Northwell Health CEO Michael Dowling — the influential head of New York’s largest health care provider and private employer — wants a post-pandemic future more focused on the root causes of health problems. He spoke with POLITICO’s Kelly Hooper about how that means looking “upstream” at social determinants of health — lifestyle, behavior and ZIP code — and expanding the definitions of health to include issues like gun violence and food insecurity. Dowling also said providers will have to adapt to the transition from hospitals to outpatient care and the growth and regulation of artificial intelligence in health. This interview has been edited for length and clarity. As we move into this post-Covid era, what are some of the biggest trends to watch in health care? Eighty percent of ill health is a result of lifestyle, behavior and your ZIP code. What you eat, whether you exercise or don’t, what you drink, what you smoke and where you live. We’re very actively involved in going what we call “upstream” so that you can actually intervene earlier so that you prevent the “downstream,” or at least curtail it to some extent, and this is why we’re very involved in issues like gun violence, food insecurity, education, diabetes screening. What about AI and its increasing role in health care? The big issue for me long term is what happens if the machines become smarter than the human brain? That, I think, is something that we have to be careful of. The use of technology to enhance our health care delivery has wonderful potential benefits, but I always caution that we have to be careful to make sure that we don't become so dependent upon very, very smart technology when we don't fully understand what it actually can do. What does integration of AI into health care look like, specifically for Northwell? It has wonderful potential because it allows you to analyze data — unbelievable amounts of data, historic data, look for trends, analyze what the data tells you, and then be able to predict what you should or shouldn't be doing with a patient. It's the wave of the future. It cannot substitute, however, for the human interaction in health care. What’s your next frontier for expanding Northwell’s innovation in healthcare? I think outpatient care is going to dramatically expand. There’s a lot of stuff done even in the hospitals today that I think in five years’ time will be done on the outside. I have 900 locations. Imaging, cancer — we’re the largest cancer provider in New York; most of it is outpatient.
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