While the world is talking about technology enhancements and AI and mission to Mars, healthcare sector is evolving rapidly to redefine itself. Very soon the changes will dwarf the other sectors in terms of impact and importance to human history. This article talks about digital revolution that will transform the healthcare landscape globally.
Prescriptive and reactive care to Predictive and proactive care
Traditionally, medicine in healthcare has been mostly treatment based for an ailment. External factors like bacteria or virus impact health of an individual and medicine is expected to help human body fight these external enemies. Medicine of today starts when a patient, who is unwell, approaches a clinical expert to help fight against his health problems.
This is very counterintuitive in cases of cancer, diabetes, hypertension etc., which do not have any known external influencers. Research on genomics shows potential relation between structure of genes, and physical & emotional health of an individual. Patients have started worrying about why and how they have been victims of a particular health issue. Especially with respect to lifestyle diseases, they demand cause and effect to be mapped in a scientific manner at least going back to their genome sequence.
Major trend setting forces here are Big Data and AI. With end-to-end EMR and genomic data of millions of patients available like never before, technology can start clustering and categorizing populations based on genomic sequences, habits like smoking, family history, and much more. This then can be linked to early warning signs and symptoms, reactions to specific treatment protocols, health outcomes and most importantly, risk of getting into a specific health condition like Cancer or Diabetes.
Predictive sciences take it one step forward with deep learning algorithms that not only predict “what” but also predict “when”. Today, these innovative technologies are being deployed on a pilot basis and very soon we will see these getting into the mainstream.
As per a research study, age adjusted admission rates for all-cause hospitalisation were 631.3 and 454.8 per 1,000 participant years and the mean length of stay was 8.2 and 7.1 days respectively for participants with and without diabetes. When we are able to have effective predictive and preventive methods, can we focus on these high risk patients?
The paradigm changes here from treating a patient (when he presents himself with a complaint) to helping a global citizen live a healthy life by not being a patient. In tomorrow’s world, no global citizen is going to experience the typical symptoms. Even before those symptoms come to the surface, the risk will be mitigated. This is just like destroying a plot of terrorist attack!
Episodic Cost management to Reduce number of incidents to manage costs
The biggest challenge for any public or private healthcare organisation is reducing costs of healthcare and making it more and more affordable. While the machinery is working on reducing cost of generic medications, we really want adequate money to be spent and intelligent minds to be working on best of innovations in health and be able to compensate them for their best of efforts. Now this gets you into catch 22 with debate on how much profit you really want them to be able to make.
I strongly believe that the above argument is coming to an end. The way Moors law worked on hardware, in healthcare the targeted therapies and predictive and proactive approaches are going to reduce the number of incidents by more than 80%. This huge reduction will make way for money to be spent in the most critical areas of healthcare.
In the US, CMS has already started working on outreach programs to reduce hospitalization of comorbid patients. Programs like these are getting acceptance in developed countries through effective control on payer side. Today, a lot of health insurance providers are giving special discounts on gym membership and other preventive health measures.
While the number of incidents is getting reduced, Big Data is going to play a huge role to take NNT (Number Needed to Treat) to a perfect score of 1. This will eliminate discussion on side effects of the treatment.
Registries for reporting to making use of registries for effective management of conditions
In the past, a lot of data was being captured by various government and other organizations to understand criticality and severity of a particular disease. While it helped us to target treatments like Polio in the past, technology has now already started moving to the next logical step.
You don’t need connected hospital systems anymore to be able to identify outbreaks. Google has proven it in the last few outbreaks already, by providing just the search terms in search engine to predict with high accuracy for effective management of those outbreaks.
Can we take disease registries to the next level to add not only clinically relevant data but also twitter tweets, facebook updates and whatsapp private chats, etc.? Can we profile registries by genomic markers?
Can we make all the registries open to researchers to be able to do meaningful research? Can the exceptional cases with positive outcomes across the globe be analyzed to get effective treatment protocols which are evidence based, not in a clinical trial, but in real life cases.
Large Health facilities to Home based tele-health
Health systems evolved with necessity of creating best infrastructure to get best diagnostic services, and then best of healthcare. Currently, the large facilities can afford best of technology with accurate monitoring capabilities and speedy treatment.
Very soon the wearable technology is going to be ubiquitous and highly accurate with support from required deep learning algorithm. This, linked with efficient response system from health worker on tele-health platform, will take away need for patients to present themselves in hospitals. Robots are already making their way in tele-health.
This single change is not only going to improve efficiency of the whole healthcare delivery system but will also be highly beneficial to the patient community.
About the Author:
Milind Pol is the Sr. Vice President of Ohum Healthcare Solutions Pvt. Ltd., a clinical transformation company offering world class products and processes to improve patient safety, clinical outcomes, and lower costs. As a B-Tech from IIT Bombay, Milind is an effective analyst, problem solver and communicator.