Digital Medicine: Healing Better In A Complex System
The prognosis for the global healthcare system, as it stands, is not good.
Most industries, in recent years, have seen expenses decrease and service delivery improve with the application of new technology. Yet healthcare costs continue to rise, currently exceeding local inflation levels worldwide by more than 6%. Average health and long-term care expenditures are projected to nearly double by 2050. Research and development costs are skyrocketing; it takes an estimated $2.6 billion to develop a new prescription drug. And the vast majority of investment is focused on treatment rather than prevention.
Restructuring the health care system is a daunting task. However, several powerful trends are converging that could turn healthcare on its head: access to an abundance of genetic, phenotypic, and clinical data; real-time and in memory computing required for advanced analysis of that data; and a more digitized and empowered patient population.
Despite the availability of new, more powerful data and tools, technology has not yet transformed healthcare the way it has manufacturing or financial services, for example. The complexity of biological systems and a limited understanding of how they actually operate and respond to various situations has been a huge hindrance. The human body, the result of billions of years of development, is difficult to understand and predict. X does not necessarily lead to Y, and disease has multiple causal components.
Medical science is evolving rapidly. With increasing digitization we will have much more data than ever before as well as the tools required for real-time analysis. But big data alone will not cure what ails healthcare. As Sandra Mitchell, a leading professor on the philosophy of science, has pointed out: mankind needs a new approach to managing the intricacy of the human body. We must develop techniques for studying the whole system to identify causes that are not accurately assessed in isolation. (Read Dealing With Complexities In Biology And Medicine: Q&A With Prof. Sandra Mitchell)
Getting smart – and connected
Individuals are already embracing wireless tracking devices like FitBit or the Apple Watch that enable them to collect and act upon some of their own health data.
But a digital medical revolution — enabled by connectivity, big data, and analytics — will go far beyond simply monitoring whether we got our full eight hours the night before or how we’re are performing against fitness goals. These consumer tech trends offer a glimpse of what is possible when we employ sensors to gather real-time data on the complex and delicate machine that is the human body and deliver that information to our healthcare providers.
As McKinsey recently noted, the idea that data sharing between a company and its customers can lower costs and improve quality has already been well established in a wide range of industries. And it could have the same impact on healthcare: boosting accountability, productivity, and quality of service; increasing patients’ involvement in their own care; and driving economic growth.
Applications using data gathered through GPS devices and mobile apps that capture patient activity or reports can have a big impact at scale. Remote patient monitoring for chronic conditions, including heart disease, asthma, and diabetes, could save more than $200 billion itself, according to a 2015 report by Goldman Sachs Global Investment.
A division of Avery Dennison has developed a disposable device called IH1, which sends data directly from the wearer to a device to a caregiver. Applications include cardiac telemetry, tracking sleep patterns, disease management, and remote monitoring. Pharmaceutical and diagnostics company Roche and Qualcomm are partnering to capture data from a patient’s medical devices (starting with anticoagulation meters) and send it to their healthcare providers to reduce both complications and costs. Researchers at the University of Illinois have developed a flexible skin patch that can monitor blood flow and may soon have applications inside the body.
Such rapidly improving data collection and analytics capabilities, by enabling a pluralistic approach to biological systems, can change the focus of healthcare from treating the sick to preventing illness. In the near future, the focus will shift from today’s one-size fits all inefficient, reactive healthcare system to the proactive, individualized delivery of health management and disease prevention.
Treating the individual
While preventing health problems is the goal, advanced technologies will enable better, more personalized patient care and treatment.
Pharmacogenomics promises to identify sources of an individual’s profile of drug response to predict the best individual treatment. Predictive biomarkers and medical devices known as companion diagnostics can match patients with appropriate treatments and medications. Advanced analytic engines and algorithms will help doctors scour terabytes of medical data and research to tailor treatment plans in real-time. 3D printerswill produce living tissue and organs; create custom prosthetics and implants; and aid pharmaceutical research. Robotic systems will help with diagnostics, screening, and exacting surgical interventions.
Some of this is already taking place. Scientists have developed nano “drones” that can deliver anti-inflammatory drugs directly to problem arteries. The U.S. Food and Drug Administration approved the country’s first prescription drug made through 3D printing. This summer, a woman with a rare bone ailment successfully received a 3D printed skull implant that saved her life. CRISPR, a cheap and easy gene-editing method, is being used in labs around the world.
The healthcare industry today has the opportunity to harness digitization to embrace – and better manage – biological complexity rather than trying to root it out.
A number of challenges exist. The industry must move away from fee-for-service care and embrace new processes centered on outcomes and consumer controls. There will be ethical debates over predictive medicine and DNA-based care. Privacy and security issues will be paramount; hacking becomes even more ominous in the healthcare setting, from the breach of personal medical data to the threat of malware in medical devices.
But addressing those issues isn’t rocket science (or worse – biological science). Other industries have addressed similar security, privacy, and change management issues required for digital transformation, and healthcare can follow suit. If it does, this transformation has the potential to not only address the issue of rising healthcare costs, but also to improve access to medicine, change patient and practitioner behaviors, and shift the focus from treatment to prevention, saving resources – and, ultimately – lives.