Healthcare Trends and the Future of Healthcare. Forecasting the future of healthcare and health policy is an imperfect science. A lesson learned from the mortgage crisis- it is important to understand the events that are most unlikely to change the direction of healthcare, events with low probability and potentially high impact.
Health care is a personal issue that has become wholly public–as the debate over reforming healthcare systems in most countries makes painfully clear. But what’s often lost in the debates about the issue is a clear vision about how medicine could work in the future.
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Extract from the Study: Healthcare Trends in Canada
The Future of Healthcare: Forecasting the future of healthcare and health policy is an imperfect science. Among the predictions made in the mid-1980s were that there would be a physician surplus, a growing number of elderly people, an increase in the number of people in managed care plans, restructured health benefits, new technologies, more for-profit health care delivery, rising health care costs, and a restrained federal government role. All of these issues-with the exception of a physician surplus, which is still being debated-turned out to have an impact on health policy. Several of these will continue to challenge policymakers during the next decade, and new or re-emerging issues will also pose challenges.
Arcus has launched a global research project with the Health Strategy Innovation Cell at the University of Toronto this year. The goal of this project is to look for black swans, extreme outliers, high-impact and hard-to-predict trends that are beyond the realm of normal expectations. These big trends and ideas may not be getting adequate attention from business, governments, academia, NGOs and other important groups even though these black swans could very well define the future of healthcare.
The world of personalized healthcare
If well funded and adopted widely, many different technologies–from electronic records to algorithms to remote monitoring devices–promise to streamline the health care system, saving money and improving services. The end result is a future in which health care is more personalized–and frequently delivered outside of the doctor’s office and hospital.
Wireless monitoring and communication devices are becoming a part of our everyday lives. Integrated into our daily activities, these devices unobtrusively collect information for us. For example, instead of doing an annual health check-up (i.e. cardiac risk assessment), near real-time health data access can be used to provide rolling assessments and alert patients of changes to their health risk based on biometrics assessment and monitoring (blood pressure, weight, sleep etc). With predictive health analytics, health information intelligence, and data visualization, major risks or abnormalities can be detected and sent to the doctor, possibly pre-empting complications such as stroke, heart attack, or kidney disease. Wireless scales and activity monitors gather information about our health and behaviours and feed seamlessly into desktop software, Web applications, and social networks
While much work remains to be done to connect these devices and the data they generate in universal and interchangeable ways, there are standards evolving to ensure that the data will speak the same language, that the algorithms, analytics, and data output are validated, and that the collective potential of these devices will paint a truly holistic picture. Similarly, increasing adoption of open identification and authentication standards are early indicators of a truly portable and accessible social interchange upon which a secured personal health-care network can emerge. Users like the patient will depend on governed levels of access to protect their privacy while leveraging the support and power of many to manage their family’s health.
The technological advancements in networked devices and personal health networks are enlarging health-care teams and changing way health care is delivered. Research and clinical studies by companies like Qualcomm and West Wireless Health, GE, and Intel, to name a few, are yielding new medical technologies in the areas of screening, monitoring, and RFID among others. These developments require substantial innovation, validation, and adoption of a standardized, security backbone that providers can trust with their patient’s data and that patients can trust to allow them consistent access to their medical histories.
With self-diagnostics, automated schedulers, and e-prescriptions, health care will become more efficient for common maladies and will not entail hours of waiting and frustration. Retail clinics will offer flexible, cost effective, and immediate options when the family doctor is unavailable. Patient results and data will stream into a consolidated health-care record that patients and health-care providers can access and view from any location. And for people like the patient, this offers more efficient access to the information and services she needs as well as potential cost savings.
The availability and interpretation of the data over time will empower us to self-manage our wellness or chronic conditions by putting the information and tools at our fingertips. Large amounts of data can be overwhelming, but when that data is interpreted, personalized, and fit into evolving trends such as nutritional habits, sleep patterns, or blood pressure measurement, or when these are compared with family or friends, it can be immensely informative. When coupled with clinical algorithms to process the data, these devices reveal insights about patterns, cause and effect, and the impact of health and lifestyle choices that we make. Visualizing and manipulating this kind of information creates “aha!” moments that may otherwise have gone undetected. We have a daily view into our health and the choices we make as part of a larger context. It also encourages an ongoing dialogue with our friends and our larger health-care “team.”
