Technology, end-of-life care, and 'Being Mortal'


[This post originally appeared on Forbes.com on September 8, 2015.]

In Being Mortal, Atul Gawande – one of a handful of truly exceptional physician-authors writing today – tackles the frankly depressing topic of end-of-life care with thoughtful reflection, insightful analysis and astute (and often witty) observations, in prose that’s a pleasure to read. If you’re unfamiliar with the book’s main points, take a moment and read some reviews (e.g., here and here).

There are plenty of reasons to recommend Being Mortal to anyone who has considered or encountered first-hand how our healthcare system breaks down at the end of life (that is, most adults) – but I think it’s particularly interesting and important for technology experts, entrepreneurs and investors. Here’s why:

  1. End-of-life care is a huge, under-appreciated unmet need in healthcare. Gawande lays bare just how poorly our society handles patients’ needs related to aging, loss of independence, terminal illnesses, and the final weeks and months before death. End-of-life care receives less attention from both the medical establishment and the technology sector than more “glamorous” areas like genomics, advanced diagnostics and immuno-oncology, but it’s one of the most desperately underserved aspects of American healthcare today. And thanks to demographic trends, it’s going to be even more of a crisis in our lifetime without significant improvements.
  2. End-of-life care is ripe for technologic innovation. Many of the shortcomings that Gawande highlights in his book could fit with tech solutions that are already being developed in other markets. Caregivers bear the daily burden of checking on and caring for ailing independent relatives; dying patients and their families seek access to thoughtful advisors as they navigate end-of-life decisions; and healthcare professionals need training, education and support as they care for older adults and patients with terminal illnesses. Many of these are fundamentally problems of access to services and information, and it’s not a big stretch to think that advances in areas like telepresence, e-learning, mobile monitoring and on-demand services could be transformative.
  3. There are great opportunities to transform end-of-life care – but also great emotional hurdles. I suspect many people, like me, only think about end-of-life care reluctantly and under extreme stress, when a relative or close friend (or perhaps even one’s self) is terminally ill. It’s a fraught, uncomfortable topic – which is probably one reason why it hasn’t attracted the attention from innovators that it needs and deserves. Gawande’s book doesn’t shy away from those emotions, but on the whole, he is optimistic about the future of end-of-life care, and the potential improvements he highlights are creative and thought-provoking. If anyone in the tech world is going to be inspired to innovate in this area, it will likely be through a book like this one.

Being Mortal is an important call-to-action for rethinking and improving virtually every aspect of end-of-life care – and although not all of those improvements need (or warrant) technologic solutions, there are many that may. If Gawande’s book inspires even a handful of technology innovators to devote their skills and efforts to this area, then the world will be a better place.