathroom of the future, for example, might include a smart toilet that uses always-on sensors to test for nitrites, glucose, protein, and pH to detect infections, disease, even pregnancy. AI might be used to spot biomarkers that would indicate a potential change in health status long before symptoms appear.
Highly attuned sensors embedded in a bathroom mirror might track body temperature and blood pressure and detect anomalies by comparing those vitals to a person’s historical biometric data. Facial recognition technology in the mirror might be able to distinguish a mole from melanoma. Maybe this smart mirror even plays a skincare tutorial reminding the user to apply sunscreen based on that individual’s plan for the day together with the weather forecast. Breath biome sensors in a smart toothbrush might detect genetic changes that indicate early stages of disease.
Outside of the home, environmental sensors might detect UV levels, air pressure changes, and pollen levels. Such information could help keep consumers in tune with their health and quickly spot issues that could indicate the early stages of illness or disease. Rather than picking up a prescription at the pharmacy, personalized therapies based on a person’s genomics could be dropped off via drone when needed.
Cows and the future of work
Aside from watching cows wait in line to be milked, what struck me most inside the barn was the complete absence of humans—automation had significantly reduced the need for labor. No one was tending to milking machines or shoveling manure from the floor (a giant Roomba-like machine does that). Cameras throughout the barn and around the farm let Fergal keep an eye on his herd from his smartphone.
From farming to manufacturing to health care, technology has helped to free us from dull, repetitive, and even dangerous work, and has boosted employment in knowledge-intensive sectors such as health care, according to a report from our colleagues in the United Kingdom. While technology eliminates some jobs, it generally creates more jobs than it eliminates.
Automation and emerging technologies will most certainly change some health care jobs (and make others obsolete) in the years ahead. It also could allow us to work smarter. Imagine some of the changes we might see in nursing. More than 60 percent of registered nurses in the US are 54 or older and are considering retirement within three years.1 The anticipated nursing shortage could lead to suboptimal patient care, high turnover, and more burnout among the nurses who remain. If emerging technologies could take on some of the more mundane administrative tasks, nurses would have more time to spend with patients. AI-enabled digital assistants, for example, could be used to triage patient requests so that nurses can prioritize the most urgent patient needs.
For example, in facilities where we have implemented Lucy—Deloitte’s health-specific digital assistant—nurse response time has been reduced by a median of two-to-three minutes. That has virtually eliminated patient complaints about wait times. In addition, the data gathered through this technology provides input that can help nursing leaders develop more appropriate staffing schedules. Having the correct staffing levels can reduce burnout.
An ounce of prevention
I grew up in Wisconsin (America’s Dairyland) and am familiar with how dairy farms work… but I never could have imagined self-milking cows! We are living in times of unprecedented change across all industries. In the health sector, the availability of data is growing exponentially, and robotics and cognitive technologies are becoming more advanced and available. It is impossible to predict exactly what our health system will look like 20 years from now, but it’s likely that prevention and wellbeing will be a central part of it. In the future of health, an ounce of prevention might be worth a pound of cure. At robotic dairy farms, an ounce of prevention might also be worth a few extra gallons of milk.
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1 AMN Healthcare: The 2015 Survey of Registered Nurses: Viewpoints on Retirement, Education and Emerging Roles