Since the start of the COVID-19 pandemic, there’s been a rapid acceleration of digital transformation across the entire healthcare industry. Telehealth has become a more mainstream and safe way for patients and caregivers to connect. Machine learning modeling has helped speed up innovation and drug discovery. And new levels of integration and data portability have helped enable greater vaccine availability and equitable access to those who need it.

Data has been at the crux of this digital transformation — helping people stay healthy, accelerating life sciences research and delivering more personalized and equitable care. We recently unveiled partial results from our research with The Harris Poll, which revealed that nearly all physicians (95%) believe increased data interoperability will ultimately help improve patient outcomes. Today, we’re unveiling the second part of that research. 

In February 2020, we commissioned The Harris Poll to survey 300 physicians in the U.S. about their biggest pain points — this was just before the COVID-19 pandemic strained the entire healthcare system and made us all hyper-aware of the risks we take in going to the hospital. In June 2021, we followed-up with those same questions and more. What it unveiled was just how much COVID-19 reshaped technology’s role in the healthcare field and how it’s changing day-to-day operations for physicians. 

Here are some of the highlights: 

Healthcare organizations accelerated technological upgrades over the course of the pandemic. After a year shaped primarily by the COVID-19 pandemic, use of telehealth saw substantial YOY growth, jumping nearly threefold from 32% in February 2020 to 90% this year. Forty-five percent of physicians say the COVID-19 pandemic accelerated the pace of their organization’s adoption of technology. In fact, more than 3 in 5 physicians (62%) say the pandemic has forced their healthcare organization to make technology upgrades that normally would have taken years. For example, 48% of physicians would like to have access to telehealth capabilities in the next five years. Before the COVID-19 pandemic, about half of physicians (53%) say their healthcare organization’s approach to the adoption of technology would best be described as “neutral” (i.e., willing to try new technologies only if they have been in the market for awhile or others have tried and recommended them). 

Despite the technological leaps this year, most physicians still believe the industry lags behind in technology adoption but recognize the opportunity for technological support and advancement. The majority of physicians don’t view the healthcare industry as a leader when it comes to digital adoption. More than half of physicians describe the healthcare industry as lagging behind the gaming (64%), telecommunications (56%), and financial services industries (53%). However, the healthcare industry is not seen to be trailing as much as it was last year behind retail (54% in 2020; 44% in 2021); hospitality and travel (53% in 2020; 43% in 2021); and the public sector (39% in 2020; 26% in 2021). 

Better interoperability alleviates physician burnout, improves health outcomes and speeds up diagnoses. The majority of physicians say increased data interoperability will cut the time to diagnosis for patients significantly (86%) and will ultimately help improve patient outcomes (95%.) In addition to better patient experiences and outcomes, more than half of physicians (54%) believe increased access to data via technology has had a positive impact on their healthcare organization overall. A majority believe that technology can alleviate the likelihood of physician “burn-out” (57%) and that efficient tools help decrease friction and stress (84%). And, as a result, 6 in 10 physicians say access to better technology and clinical data systems would allow them to have better work/life balance (60%) and that better access to/more complete patient data would reduce administrative burdens (61%). It is therefore not surprising that nearly 9 in 10 physicians (89%) say they are increasingly looking for ways to bring together all patient data into a single place for a more complete view of health. 

Familiarity with new Department of Health and Human Services (DHHS) interoperability rules grows, and many physicians are in favor. Most physicians (74%) say they have at least heard of the new DHHS rules (launched in 2019) to improve the interoperability of electronic health information. This is a clear rise from 2020 (64%), but deeper knowledge is fairly low. Only 30% of physicians say they are somewhat or very familiar with the new rules (though, again, this is a rise from 2020, when only 18% said they were very/somewhat familiar). Similar to in 2020, among those who have heard of the new rules, nearly half are in favor (48% in 2021; 45% in 2020) but a similar proportion remain unsure (46% in 2021; 50% in 2020). And like in 2020, by far the top potential benefit of the rules is thought to be forcing EHRs to be more interoperable with other systems (70%).