Swapping health-care stories among family and friends is common. This used to be done in small, local communities, and with only a few people. People with rare conditions struggled to find information about their ailments and others with the same condition. Now the patient can interact with family and friends and thousands of people across the globe, finding similarities and differences among a huge group of people. This can pose risks, but community health sites and shared personal health records offer a new frontier of medical discovery and patient support, allowing data collection and data sharing across the population. This can provide opportunities for opt-in research and trending benefits for disease prevention, monitoring, and treatments. It can also yield human-centered responses to sharing, collaborating, and finding meaning and strength in numbers.
Beyond the emotional support the patient gets from sharing parts of her health record with a community of people, she is also learning about her health statistics and her habits by comparing them to those of other people. For example, because she is at risk for diabetes, she has recently started tracking her meals by taking photographs from her mobile phone and uploading them to a service that helps her measure caloric counts and nutritional values. As she evaluates her food choices and other health indicators, she compares them to those of other people of her age with similar lifestyles. She is surprised to learn that her portion sizes are much larger than those of her peers and that she eats more prepared foods than most people.
With the help of her health concierge, an online personal coach that she accesses through her health plan, and others in her network, she creates a meal plan with recipes and portions to help her stay on track with her diet. The service also provides a “shopping assistant” that helps the patient make healthy choices at the point of purchase. Using her phone, the patient quickly scans products to see if they fit her meal plan, and a simple “red light” or “green light” guides her selections.
Beyond the value and efficiencies a patient gains from this assistance, she can also opt to have specific types of data such as her nutrition, weight, and blood pressure anonymously shared with the medical research community for research and trending analysis. The extrapolation of multiple data points across large groups of people can hasten the pace of medical discoveries and knowledge, and can also foster dialogue between scientists and patients to discern and validate emerging insights. Facilitated by technology, this exchange of information can provide relevant and personalized guidance for the patient and her family. Instead of browsing health magazines and researching online for credible and relevant information, the patient and her family can have a vast pool of information tailored to their own health conditions and coordinated with their own unique trending patterns. This saves the patient time while allowing her to be proactive and informed.
The tools and technology may be new, but the natural instinct to respond more strongly when you are being observed is not. Studies have long shown that people change their behavior simply because they are being observed. This is based on both a desire for reward as well as fear of punishment. We have seen evidence of this in the huge success of Nike+, with its sensors and online community of runners. Another example is FitBit, which tracks activity and sleep and offers the ability to share collaborative fitness goals with friends, family, and co-workers. Connecting these monitoring devices to communities of people offers social support, peer pressure, and competition to encourage people to change their behaviour.
Continuous versus episodic monitoring of health
In the future, the patient will be able to manage much of this from her home and mobile phone–a convenience that not only saves her time and money, but also gives her peace of mind. With the wireless monitoring devices and community networks, she will have access to more tailored and complete information to assist her in making the best health and financial choices. Ongoing management and awareness also helps prevent costly, time consuming, and perhaps life-threatening emergencies for her and her family.
Continuous versus episodic monitoring of health can lead to better health outcomes. Periodic visits to the doctor, which are often rushed and focused only on an immediate, pressing issue, may not be enough. Technology allows us to keep watch more closely, leading to more timely and holistically informed health decisions. The devices and the online communities act as a vigilant safety net, making us feel less alone, more empowered, and safer as we navigate the complex world of health. The trajectories in networked health devices and social networking will help people like the patient lead more independent, healthier lives. They are converging to create a new frontier in health care. Collecting health data from mobile applications, embedded sensors, or other devices offers convenient and personalized information to help people manage their health over time. With clinically based algorithms, data visualization, and community sharing, we will receive not just more information, but more meaningful and timely information that is channelled better to improve our health.