The Future of Health Care Is Avatars, Driverless Cars, and Virtual Reality

Teams at Kaiser’s Garfield Innovation Center test-drive solutions with doctors, nurses, patients, and consultants whose ideas may lead to a new health-care delivery system.


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Courtesy of Kaiser Permanente

Imagine this: It’s a Saturday morning, and Leo and his wife, Rosemary, a mixed-race couple in their 60s, are walking down the street when Rosemary’s cellphone rings. A male voice projects: “Hi, I’m the KP avatar. From the readings on Leo’s bracelet, we’ve noticed that he’s having some trouble breathing.”

Leo is wearing a biometric wrist monitor that enables the health care providers at Kaiser Permanente to track his vital signs. The KP avatar is computer simulated—not a person but a virtual reality. Leo (a real human) is experiencing shortness of breath.

 “I’m fine, Rosemary,” says Leo panting. The KP avatar interjects: “We’d like to take a closer look.” A driverless medic car arrives in less than a minute, and the couple climbs in. Leo continues to proclaim that he’s fine as he huffs and puffs more heavily. Rosemary looks on concerned. A new voice, a female avatar, suggests that they run a few tests. Leo places his finger on a pad on the dashboard, which shows the oxygen level in his blood. He then puts his finger into an adjacent compartment for blood tests. Within seconds a monitor on the dash lights up and the couple videoconference with an emergency room doctor.

The ER physician directs Leo to place a white disk that is stored on the dash against his chest. It provides an ultrasound of his lungs. From there, the doctor explains why Leo is having difficult breathing: He has pulmonary edema, or excess fluid in his lungs. The doctor gives Leo two options. He can go to the hospital or go home with a prescription for a diuretic (a medication to reduce the extra fluid he is carrying) with a Kaiser provider following up with him later in the day. “Option two sounds fine,” says Leo, “I want to go home.”

If the scene sounds futuristic—it is. Leo, Rosemary, the avatars, and doctor are all part of a video simulation created at Kaiser’s Garfield Innovation Center. It is one of three futuristic scenarios created in a project there called Imagining Care Anywhere.

What’s unique about it? Lots: new technologies—tracking devices, avatars, autonomous medic cars, remote data collection, and more—as well as a different approach to health care. Leo’s care is proactive; there is no ER visit, no appointment needed. The Kaiser providers reached out to him. In fact, Leo received health care when he didn’t realize he needed it. No waiting. Leo was located, diagnosed, and treated in the community where he lives within minutes. And, Leo was given a choice: hospital or home.

The Garfield Center was launched 10 years ago to help health care giant Kaiser envision and navigate the changing world of health care. Housed in a 37,000-square-foot warehouse in San Leandro, it is a test lab, a space to solve problems and try out new ideas in the field of health care.

 The center looks and sounds remarkably like a real hospital. Across from a large nursing station are several patient rooms, each with a large-screen TV. Alarms ping constantly on this fake medical-surgical unit, just as they do in hospitals. Down the hall is an emergency room filled with a network of apparatus and monitors and a dummy on a gurney. A few steps away is a re-envisioned neonatal intensive care suite. There’s even a waiting room.

What makes the Garfield Center unique, according to the center’s director, Jennifer Liebermann, is the large dedicated space with mock-up hospital, clinic, and home environments where the center’s team, along with doctors, nurses, patients, and consultants physically test new ideas. Each year, approximately 10,000 people visit the center and participate in its cutting-edge, problem-solving work.

On the day I toured, Liebermann’s team was conducting an alarm simulation and looking for ways to reduce the frequency of the signal pings. Liebermann pointed out the large-screen in-room TVs that displayed information usually found on hanging whiteboards—an interactive system introduced in Kaiser hospitals in 2014. The Garfield center team has evaluated infusion pumps, ventilators, and physiologic monitoring devices, and tested the equipment in the mock hospital’s network to ensure it all works together at the center. The center has also tested more than 10 wearable devices, like the biometric wrist monitor referenced in the simulation with Leo.

“Our primary focus is how to make the health care experiences of our patients and their families safer and better,” Liebermann said. “We also focus on Kaiser staff and ways to make their jobs easier.

 “We are exploring ways to push our organization out in the community, to meet patients where they are, to integrate health care more directly into their lives,” Liebermann said.

Liebermann and her colleagues have presented the Imagining Care Anywhere video stories to thousands of Kaiser staff and patients. Questions about privacy and the idea of a health care “big brother” have come up during the presentations. “The scenarios are provocations, meant to get people talking, asking questions, and expressing opinions,” she explained.

The technology is here and available, Liebermann said. While the cost will be a factor, of course, the next step is to determine how best to integrate such technology.

Published online on Oct. 25, 2016 at 8:00 a.m.

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