Physician on the metaverse: It will fundamentally change patient care

Physician on the metaverse: It will fundamentally change patient care

Joe Kornik: Welcome to the VISION by Protiviti interview. I’m Joe Kornik, Editor-in-Chief of VISION by Protiviti, our global content resource examining big themes that will impact the C-suite and executive boardrooms worldwide.

Today, we’re exploring healthcare in the metaverse. I’m excited to be joined today by Dr. Will Strimel, a physician, healthcare executive, and founder of Tulio Health and Wellness in Philadelphia. Specializing in cardiovascular disease and internal medicine, Dr. Strimel has a wealth of leadership experience serving for more than 15 years in the U.S. Army in various command positions and, subsequently, as the president of the physician enterprise for a large integrated healthcare system in Philadelphia.

Dr. Strimel, thank you so much for joining me today.

Dr. Will Strimel: Thank you much. It’s a pleasure to be here.<>Kornik: Doctor, I mentioned that you currently lead a unique medical company. If you could tell us a little bit about Tulio Health and Wellness, its goals, and why you envision this model being part of healthcare’s future.

Dr. Strimel: Well, Joe, this is a really exciting time to be innovating in healthcare delivery in the United States and it’s because all the major stakeholders, from patients to clinicians to governments and payers, all recognize that the current system is just not sustainable. Costs are spiraling out of control, providers are burned out, and clinical outcomes for many people are actually getting worse, and it’s in large part due to the fact that we, rather than having a healthcare system, we really have more of a sick care system that’s designed to treat illness instead of engaging people before diseases start. At Tulio Health and Wellness, we’re changing that and we’re doing that by using advanced technology and testing, and then combining it with an experience that feels unique so that people are more engaged to optimize their health and delay the onset of illness. We spend much more of the healthcare dollar upstream, kind of protecting risks and trends before they develop, and then we partner with our clients to provide personalized solutions that really promote overall wellness.

Kornik: Thanks. Yes, you talked about technology there and I know telemedicine certainly has seen rapid uptake following the pandemic. As we move into a Web 3 world, do you see that momentum continuing in the metaverse? Is that the next iteration or evolution of healthcare?

Dr. Strimel: Yes, so telemedicine was a critical advancement during the pandemic but in many respects, it didn’t really change the delivery model all that much. Now, while we are now able to interact with patients in a way that feels a bit more personal by integrating video into a visit, in many respects, it’s just a glorified phone call. But the fact that there was such rapid adoption shows that there’s promise evolving this in the metaverse.

For instance, prior the pandemic, less than 50% of healthcare systems offered telemedicine services. By the end of 2020, that was up to 95%. And a patient visit in the metaverse can be so much more. By securely uploading biometric data and other information and time that with the way that we can interact with a patient in real time, it can be so much more than just a single data point in that visit. Then when you have a Web 3 platform, one that’s facilitated by haptics technology, where you can actually hear breath sounds or lung sounds or even perform a virtually exam that feels very much like a person is in front of you, that can really change the delivery model.

Kornik: Right, Doctor, and I know that you’re probably familiar with the metaverse hype cycles that we’ve had the last few years. Coming out of the pandemic, it has been on, it has been off. There has been a lot of news. Metaverse certainly has been in the news a bit, and healthcare is certainly one of those industries and one of those sectors that I keep hearing will be fundamentally changed by technology, Web 3 in the metaverse. I’d be curious to hear your thoughts. Do you think the metaverse will be a revolutionary gamechanger in healthcare, or do you think we’re getting a little bit too far ahead of ourselves there?

Dr. Strimel: Well, I do think that the healthcare delivery system will look very different as the concept of the metaverse evolves, but I suspect the further out on the value chain that you look, and what I mean is by that ending directly at the care of the patient, I think it’s going to be harder for that change to come. Of course, there’s going to be an iterative nature to it, but I believe that healthcare is more likely to see periods of big advances and then plateaus for a while instead of, for instance, a straight line up into the right in terms of innovation.

When you look at companies like Amazon and Netflix, they were able to radically disrupt their markets on the [backs of] technology because they really created whole new methods of delivery for their products, filling somewhat of a white space. Now that we have others in the market trying to follow their lead, but given the nature of healthcare services, it’s going to be extremely difficult or really impossible for any one entity to become that true dominant developer. I think we’re more likely to see a lot of competing technologies at different adoption rates.

Now, when one of these breaks through, I think you could have the ability to see mass adoption but it’s going to take time. I think a good example of this is electronic medical records. They’ve been really around since the early 1990s and while 30 years later, almost all health systems and providers use electronic medical records, there still are tremendous challenges in terms of interoperability, cost, security, and really ownership of the data.

Kornik: Right, and when you talk about the potential, the possibilities, it just seems like they’re almost limitless when I think about the space. What excites you the most when you start thinking about a metaverse future?