Google was founded on the idea that bringing more information to more people improves lives on a vast scale. In healthcare, that means creating tools and solutions that make data available in real time to help streamline operations and improve quality of care and patient outcomes. For example, our recently announced Healthcare Data Engine makes it easier for healthcare and life sciences leaders to make smart real-time decisions through clinical, operational, & groundbreaking scientific insights. To find out more about the Healthcare Data Engine, click here.

^{Survey methodology: The 2021 survey was conducted online within the United States by The Harris Poll on behalf of Google Cloud from June 9 – 29, 2021 among 303 physicians who specialize in Family Practice, General Practice, or Internal Medicine, who treat patients, and are duly licensed in the state they practice. The 2020 survey was conducted from February 18 – 25, 2020 among 300 physicians who specialize in Family Practice, General Practice, or Internal Medicine, who treat patients, and are duly licensed in the state they practice. Physicians practicing in Vermont were excluded from the research. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. For complete survey methodology, including weighting variables and subgroup sample sizes, please contact press@google.com.}

Organizations are pressed with the need to engage, retain, and upskill employees with many positions staying fully or partially remote as the pandemic continues. The Center for Digital Government (CDG) reports that 74% of state and local governments believe they will continue hybrid operations for the long-term. This transition is the latest in a long list of reasons agencies are looking for solutions to help train their workforce digitally. Some have found Google Classroom to be the perfect solution.

The State of Iowa knew about the advantages of digital classrooms even before the pandemic. They were already successfully using Google Classroom for in-person training, making the transition to digital seamless when the state closed down. Jessica Van Heuveln, a Google support specialist for the State of Iowa CIO’s Office, says the switch to digital doesn’t deprive workers of hands-on training. “You can use Google Classroom for many different environments, so if you’re doing self-taught, in-person or virtual training, it’s going to work with all those approaches.”

The logistics of a digital classroom

Iowa uses Google Classroom to onboard and upskill employees as well as train volunteers. When the pandemic shifted the state’s workforce to 70% working from home, they needed a  platform that could not only handle a vast range of topics and teaching styles to support remote workers but also scale to meet their demand. Van Heuveln notes that Google Classroom was particularly helpful for handling compliance training, especially with its integration with Google Meet. These trainings often require an entire sector of the workforce to attend a single class with more than 100 attendees, according to Van Heuveln. The logistics of these larger sessions cuts down on the number of total sessions the state needs to host. Iowa also found that employees were less apprehensive about learning when they could do it from the comfort of their own homes.

Iowa follows a train-the-trainer model to train employees expected to instruct using Google Classroom. Trainers working in departments across the state learn to use Google Classroom to create and host virtual learning experiences specific to their own departments. 

Collaborative classrooms made simple

Google Classroom meets many needs for Iowa, such as setting up training, managing attendance, reviewing uploaded coursework, and communicating with attendees. Both course attendees and trainers have everything they need in one place, and robust engagement tools help attendees stay focused while giving trainers the feedback they need from their lessons. Built-in survey options let trainers gauge attendee knowledge, and the chat function ensures no one ever misses a question. The reporting dashboard gives trainers access to analytics to track engagement and attendance, providing insights that can improve future training sessions.

Google Classroom also makes it easier to ensure attendees stay on board throughout the training program. Coursework can be uploaded directly into Google Classroom, and training sessions can be recorded and archived. This feature allows employees to work at their own pace or lets them catch up when a scheduling conflict means they might miss a session.

The enterprise version of Google Classroom Iowa uses interfaces with other Google Workspace tools such as Google Meet, Google Calendar, Google Drive, and Gmail, which streamlines training and leads to more collaboration between employees and trainers. It can also interface with applications from other providers, further boosting its utility as an effective virtual classroom. Google Drive stores training materials securely. Lastly, Google Classroom enterprise comes with 24/7 support to make sure agencies always have everything they need for success.

Helping employees be better prepared to serve

Google Classroom can be a powerful part of any training program, whether it be digital or in-person. Building virtual connections empowers organizations to deliver better experiences. Google Classroom is helping the State of Iowa accomplish this for their constituents. Designed to scale and be accessible from anywhere, the platform helps public employees better serve the public. Virtual training strategies are essential for agencies that are looking to grow their workforce and build employee skill levels. The most important thing, however, is that training programs enable employees to further your agency’s mission. To learn more about Google Classroom and see more solutions designed with government in mind, check out the Google Cloud for government page.

