TheFutureofHealthcare|AnEmergingViewInsightsfromMultipleExpertDiscussionsAroundtheWorldDr.TimJones|Programme Director|24August2017

FutureAgendaTheFutureAgendaistheworld’slargestopenforesightprogram

thataccessesmultipleviewsofthenextdecadesoallcanbebetterinformedandstimulateinnovation.

LookingForwardsOrganisationsincreasinglywanttoidentifyandunderstand

boththeanticipatedandunexpectedchangessothattheycanbebetterpreparedforthefuture.

TheFutureofHealthcare

Data’sImpactonHealthBetteruseofdataandtechnologyhasthepowertoimprovehealth,

transformingthequalityandreducingthecostofhealthandcareservices.Itcangivepatientsmorecontrolovertheirhealthandempowercarers.

DeeperCollaborationPartnershipsshifttobecomemoredynamic,long-term,democratised,

multi-partycollaborations.Competitoralliancesandwiderpublicparticipationdriveregulatorstocreatenewframeworksforopen,empatheticcollaboration.

ADataMarketplaceDataisacurrency,ithasavalueandaprice,andthereforerequiresamarketplace.Ecosystemsfortradinghealthdataisemergingand

anythingthatisinformationisrepresentedinanewdatamarketplace.

TheRiseofMachinesThegrowth intheintelligenceandcapabilitiesofmachinespresentsbothathreatandanopportunity. Greaterautomationfreesuptime,butalsohasthepotentialtothreatenmorejobsinmanagerialoradministrativeroles.

GeneEditingEquippedwithgreaterunderstandingoftheindividual’sgeneticdispositionandnewinterventiontechnologies,wecanproactivelyeditgenesandundertakeminimallyinvasivesurgerytoreducetheneedformajorsurgeryinlateryears.

IndividualizedMedicineWearegoingtobeleavingpopulationmedicine– whereonesizefitsall

– infavour ofindividualizedmedicine.Implicitinthisisthatthepatientswillincreasinglydrivetheirowncare.

NewTrustRelationshipTheadoptionofmanydigitaltechnologieswithinintegratedhealthandcaresystemswillrequirethe

developmentofanewtrustrelationshipwiththecitizen.

LimitingHealthcareAccessSeveraleconomieswhereuniversalaccessisthenormarelookingatwaysoflimitinguse.Optionssuchasco-paymentforalltreatmentsoramaximum

numberof(non-emergency)visitsperyearareincreasinglydebated.

CostofCancerDrugsTheaveragebenefitfromthe50mostrecentlyapprovedcancerdrugsintheUKis3weeksofextralife– atandaveragecostofaround$70,000.

Incostconstrainedsystems,continuingsuchsupportisbeingquestioned.

IndiaSettingGlobalStandardsIndiaisdemonstratinganinnovativeapproachtohealthcarechallengesandhasprovendesignsolutionsforlow-incomepopulations.Thesesolutionswillbeappliedtohigherincomeeconomieswithevengreaterefficiencybenefits.

PersonalDataStoresPatientswillnotonlyaccesstheirdata,butalsoownit.Theadoptionof

personaldatastores leadtouniversallyacceptedcredentialsandsharedatawithmultiplepartners sothatpatientscanreceivepersonalizedservices.

DecentralizedSecureDataWeneedtodecentralizehealthdatabecausethemoreit’samassed,themorelikelyit’sgoingtobehacked. Centralizedownershipof

medicalrecordsisincreasinglyseenasasecurityrisk.

InternetofMeThecombinationofincreasingcomputingpoweranddigitalhealthleadstotheInternetofMe:Patientsgetinformationthatishighlycustomizedtowhotheyareandtreatmentsbecomemoreeffectivethroughgreaterpersonalization.

HumanTouchAsserviceprovisionandconsumptionbecomesevermoredigital,automatedandalgorithmic,thosebrandsthatcanoffermoreemotionalengagement

andhuman-to-humancontactbecomeincreasinglyattractive.

SystemChangeFormany,implementingdigitalhealthtechnologiesrequiresawholesystemchange.Suchatransformationismoredifficult

toimplementwhenanestablishedhealthcaresystemisinplace.

ConservativeRegulatorsAslegislatorsandfundersofhealthcaretendtoberiskaverse,thereisa

regulatorydesireforcertaintywithacontinuousconcernaboutunintendedconsequencesofchange.Regulatorsmaythereforeslowadoption.