Dr. Strimel: Well, I’ll tell you, Joe. As someone who remains connected to the care of the patient, I am extremely excited about the possibility of linking generative AI with biometric data in real time. If you think about it, it has been estimated that it takes approximately 17 years for medical research to become fully integrated into clinical practice. Generative AI has the ability to shorten that to months, if not sooner, and that’s even at a population level.

For instance, when we take that capability and then we integrate a patient’s current biometric data, layer that perhaps even with genetic information, we’re going to be able to apply the most up-to-date treatments more precisely and at lower risk than we ever imagined. I think that once physicians experience this and develop a comfort level around this, they’re really going to demand it.

I think the other thing that’s interesting is the way that we’ll be able to redefine the way healthcare is acquired, stored, applied and controlled. This is where the blockchain really becomes extremely important. It can actually flip the script on healthcare information because up until now, it has really been either the government or the payers or the health systems that have had control of your healthcare information. On the blockchain, securely stored, you can now control that and you can move it and use it in a way that’s going to be way more meaningful to your care that it has ever been in the past.

Kornik: Well, I would say like it would solve one of the big impediments to adoption which I’ve been hearing a lot about which is privacy and security, and I know that’s a big issue. You think blockchain is the key to unlocking that particular set of [solutions to] problems?

Dr. Strimel: Well, I think we’ve already demonstrated that we can store the data there. I think the big question is going to be interoperability, so are we able to create a system that allows seamless flow? Right now, we don’t have one. We have electronic medical records to store a wealth of information but it’s not readily usable. I think that’s where a lot of startup companies are really starting to work at, how can we create almost a digital wallet for your healthcare information that you can control?

Kornik: Right, and that’s happening in many other places on the metaverse as well, that digital wallet that travels with you and secures assets in a secure environment. Wow, a lot of exciting opportunities here. I feel like another area that could see significant change is the ability to train and even, I guess, perform remote surgeries in the metaverse because of digital twinning. I’ve read about this. Obviously, you would know much better than I its potential. How do you see that moving forward? How could that improve patient care?

Dr. Strimel: Sure. Well, this is already becoming a reality. In fact, in June 2020, neurosurgeons at Johns Hopkins performed the very first augmented reality surgeries, and in both of these cases, they were performed using headsets with see-through displays that had images of the patient’s anatomy that were acquired by CAT scanning projected onto them that facilitated the procedures. It’s also important to remember that the healthcare practitioners tomorrow literally grew up with technology, so not only are they going to adapt well to an educational experience that’s immersed in technology, they’re going to seek it out.

Finally, I can’t emphasize enough the importance of creating more realistic training, especially procedural specialties. The classic model requires live patients for future physicians and proceduralists to learn their craft. This, unfortunately, exposes people to risk and it takes a lot of time to get the number of cases you need to become proficient. Well, in the metaverse-based training environment, using realistic models of both diseased and healthy patients, we can theoretically speed up the time to train future clinicians and doing it with much less risk, producing more doctors in less time.

Kornik: That’s interesting. Thank you, Doctor, for your time. You’ve been very generous with it. I have just one more question. We call this initiative VISION by Protiviti because we like to look ahead and envision just what’s possible. If you could take me out a decade or even more and tell me how the metaverse has transformed healthcare, let’s say by 2035, what’s different a decade from now?

Dr. Strimel: Sure. Well, I think the healthcare will definitely be different based upon innovations in the metaverse, but I do think it’s going to be slower than other industries. I think it’s important to identify the real-world challenges that are somewhat unique to healthcare, and chief among them is legislation. Healthcare is one of, if not the most heavily regulated industry, and legislation takes time to catch up with the ability of our tools. That’s one big area that people are going to need to have foresight and be proactive and seeing these changes coming out of where they work, whether state and local governments.

As I mentioned, there’s going to be no clear leader as far as the innovation. There’s going to be a lot of competing technologies and given the influence the governments play in financing healthcare, there’s going to be a little bit of a struggle with market forces to really drive the innovation. My ability in insurance reform and to make sure that we can keep people safe while this new type of care is delivered is important. Also importantly, access to this technology, whether it be high-speed networks or computing devices. For the people who are really going to benefit from this care the most, that’s just going to take a long time for that to become a reality.

With that said, I think within 10 years, we will see significant changes probably further up that value stream that I referenced, so things like drug creation delivery, training both for medical education and in real-world environments to make systems safer and more efficient. Generative AI with imaging, we’re already seeing this where you can use AI to improve the diagnostic accuracy of things like chest x-rays, CAT scans, EKGs. I do think we’ll see rapid evolution of what’s possible in the blockchain in terms of healthcare data and probably in terms of actual delivery, I think we’ll see much of mental health services start to move in this direction both because of the significant need and the significant barriers that already exist in this care right now.

Kornik: Thank you so much for the fascinating conversation today, Dr. Strimel. Thanks for your time.

Dr. Strimel: It has been a real pleasure, Joe.

Kornik: Thank you for watching the VISION by Protiviti interview. On behalf of Dr. Strimel, I’m Joe Kornik. We’ll see you next time.