AgroStar has launched a cloud-based mobile app that is helping to boost crop yields and encourage best practices for small farmers in India. Launched as an on-premises ecommerce platform selling farm tools in 2008, the firm turned to Google Cloud Platform (GCP) to expand its offering. It now uses cloud-based analytics and is deploying ML models to provide timely advice in five languages on everything from seed optimization, crop rotation, and soil nutrition to pest control.

A 2018 survey underscored the demand for agricultural planning for Indian farmers. While farming remains a dominant sector in India, employing half of its labor force, 70 percent of small farmers – those cultivating fewer than three acres – said their crops are damaged by unforeseen weather and pests. An even higher number – 74 percent – say they lack access to farming-related information.

Widening that gap is the relative lack of access to new, higher yield seeds and improved soil analyses for small farmers, who must otherwise rely on traditional methods. “It could take a few years for innovative information to trickle down from universities to small, grassroots farmers,” says Pritesh Gudge, AgroStar Software Engineer. “Today, just by clicking through our Android application, farmers learn about new, effective farming practices and receive advice customized to their crop and soil.”

Connecting a million farmers in the cloud

Operating in the Indian states of Gujarat, Maharashtra, Rajasthan, Orissa, Bihar, and Karnataka, AgroStar is closing the knowledge gap with a full-service, cloud-based SaaS solution – the only one of its kind in India. It combines agronomy, data science, and analytics to help farmers by providing a variety of resources.

AgroStar has reached over a million farmers through its Android app, the AgroStar Agri-Doctor. The mobile client is available as a web-based or full-featured native app. Both provide access to the firm’s knowledge base hosted on GCP, a Q&A forum that connects farmers to each other to help understand and better solve problems and to learn about innovative practices and products. Farmers can also click through to follow local and national market trends that help forecast crop prices.

In addition to the self-service knowledge base, AgroStar provides access to agronomy experts who use cloud-based analytics tools and historical data to provide season-and locale-specific advice to each farmer. “We are now tracking thousands of calls in 5 languages each day,” says Pritesh.

The AgroStar app also provides links to purchase and then track the delivery of farm tools and supplies such as cultivators and fertilizers. An in-house platform manages fulfillment centers and a doorstep delivery network simplifies the supply chain while giving farmers what they need, when they need it. By procuring directly from the manufacturers and primary distributors of farm supplies, Agrostar is achieving cost savings, which it passes on to farmers.

Build fast, pivot faster

From the start, the human and environmental variables of farming in India, not to mention the volume of AgroStar’s few hundred thousand monthly active users, made a highly scalable cloud-based solution inevitable. Farmers rely on the firm’s Agri-Doctor app to provide advice in multiple languages on topics that range widely throughout three growing seasons, each with distinct crop nutrition and rotation cycles and farm implementation requirements.

“For farmers, the focus keeps changing every month, and every season,” says Pritesh. “To serve our growing community, we needed a platform that could process images at high volume, fulfill tools and seed orders across thousands of miles, and respond to multilingual queries. We quickly moved away from spreadsheets and server-based solutions – we needed to build fast and pivot faster.”

Ending late-night deployments

The firm’s first cloud experience was with an AWS solution. At the time, AWS was the only cloud provider in India, but AgroStar wanted to find a solution that was easier to use and offered better integration with Android devices. “Deployment and processing costs were very high, and the developer tools and documentation were not as intuitive as we needed,” says Pritesh.

When GCP service arrived in India in October 2017, AgroStar embarked on a platform re-implementation that made possible dramatic changes in the way it developed and deployed its solution. Using Google Kubernetes Engine (GKE) for crop advice management and Compute Engine for its production application services, the firm built the backend for the Agri-Doctor discussion forum in only three weeks. The platform’s microservice architecture is implemented in Python and Golang and deployed on GCP.

AgroStar began to realize significant efficiencies in its build, deploy, and test cycles. “We previously needed to work overnight to deploy to production,” says Pritesh. “Now using Google for Kubernetes containers and a rolling update strategy, we can deploy during the day without any problems or interruptions to service.”

