A growing number of doctors and medical students are melding IT and medicine to create healthtech solutions that understand both worlds to create more efficient, effective and accessible healthcare.

Ever since Dr Josh Case was child he has been enamoured with the world of gaming. Though he enjoyed playing all sorts of computer games growing up, at around 12 years old, defeating Bowser in Mario Bros was no longer enough.

“At a certain point, I basically decided I'd like to try and make my own games too... which turned into several years of trying to make increasingly complex games,” says Josh. 

Building on this passion, at medical school Josh and his friends created a large database of questions, which then became online quizzes and a mobile education app. Now working as a doctor in Queensland, he is utilising his interest in coding to drive reform in the world of digital health— creating apps and functions in electronic medical records, to save hospitals time and money. 

For Josh, the intersection between coding and healthcare was not a sudden realisation, but rather incremental moments that eventually coalesced. 

“When I got into the hospital system I started to see some of the complexity that was at play and the sluggishness with which widely available consumer technologies weren't being applied.” 

Frustrated by the reliance on manual data entry and on pen and paper, rendering patient records not as readily distributable as they should be, Josh saw the opportunity to evolve these manual processes into automated ones. However, he found that the dogmatic and traditional culture within the field of medicine can stifle technological reform.

 “I think it suppresses the sort of naïve optimism that every young person kind of has when they enter the system and wonder - Why isn't this an app? Why isn't this a one-click job?,” says Josh. “Not that many people understand both worlds and also technology adoption is quite low in healthcare.”

Josh saw this separation between the clinical and technical worlds as a very clear gap in the market and in some ways a lost opportunity. 

“They all want tech-y doctors and the insider knowledge that you have, being in a clinical role dealing with these problems,” says Josh. “Having a technical skill set essentially allowed me to connect the dots and know that the problem is not that hard to solve from a technical perspective.” 

While Josh may have entered this world at a young age, being an accessible coding evangelist, he wants to stress that it’s never too late to start. Among other initiatives, Josh offers educational training to clinicians and authored the book, Code Blue: An Introduction to Programming for Doctors and Medical Students.

“I'm a big advocate for lots of people in healthcare to get involved in programming and just because I started very, very early I don't want everyone to feel like they have to,” says Josh.

“If you have an intermediate level of knowledge in programming and any sort of technical skill in graphic design, product design, user experience, you can connect these dots and just be the driving change that our systems need.”

“They all want tech-y doctors and the insider knowledge that you have, being in a clinical role dealing with these problems. Having a technical skill set essentially allowed me to connect the dots and know that the problem is not that hard to solve from a technical perspective.”- Dr Josh Case

Allen Gu, a medical student at the University of Melbourne is one of the founding members of Melbourne Bioinnovation Student Initiative, an organisation dedicated to helping students access healthtech. He saw the benefits of medical students understanding the world of tech and along with his friends, ran a free beginner’s coding workshop for his peers. Allen felt that the degree does not prepare junior doctors sufficiently for the world of coding and data analysis. He also felt this knowledge would help students entering their required research semester.

“Medical students end up finding it very difficult or off-putting when they are thrown in the deep end and they're expected to analyse hundreds of lines of data with no grounding in programming,” says Allen. 

Creating these hands-on workshops helped medical students see the benefits of using programming in their work and proved how accessible these skills can be. 

“It stung the notion that programming is off limits and only the domain of massive computer geeks,” Allen adds. 

Similar to other coding enthusiasts with medical backgrounds, Allen advocates for the importance of coding in medical education as he feels that medical students already have the mental structure that would be required of a programmer. Cutting, pasting and combining lines of code to create a function in a programme is analogous to the way we approach treating patients. 

“Medicine is about problem solving. It’s often about figuring out what combinations of symptoms lead to certain treatment options,” Allen says.

He also sees parallels in the job satisfaction you feel in medicine when your piece of code works. 

“You get the same sort of buzz when a consultant asks you a question and you answer correctly, or if you're an intern seeing your patient get better from the treatment you prescribed.”

Dr Thomas Kelly, CEO and founder of Oscer, an AI company that builds virtual patients to train students in clinical and OSCE skills agrees. 

“So much of medicine could benefit from AI assisted diagnostic tools. It relies on clinicians having at minimum an appreciation for the power of technology, and teaching medical students to code is a key step in that continuum,” says Thomas. 

“As a student learning clinical reasoning, it was very didactic and lacked enough practical applications outside of practising with friends or patients, so when I graduated I used my knowledge of programming with colleagues to create the digital clinical reasoning tool I wish I had. We’ve just launched Oscer and already the University of Sydney and University of Melbourne are piloting it with their students.”

According to Peter Birch the creator and host of the podcast and community, Talking HealthTech, medical education needs to harness the opportunities that this intersection can create. 

“There is a new wave of digital-native doctors coming into clinics, embracing technology and doing things in new ways with better knowledge of what's possible, what can be automated and what can be coded. There's bound to be more effective and efficient healthcare to be delivered,” says Peter.

“I want to see digital health enablement and a passion for doing something meaningful with technology and healthcare taught more in medical schools and universities and even in high schools; for the benefit of clinicians and patients too.” 

At the end of his intern year in 2020, Dr Josh Case made the bold decision to leave his full-time job to work part-time as a doctor so that he could pursue his passion and career in healthtech. For Josh, taking a step back from clinical work enables the innovation that’s difficult to imagine when you’re constantly running to keep up.

“When you're in a hospital, especially a big public hospital, you're furiously putting the train tracks down in front of the train. Just holding the fort down each day is an absolute ordeal and it’s because of the systems in place,” says Josh. 

“So thinking about making tomorrow better, or even next week better, it's just very hard to do while you're working full-time clinically. Very rarely do you get the chance to put everything that you've got into making the system better...and so, because I wanted access to that kind of electric rampant optimism, I knew I had to do something off the beaten track.”

To follow Dr Josh Case’s current projects you can check out his blog. He is also happy for readers to reach out and ask any questions via his Twitter.

Allen and his colleagues at Melbourne Bioinnovation Student Initiative can be reached via email at contact@mbsi.org.au You can also view their projects on their website or Facebook page.

Dr Thomas Kelly can be reached at tom@oscer.ai if you have any further questions about his work. You can also practice your clinical skills and train with virtual patients at oscer.ai

For more updates by Talking HealthTech, check out their website or Twitter.