Vinod Khosla wants a healthcare system that takes care of patients before they are even symptomatic, and he's betting that his vision is achievable—with the help of artificial intelligence.
The billionaire venture capitalist participated in a wide-ranging fireside chat with startup accelerator Startup Health on Tuesday, where he laid out his hopes for the future of the healthcare industry after a tumultuous year.
His vision is an AI-assisted "learning health system" that relies on intervening before a patient's condition worsens to the point that they come to a doctor's office with symptoms. By catching diseases at earlier stages by collecting real-time patient data and adding it to an integrated AI disease model, Khosla said he thinks medicine can move from a practice dependent on highly trained humans to a science driven by predictive data.
"Eliminating symptom-based medicine should be a key goal for 2030," he said. "You shouldn't have to start losing your memory before you're diagnosed with Alzheimer's."
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By using AI-assisted diagnosis to catch chronic conditions before they require cost-intensive treatment, he imagines patients will be spared the worst of the illness and significantly reduce healthcare costs for hospitals and health systems.
Khosla, whose venture firm Khosla Ventures has invested in several health-tech startups, has said repeatedly he's simply "not interested" in incremental change to the healthcare system.
Many startups have tried, with varying levels of success, to execute Khosla's vision. Lark Health, for example, has incorporated AI into a nursing platform helping 2 million patients manage chronic disease. Owkin developed machine learning software to analyze medical records like x-rays.
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Khosla's kingmaker reputation among entrepreneurs holds significant influence over Silicon Valley. He repeatedly emphasized the need for entrepreneurs outside of the traditional healthcare system to come in and disrupt the ways it's organized and practiced in the US.
Khosla's ideal system breaks down the artificial barriers created by medical specialties
When asked by Startup Health cofounder Steven Krein if the pandemic might have made certain industry shifts possible, Khosla reiterated the well-established realities of what COVID-19 has done to healthcare. Providers have adopted telehealth more widely and the overall system has been forced to adapt to rapidly changing regulations and public health guidelines.
Most medical decisions are currently made by a specialized physician, Khosla said. That system works because individual human beings need years of medical training to correctly diagnose patients.
The problem arises, however, when the cardiologist doesn't know what the endocrinologist is doing. Ultimately, the patient loses out on an integrated approach to their care.
Thanks to the pandemic and increasing capabilities of artificial intelligence, he said he has a hard time believing this adherence to rigid disciplines will continue.
"We are well on our way to leveraging AI to do 80 percent of what doctors do," he said, referring to a prediction he first made at a Rock Health accelerator event in 2012.
The healthcare system should shift away from only treating patients after they come to a healthcare provider with symptoms
Although healthcare has improved in increments overall and significantly in some areas, Khosla said he doesn't believe the practice of medicine has fundamentally changed. Patients still largely enter the healthcare system only when their symptoms are severe enough to notice.
"Change the practice of medicine to the science of medicine," he said. "Having humans relearn all of medicine is hard."
Khosla envisions an AI-assisted system that improves by integrating data from every patient in a given system, not just one provider's patient base. In doing so, Khosla mentioned his son Neal's startup, Curai, which integrates AI into primary care. The elder Khosla backed Curai via Khosla Ventures in a Series B financing round in December.
"I'd be shocked if it wasn't possible to do free primary care to every person on the planet," he said in response to how this system would impact healthcare in low- and middle-income countries.
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