Interaction with the healthcare system can be harrowing, especially when information slows to a trickle. Many people during the COVID-19 pandemic have waited anxiously, whether at a facility or at home, for a frazzled doctor or a nurse to surface and give them news of their loved one.
Amid all the suffering, healthcare rapidly advanced into the high-tech era. By the time the pandemic began to ease, the usual tense wait for information very well might have been replaced by automatically generated text messages every hour with a loved one’s status, providing comfort and reassurance.
“Covid accelerated the adoption of technology,” said William A. Tanenbaum, a partner with Moses & Singer LLP in New York who is also the chair of the Practising Law Institute’s Healthcare Technology 2021 program and co-chair of its Outsourcing 2021 program. “Hospitals are moving that way anyway, and the pandemic pushed it forward.”
Contract Explosion
Tanenbaum is a transactional attorney who represents both companies that provide technology and hospitals and other institutions that use technology. He reported significant growth in the contracts necessary to sell technology and contracts with complex privacy provisions. This meant some healthcare providers couldn’t buy the latest tech without upgrading their fundamental information technology infrastructure.
“Healthcare is 20 percent of the economy,” he said, “and it just got a big boost from increasing the level of IT, a long-term trend.”
Telemedicine and remote medicine greatly increased during the pandemic, Tanenbaum said, as did the use of artificial intelligence and machine learning, especially for research into the COVID virus.
“A lot of technology that was patient facing or for supporting hospital operations was quickly purchased,” he added. “The companies that sell this technology saw a tremendous increase in sales. Part of the reason was a demand for patient care and the general demand placed on hospitals.”
The adoption of new technologies allowed doctors to spend more time with patients and handle things more quickly and efficiently.
“Everyone said, ‘We need technology now.’ These things probably would have happened anyway, but the need became acute and the sales cycles became shorter and technology deployed much faster.”
The ‘IoMT’
While telemedicine, like telecommuting, was a trend during the pandemic, the widespread use of sensors was another big change, Tanenbaum said. Sensors can increase efficiency.
Healthcare technology companies helped hospitals “put sensors on everything,” he said. “From operating room doors on up, devices became smart and were assembled in a system of connected devices so that data collection and transfer became the engine of a special branch of healthcare innovation.”
This was such a pronounced trend that the “Internet of Medical Things,” got its own alphabet-soup abbreviation: the IoMT, according as noted in HealthTech Magazine. The sensors and interconnected devices gave rise to the patient status text messages that provide comfort to families, the article said.
The IoMT and cloud computing also allowed an expansion in the use of data analytics, another means to increased efficiency.
“Hospital use had been trending this way but it accelerated with the pandemic,” Tanenbaum said.
Like in other industries, bringing healthcare data to the cloud has been driven by advances in fast and inexpensive computing power. “Storage is virtually free,” he said.
Tanenbaum makes a distinction between digital health and digital medicine, both of which have benefited from cloud computing. He defines “digital health” as processes and technology that are not clinical but contribute to care — such functions as maintaining databases, transferring information back and forth, and analyzing the aforementioned sensor data to increase scheduling efficiency and make the most of equipment.
“Digital medicine” is a subset of digital health and focuses on patient treatment and direct clinical use. It may describe diagnostic tools, robotic surgical aids, and post-surgery remote monitoring.
Of course, the two overlap in countless ways.
“The new challenge is preventive medicine. Most hospitals and medical facilities tend to focus on interventions. Preventive medicine is what it sounds like. It straddles digital health and digital medicine,” Tanenbaum said. “It includes things like wellness data and fitness watches, not medical devices.”
“Hospitals are coming into that field. They are buying technology from companies developing data-driven tools,” he said.
Machine learning and artificial intelligence have proven useful on the diagnostic side of digital medicine, such as in radiology, and can also help increase efficiency and make better use of a professional’s time and expertise, according to Tanenbaum. For example, radiologists can feed their systems a high number of images where cancer is present. By processing these images, the machine — the software — learns what cancer looks like.
“Medical imaging is a particularly good area for machine learning. Image and pattern recognition are very good and computers don’t get tired,” Tanenbaum said. “They can go through enormous amounts of data and find correlations more quickly. I think the biggest takeaway on AI in healthcare is that really it’s augmented intelligence rather than artificial intelligence. It gives information to doctors to make decisions, it doesn’t make the decision by itself.”
This is in contrast to, say, an online advertising AI, which decides which ads to push to consumers entirely on its own.
Privacy Risks
While all endeavors that involve the collection of copious amounts of personal data are being scrutinized these days, no sector places more of a premium on privacy than healthcare, largely because of the federal Health Insurance Portability and Accountability Act of 1996, or HIPAA.
While the cloud storage being used more and more by hospitals is safe — “If the CIA can use the cloud, hospitals can use it,” said Tanenbaum — there is some risk while transferring data to the cloud.
“The biggest risk to security when you’re employing all these devices and putting them on the [IoMT] is that if it’s on the internet it can be hacked,” he said. “You’re putting in another avenue of attack for the bad guys. Stealing credit card numbers is a business. Criminals will steal credit cards and sell them in batches of hundreds. But stealing medical information? That is much more valuable. If you steal a patient’s chart that’s identity theft on a platter.”
Given the commercial and criminal value of sensitive personal information in healthcare, HIPAA has strong rules for how patient data must be treated, according to Tanenbaum. He also noted that a number of states have adopted their own privacy laws.
“From a regulatory compliance point of view, it all becomes more complicated,” he said. “From a technology point of view, new technology introduces risk.”
Although many products these days have security by design, Tanenbaum said that “hospitals need to be careful, because the risk has to be seen as a combination of these products and the underlying IT system to which they connect.”
Elizabeth M. Bennett was a business reporter who moved into legal journalism when she covered the Delaware courts, a beat that inspired her to go to law school. After a few years as a practicing attorney in the Philadelphia region, she decamped to the Pacific Northwest and returned to freelance reporting and editing.
Olga V. Mack is the CEO of Parley Pro, a next-generation contract management company that has pioneered online negotiation technology. Olga embraces legal innovation and had dedicated her career to improving and shaping the future of law. She is convinced that the legal profession will emerge even stronger, more resilient, and more inclusive than before by embracing technology. Olga is also an award-winning general counsel, operations professional, startup advisor, public speaker, adjunct professor, and entrepreneur. She founded the Women Serve on Boards movement that advocates for women to participate on corporate boards of Fortune 500 companies. She authored Get on Board: Earning Your Ticket to a Corporate Board Seat and Fundamentals of Smart Contract Security. You can follow Olga on Twitter @olgavmack.
Jordan Rothman is a partner of 