ResistancefromHealthcareProfessionalsChangefromcliniciansandprofessionalsinhealthoftenhavetheleast

appetiteforchange– itisoftenviewedasathreattorolesandresponsibilities.Dialoguearoundnewinnovationsiskeytoovercomingresistance.

CreatingPullOneofthemosteffectiveleaverstoencouragingadoptionofdigitalwillbethe‘fearofmissingout’ongainingacompetitiveedgeincostandquality.Creatingpullaswellaspushwillbepivotalforwiderpatientdatasharing.

Personalised HealthcareFortheprivilegedfewwithaccess,personalised healthcaretailoredaroundindividualmedicalandpyscho-socialneedsprovidestherapies

thatarebetteralignedwithspecificratherthangenericprofiles.

DigitalAutonomyIncreasingaccesstomorepersonalandgroupdataallowsindividualstotake

informedviewsontheirhealth.Asinformationisdecoupledfromtheprofessions,thepublicbecomemorespecificabouttheirneeds.

DataPrioritisationAnincreasinglydigitalhealthcaresystemisdrivenbyaccesstocredibledatathatisprioritised abovethenoise.Thevalueofsuchkeydataincreases

asitsabilitytounlockopportunitiesandimprovediagnosisrises.

ShiftingRiskandResponsibilityBusinessbecomesmoreactivelyengagedinthewellbeingofitsemployeesand

society.Greaterresponsibilityforhealthisincentivisedbytaxbreaksandreimbursementsdesignedtosharerisk,withlessonstakenfromelsewhere.

SustainableHealthcareWithlimitedresources,risingdemandandescalatingcosts,decouplinghealthcarespendfromeconomicgrowthisaglobalchallenge. Amoresustainable,integratedmodelmayemergefrombeyondtheUS/EU.

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IncentivesinFluxBudgetarypressurescontinueandreimbursementmodelswillneedtochange.Thereisgreateremphasisonpayinghealthcareprovidersbasedonmeasurableoutcomes,ratherthansimplyforthenumberofprocedurestheyperform.

CollectiveActiontoControlChronicDiseaseTostemtherunawaycostsoftreatingchronicdiseases,multiplestakeholders

collectivelyseektohaltkeyconditions:Remotemonitoring,educationalprogrammesandfocusedbudgetsareallintegratedaroundcommonaims.

AmbulatoryCentresSmall,localwalk-incentresbecomepopularforcareandlightinterventions.

Theyreducemajorhospitaldemandandprovidecostsavingsforthesystemwhilealsohelpingpatientsavoidthe‘taboo’ofhospitalisation.

SurgeonasSupervisorMorepervasiverobotics,increasedautomation,augmentedrealityand

artificialintelligenceallcombinetotakeovermoreexpertsurgicalactions-leavingthesurgeontostandbackandbeavailableincaseofanemergency.

TheChangingNatureofPrivacyAsprivacyisapublicissue,moreinternationalframeworksseektogoverntheInternet,protectthevulnerableandsecurepersonalhealthdata:Thebalancebetweenprotection,security,privacyandpublicgoodisincreasinglypolitical.

UniversalHealthcareDataAccessInformationsilosareconnectedviathirdpartiesabletounify,mineand

discovernewinsights.Integratedpublicandprivatedatasetsprovideholisticviewsoftheindividualandvalueshiftstodecision-makinganalytics.

GenerativeManufactureIn-theatreprintingofbio-materialsbringsmultipleopportunities

forthe3Dbuildingofbiologicaltissueandbespokeorgans.Wecreatereplacementpartsthataremadefromour‘own’cells.

SimulatedLearningVirtualreality,remoterobotics,simulationandgamification allchangehowhealthcareprofessionalsandwiderteamsgainskills,becomefamiliarwithnewapproachesandhelpthemtorehearsecomplexproceduresinadvance.

ChallengingModelsIncreasedaccesstopersonalhealthdatawillchallengeexisting

healthcaremodelsfocusedonstereotypicalconditions.Inthefutureseveralgovernmentsexpectpersonalizeddiagnosistobecommonplace.

GeneticProfilingKeyisthewideruseandreducedcostofgeneticprofiling.Withthegrowthoforganizationsprovidinghereditarygeneticinformationcommercially,morepeoplecanseefutureconditionsearlyandsotakepreventativeaction.

GettingClosertothePatientNewdigitaltechnologies providingtailoredadvicemeanthathealthcare

systemsaredesignedmoreforthepatient’sconvenience,athome,andlessaroundexpensive,over-stretchedfacilitiessuchashospitals.

