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David Goldman, M.D., Residency Program Director and Vice Chair for Education, Department of Ophthalmology, Henry Ford Hospital
When the iPhone was introduced in 2007, many could not see the potential. It could help you find the nearest Starbucks or queue up your favorite music, but could it really change your life? Over a decade later, the answer is clear. Smartphones have permeated every aspect of our work and personal lives, and it’s hard to remember the world without them. In a similar way, autonomous vehicle technology is poised to have a transformative effect on life as we know it, and nowhere will this be more disruptive than in healthcare.
"By reducing accidents up to 90 percent, the U.S. could potentially have saved $190 billion in costs"
Henry Ford Health System is the first system in the nation to address this emerging trend, through our biennial research congress in Detroit: “The Eye, The Brain & The Auto.” This program brings together leaders in multiple fields to share ideas and help facilitate progress.
Congress objectives
Our latest event in October 2018, “Focusing on the Impact of Disruptive Autonomous Vehicle Technology on Healthcare,” had several objectives:
• Appreciate the potential that big data management and the disruptive IT technology developing in the transportation industry may play in healthcare and wellness
• Understand the role that user’s vision and cognition will play in a journey from no-driver-assist technology to full autonomy–i.e., level zero to level five
• Better understand how the medical field can contribute to and benefit from the development of autonomous vehicles and the technology for their safe universal acceptance
• Understand the progress being made in autonomous vehicle development and the potential role this disruptive technology might have in human medicine
• Review progress in the field of human-machine interface in automotive transportation and the roles that vision and cognition will play in this rapidly unfolding field
Core questions
Autonomous vehicle development is a vast topic that crosses over many fields of study, and there are several potential applications to healthcare. As a focusing element, this year’s event asked the following core questions:
• How can medical and visual scientists play a role in human factors and auto design issues?
• How does a revolution in transportation influence human medicine?
• Can sensor data or driving performance changes indicate possible health challenges?
• What role will this democratization of transportation play in human medicine and rehabilitation?
• How must these vehicles be modified for the blind and/or physically handicapped communities?
• Can physicians identify design changes in semi-autonomous systems in response to known medical challenges?
It starts with safety
The driving force behind The Eye, The Brain & The Auto was to reduce the number of accidents. The death toll on our highways has increased in recent years to over 40,000 per year. This is due to several factors, including alcohol-impaired accidents, speeding and distracted driving— using those smartphones for talking, texting, engaging on social media, following directions and more. It’s easy to see how autonomous vehicles could help negate these trends and reduce the death toll and costs. One research firm, McKinsey & Co., analyzed a recent year’s statistics and calculated that by reducing accidents up to 90 percent, the U.S. could potentially have saved $190 billion in costs.
The opportunity for safety advancements goes beyond compensating for poor or impaired decision making by drivers, however. With advanced sensors in an individual’s car, an event such as a cardiac arrest could be sensed faster, and an emergency vehicle deployed immediately. That vehicle itself could benefit from autonomous technology, while using fewer emergency personnel to administer care. This efficiency and cost savings could carry through to the emergency room, where a streamlined system featuring multiple autonomous vehicle drop-off points could help to reduce congestion.
Non-emergency care and wellness
Emergency medicine is not the only area that will be impacted by autonomous vehicles. One of the key issues in non-emergency care is transportation to appointments, a particular challenge with special populations such as seniors, the disabled, and those who are blind or have low vision issues. Several studies in recent years have examined this issue, and the two largest ride-hailing platforms, Uber and Lyft—disruptive transportation technologies themselves—are developing partnerships with health systems to provide a transportation option for patients who need them.
Even for those who are able to drive themselves, there are several potential wellness benefits to autonomous vehicles, starting with reducing driving-related stress. In addition, cars equipped with special sensors could not only alert an individual to a potential acute health threat, but also passively measure biometric data and upload it to the cloud, where it could be used by health providers to discuss wellness improvements.
Barriers to advancement
These are just some of the benefits that autonomous vehicles could bring to both health systems and patients, but there are several challenges. It begins with the general public, which has shown little concern for auto fatality rates, and which has shown some suspicion of autonomous vehicles—in part due to highly publicized accidents during testing.
As with any other disruptive technology, autonomous vehicles will bring with them a sea change, and regardless of public opinion, it’s already happening. More states, including Michigan, are passing legislation allowing autonomous vehicles on the highways. In addition, the federal government has followed suit by passing the SELF DRIVE Act, which is designed to ensure the safety of highly automated vehicles by encouraging the testing and deployment of these vehicles.
Every major auto manufacturer is investing in R&D to develop these vehicles, as are other tech companies such as Google. With The Eye, The Brain & The Auto, Henry Ford Health System will continue to ask the important questions, and help to facilitate healthcare applications for these autonomous vehicles, improving safety and efficiency—and ultimately helping to drive down the cost of care.
Dr Amlan Basu FRCPsych, Chief Medical Officer at The Huntercombe Group, Non-Executive Director at Oxleas NHS Foundation Trust, and advisor to The Healthcare Improvement Studies Institute