The future of healthcare – a challenge for all
Health and technology opinion leaders met in London recently as part of the Future Agenda open foresight programme. In this first of a series of articles, Louise Fox considers the overarching health trends they discussed, which are demanding innovative solutions.
The Future Agenda is the world's largest open foresight programme, enabling companies, institutions and governments to improve their use of strategic insight to anticipate emerging issues and prepare for new opportunities.
During 2015, over 100 future agenda workshops have taken place across 34 cities in 23 countries. One of these brought together 24 health and technology opinion leaders to discuss the challenges facing the healthcare sector. The group included technology experts, pharmaceutical drug developers, educators and data and analytics experts.
Healthcare in 2025 and beyond
The group examined key themes that are likely to affect the sector in 10 years' time:
Increased access to personal health data, predictive analysis and genetic profiling will start to challenge existing healthcare models, which have historically focused on typical conditions. Personalised diagnosis and the visualisation of future needs could adjust our individual attitudes and behaviours to show the long-term effects of our actions.
Global trends see barriers to access reducing and a drive towards providing healthcare for all. However, many countries continue to see poor medicine supply and distribution, insufficient health facilities and health personnel, coupled with low investment and high costs of the required medicines.
Other factors will also affect health. The increase in the ageing population creates a higher demand for change in the way the healthcare system delivers support, with greater co-ordination needed across service providers and a higher degree of in-home care. A growing ageing population also demands a frank conversation about the right to die. Alzheimer's disease, described as the 'ticking time bomb' by some, highlights an increased desire to halt the mental degredation caused, to enable 'quality ageing', improving cognition and slowing the rate of decline.
The rising proportion of older people is placing significant upward pressure on healthcare spending. For the first time in history, those aged over 65 will outnumber children aged under 5 and it is difficult to predict the impact of this on health and social care services.
Chronic diseases
The explosion in the rate of chronic disease will create a demand to stem the trend. A 'positive wellness' approach will be required, which shifts accountability and responsibility from organisations to individuals.
Chronic disease is set to account for 60% of the global disease burden, the four key chronic diseases being cardiovascular, cancer, chronic respiratory disease and diabetes. Most commentators agree that current strategies to counteract them see 21st century problems targeted with an outdated, 20th-century approach. Many would agree that only through an aggregated approach to wellness and the integration of primary, secondary and tertiary prevention will solutions be found. Prevention needs to be central to this, with a strategy to keep people healthy as long as possible to avert progression of disease.
Perhaps this could involve clinical interventions, like vaccines or screening programmes, or community-based interventions, such as weight management for those categorised as pre-diabetic. Is there a sound evidence base for prevention, and how will this be created and made credible globally? Examples do exist where up-front investment in prevention pays off in terms of increased health outcomes, lower costs, or both. It has been estimated that a programme to target pre-diabetics in one market alone could ultimately generate savings of $1.3 billion. But how will the systems and processes be created which facilitate this shift in responsibility?
Access for all
How will the ethical and moral dilemma play out, in relation to the barriers to access across healthcare globally? The Universal Declaration of Human Rights states that access to medical care is a basic human right, yet access is a long way from universal, particularly in heavily disease-burdened areas.
In 1895, the world's first heart surgery took place in Oslo, yet today only 10% of the global population can afford, or have access to, this treatment. Transportation and financial barriers are the most pressing; getting patients to healthcare facilities is described as the problem 'of the last mile' and may lead to solutions in innovative healthcare delivery. Increasingly, the healthcare systems with the least resources move most quickly to develop innovative solutions to reach areas of greatest need. Reverse innovation, which sees ideas developed for a low-income country spreading to a wealthier country, is a growing trend. For example the model for cutting costs of cardiac surgery originated in India but is being adopted by other markets internationally. Dr Devi Shetty, a cardiac surgeon and chairman and founder of Narayana Health, India, commented that what "healthcare needs most is process innovation and not product innovation" – but what will this look like and how will it be facilitated?
Undoubtedly global health challenges are shifting. How will the industry respond? Will reverse innovation, and the acceptance of innovation created elsewhere, become increasingly common? Will closer collaboration between the food, education and health industries become the new norm? What will the role of prevention be?
This series of articles will look in more detail at the potential disruptive impact of technology and its ability to reshape healthcare globally. It will also investigate behavioural change and its effect on health, particularly with regard to chronic disease.
We hope that you will share your views and open up the debate.
About the author:
Louise Fox, consultant at Strategic North, has 15 years' experience in the strategic management and development of global brands. She trained at Unilever and has worked across a broad spectrum of consumer and healthcare brands. Her key skills are brand strategy creation, equity development, foresight and commercial delivery.
Strategic North is a healthcare brand-building agency that works with pharma clients to build the successful brands of today and tomorrow, developing compelling, future-focused brand strategies, grounded in customer insight and scientific understanding.
On 14 January 2016, Tim Jones, the founder and programme leader of the Future Agenda, will be presenting on the Future of Health at the networking event 'Let's Inspire our Future Thinking' in London. His speech will be based on the Future Agenda report that will be launched in the first week of January. Also speaking will be Charles van Commenee, the former head of UK Athletics and a motivational coach and performance management expert.
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