In the 20th century, we built a healthcare system to manage acute problems such as trauma and infectious disease. It was based on the signature tech of that time: highly-educated clinicians, nursed hospital beds, and advanced medical equipment.
In the 21st century, chronic disease is one of the the time period’s great health crisis, and the solution hinges on a systemic shift to people powered health enabled by technology.
Society cannot cope with chronic disease unless we equip patients and families to look after themselves for the 99 per cent of time they are away from medical professionals. Ubiquitous digital technology such as smartphones and wearables can supply patients and families with the information they need to take a greater role.
When seen as the core driver in a shift in power and responsibility in health, digital health represents a significant commercial opportunity. Given declining research productivity in the traditional pharmaceutical sector, and a lack of blockbusters from genomics of biotech, this may represent one of the most promising opportunities in the sector.
The businesses that transform the future of health will be those that can combine strong technological nous with the ability to harness people-power – networks of patients, carers and clinicians.
One key trend is monitoring and improving people’s health through wearable devices, which has been in the news for several years now. Health and exercise tracking devices, such as Fitbit, have gone from being novelties to everyday items. Yet, recent research shows that in the UK only 16 per cent of people managing an on-going health issue (like diabetes or a heart condition) are choosing to actively share the data they gather from wearables or apps with their doctor. Most people – 54 per cent – believe there is no benefit in sharing this information. This is precisely the demographic that should be maximising on technology like this
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Of course, we also already have pills that broadcast a signal when they have been swallowed allowing precise tracking of medication, home EKGs36 to track brain activity, and bluetooth-enabled spirometers37 for tracking asthma or lung disease.
A second key area is smarter analytics. To make sense of the flood of data now arriving from these mobile devices the industry will require sophisticated analytics tools – perhaps, even, the beginning of a discipline of algorithmic medicine.
We need machines to be able to read a cardiogram, or look at spirometry data, or track the tremors of a Parkinson’s patient, and turn that data into a signal that a patient or doctor can act on. Further, unlike most medical technology, these innovations would make care cheaper, through precise targeting of treatment. New applications and services that merge biometric data and genomic information with data from other patients, and allow patients to work with clinicians and wider networks to manage their own health
Data and analytics need to be blended with a softer set of skills. Many self-tracking and fitness apps have big drop out rates – we need to understand better how to engage the user, their peers, and professionals so these digital services get real traction. We can learn from effective online communities, and from offline ones such as Weight Watchers, about how to marry data with other kinds of support. It’s also important to realise that all the relevant data is produced, owned and controlled by patients. Developing and improving analytics will require negotiating access to this data. While in some sectors of the economy, businesses have been able to make extremely free use of customer data, this is legally and reputationally difficult in healthcare.
Patient networks and user communities must be carefully nurtured and collaborated with in order to facilitate access to the best data, and to take advantage of mutual support and collective expertise. As is often the case in the digital world, the user community is the key asset – indeed, it will be both helpful and accurate to see these communities as patient owned and patient led. In essence, data driven healthcare will need to be people powered.
The potential of this combination of rich data, strong communities and sophisticated analytics is huge. We will be able to support patients’ own self-care with evidence based real-time advice, will also need to be prepared for.
This is complex, systemic innovation. Like all successful businesses, having the right brand and skill-set to deliver this will be critical. But, the prize, providing powerful, personalised health support, is huge, both from a commercial point-of-view and a social one.
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