The move to GCP streamlined AgroStar’s stack. “We were running 12 independent instances on AWS,” says Pritesh. “With Google Kubernetes Engine, we are deployed on a single cluster at a cost savings of $1,300 per month and growing.”

Improving customer response times by 85 percent

With a managed deployment capability, AgroStar can devote more time and resources to executing on its platform and Agri-Doctor app development plan. A strategic goal was managing customer response times as the firm grew its base. GCP has helped the firm meet that goal, achieving an 85 percent improvement in customer response times even as traffic grew significantly.

“With our on-premises solution, we could handle around 100 customers daily, which took 30 to 50 minutes for each customer,” says Pritesh. “We now handle thousands of customers daily, taking only 4 to 5 minutes for each one.”

AgroStar used Firebase to implement its Agri-Doctor app. A real-time cloud database, Firebase provides an API that enables the Agri-Doctor advice forum to be synchronized across all its far-flung mobile clients, effectively sharing knowledge base updates with one million users in near real time.

Using cloud tools to manage and monitor

Cloud Pub/Sub, Kafka, and Cloud Dataflow manage data ingestion and queueing of event and transaction data to the analytics layer. BigQuery fetches and persists data to Cloud Storage. Cloud SQL and dashboards powered by Tableau deliver farmer crop and soil profiles within minutes.

Cloud IAM helps AgroStar control access to all its cloud resources. And Stackdriver, the integrated logging aggregation capability for GCP, helps monitor and speed debugging on every tier of the AgroStar solution.

Machine learning to enhance yields

AgroStar is developing a variety of ML components to improve responsiveness and extend its platform offerings.

To speed up the diagnosis of and treatment for crop blight, AgroStar is building a deep learning pipeline using TensorFlow. The pipeline relies on GoogLeNet models that use multi-layered convolutional visual pattern recognition. It will assess uploaded images to support a disease-detection capability on the mobile app. Based on the commercially successful AI algorithms that automated postal code processing, GoogLeNet offers improved performance and computational efficiencies by using a creative layering technique that distinguishes them from older, sequential recognition engines.

To improve its customer search experience, AgroStar is developing an ML pipeline that shrinks fetch times by suggesting tags mapped to stored data. Processed using TPUs, Cloud Natural Language and Video AI, the tags provide a metadata layer that supports queries in any of the ten natural languages that AgroStar farmers can use.

The AgroStar search pipeline consists of Long Short-Term Memory (LSTM) models of Recurrent Neural Networks. Recurrent networks exhibit “memory” through iterative processing and are distinguished from feedforward networks by a feedback loop connected to their past decisions, ingesting their own outputs moment after moment as input.

Implementing a recommendation engine

The firm is also adapting the Random Forests TensorFlow AI model to develop a crop and product recommendation engine. The model is trained by consuming numerical (rainfall, humidity, water availability per acre) and categorical (soil type, water sources) parameters to suggest appropriate products by season, region, and locale.

To simplify the product suggestion experience, AgroStar developers are testing Cloud Dialogflow, the Google Cloud conversational interface, to build a chatbot capability into its mobile app. The bot will track a farmer’s crop schedules and answer simple questions by linking to the recommendation engine.

AgroStar is also extending its analytics platform with AI-powered sales planning and forecasting. Using linear regression models implemented in TensorFlow and powered by Cloud ML Engine, the capability will enhance supply chain logistics as the company scales its operations across India.

To provide a credit on-demand offering for a range of seed-to-harvest cycle products, AgroStar is attempting to use Vision API to create an AI model that will convert uploaded photos of customer application records into standard data formats. The firm’s credit policy features a grace period in which farmers begin paying back loans after harvested crops go to market.

A versatile and friendly development ecosystem

AgroStar credits the convivial tools and documentation that GCP offers and its incremental, pay-as-you-go pricing model for both the firm’s success and its ability to manage growth.

“What Google Cloud offers is extremely good documentation and extremely simple-to-use tools and interfaces across all services,” says Pritesh. “It helped us initially deploy our platform and at every scale that we have required since then, and its cost effectiveness enabled us to staff up to meet new feature milestones.”