AIDrivingAccuracyItwillbecomecommonforpatientstochatwithartificialintelligencehealth

advisersthroughmessagingapps- Asmorepeopleusetheseservices,themoredataiscollectedandthereforethemoreaccuratediagnosiscanbe.

AnInformationBusinessDataanddataexchangehaveemergedasthe‘newcurrency’in

healthcare,andwillbecomeamajorforceinredefiningrelationships,transformingtheindustryintoaninformation-drivenbusiness.

DataGapsInmanyinstances,healthdatadoesnotyetfollowthepatient,creatinggapsincoverageandleadingtofragmented,uncoordinatedcarethatdiminishes

qualityanddrivesupcosts. Inthefuture,thesegapswilldisappear.

IndividualCustodiansAsmoreinformationisavailabletotheindividual,manypeopleareabletomakemoreinformeddecisionsabouttheirhealthbecause

theycanbecomecustodiansoftheirownhealthrecords.

PersonalDataSharingThesharingofpersonalhealthdatawithpatientsinestablishedsystems

willgivethemgreatercontrolovertheirownwellness.Patientswillincreasinglyneedtotrustinthesharingoftheirowndatawithothers.

CombiningDataSetsPickingthedataworthsharingandmatchingitwiththemostappropriateplatformsaroundspecificissues,conditions,demographicsorpublicvs.privatehealthcaresystemsisseenasthemostpragmaticapproach.

PredictiveAnalysisAswemovetoreal-timesynthesisofmultipledataplatformswewillgainimprovedaccuracyandspeed.Predictiveanalyticsandgeneticprofiling

togethercreatemoreconnectedpredictionanddrivehyper-personalization

PublicConcernsPublicconcernsaroundtheunregulatedofuseofdataaregrowingand,

unlesscontrolledsuccessfully,asappsbecomemorepopular,fearsaroundhowpersonaldataarestoredusedandsharedwillbecomemorepointed.

ProprietaryDataAsignificantchallengetoprogressinhealthcareresidesinthebarriersandrestrictionsthatderivefromthetreatmentofmedicalcaredata

asaproprietarycommoditybytheorganizationsinvolved.

StewardsandSecurityDespitetheincreasedenthusiasmforpatientdataandtheadoptionofEHR,insufficientattentionisbeingpaidtosecurity.Withmoreprominentcyber-

attacks,wewilltrustourdataonlytothosewiththehighestlevelsofsecurity.

APublicGoodBroaderuseofhealthcaredatarequiresnotonlyfosteringdatasystem

reliabilityandinteroperabilitybutalsoaddressingindividualdataownershipandtheextenttowhichdatashouldconstituteapublicgood.

PublicBenefitvs.PersonalRiskInlinkingandsharingmoredatawewillincreasinglyweighpublicbenefitsagainstpersonalrisk.Thepotentialharmfromunauthorised releaseofconfidentialdatawillbeaconundrumformanyinthehealthcaresector.

ElectivePreventionEquippedwithgreaterunderstandingoftheindividual’sgeneticdispositionandnewinterventiontechnologies,weproactivelyeditgenesandundertakeminimallyinvasivesurgerytoreducetheneedformajorsurgeryinlateryears.

GreaterEvidenceWidergenerationandsharingofdatashiftsthescale,typeandaccuracyofevidenceusedtomakedecisions.Thebestproceduresbecomemorevisible

andarebettersupportedbypayers andthewiderhealthindustry.

WearableDataUbiquitouswearables withembeddedmonitoringanddiagnosticsunlockinaccessiblepatientdata.Thisenablesreal-timepreventativehealthcaresolutions,greaterpersonalresponsibilityandarealignmentofinsurance.

SmallandDistributedSurgeryWiththedemocratisationanddigitisationofpersonalhealthdata,surgical

supportshiftstomorelocalsystemsforearlier,minimalintervention.Providerscorrespondinglybecomesmaller,de-centralisedandmoreoutcomefocused.

InformedConsumersMoreinformedanddemandingpatientsbecomepartnersintheirown

healthcare.Equippedwithawealthofpersonaldiagnosticandmonitoringdata,consumerschallengeregulatorsandhealthcarecompaniestoimprove.

ChangingBusinessModelsDrivenbynewapproachesforemergingmarketsandverticalintegrationonpivotalissues,newbusinessmodelsemerge.WiderinsuranceinIndia,frugalinnovationandmoregovernmentfocusonpreventionactaschangecatalysts.

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