New advances in technology are having a tremendous impact through the entire healthcare spectrum. Technology is transforming traditional systems and processes in the industry – from drug targeting to diagnostics and clinical trials – digital technology is playing a leading role in administering therapies and engaging patients through all stages of their journey.
The ‘digital health and m health’ age is now not just focused on apps and managing medication or prescriptions, but emerging health tech enabled solutions show promise in accelerating drug discovery, aiding in diagnosis and improving care and safety. These together will result in lowering overall costs for healthcare payers.
The healthcare industry is at an inflection point where the shift away from a traditional fee-for -service model will begin to more rapidly move toward value-based reimbursement. A key driver of the shift is the unsustainable level of US healthcare costs with suboptimal results, with growing patient cost burdens threatening demand and ability to afford care. This is a change toward a system where providers and manufacturers are paid more on the basis of clinical outcomes rather than on the volume of patients they treat or procedures they perform. This shift to value-based reimbursement is set to reshape the healthcare landscape. Against this backdrop, health tech seems to be an obvious winner as the need for sophisticated data collection and analytics capabilities spurs continued investment in solutions with the aim of improving clinical outcomes and access to care in a cost-efficient manner.
New technologies have the potential to help people stay healthier through applications that put them in control of their health and wellbeing, as well as improve medical diagnostics and drug discovery in the industry. Technology has permeated the industry and if the adoption is as widespread and rapid as it is estimated to grow at, the potential benefits are far-reaching.
The team at Optimum has been following this space for a number of years and it is very exciting to see what a pipe dream was once is all now becoming very tangible and is making a real impact on how health and care evolves.
Pace of change
At Optimum’s recent 10th Annual Healthcare Investor Conference, the debate ranged from using technology to improve productivity, to questions around the NHS and its position as a leader or follower in embracing and implementing new technologies.
It is interesting that the pace of change in healthcare has lagged behind a number of other sectors. New technology has had a visible and lasting impact and radically changed industries as diverse as coal mining and printing. Conversely, the speed of technological impact across the pharma industry has been at a glacial pace.
Looking closely at the challenges facing the industry, there are still 6,000 diseases to be treated and this requires a pressing need to address and change the economics of drug development: it is here health tech can make a real difference.
The big question: how will this happen and what are the tools that can enable it?
Artificial Intelligence: Hype or true disruption
The hunt for efficiencies is particularly important in an industry suffering from unfavourable statistics. It takes an average of 12 years and $2bn to bring a drug to market, when most clinical trials are unsuccessful and hugely expensive.
Revolutionary new developments in health tech are now beginning to drive change in the healthcare industry. Of these, Artificial Intelligence (AI) is clearly one that cannot be ignored. AI is a constellation of technologies—from machine learning to natural language processing—that allows machines to sense, understand, act and learn, which is crucial to comprehend what we are finding through DNA sequencing.
The healthcare industry is particularly primed to benefit from AI because it deals with huge amounts of data on a daily basis. Patient information, medical histories, diagnostic results, hospital billing, and clinical studies are just a few of the data sources available in healthcare. This huge pool of data can train AI and machine learning to detect patterns and come up with predictions, recommendations, or conclusion, whatever the case may be. As it is now, much of these data do not go through any type of processing.
About $5bn was invested in AI companies in 2016, with healthcare one of the fastest growing sectors. By 2021, the value of the segment is expected to reach $6.6bn, and China is expected to own a large piece of this pie. The use of AI will help with evaluating and improving outcomes within drug development. AI platforms could be transformational across the board on selecting targets, stratifying patients, and predicting efficacy, lowering costs and increasing speed of development.
AI also has multiple uses in diagnoses. In the UK, five new government-funded technology centres are scheduled to open in 2019 and will use AI to hasten disease diagnosis with the aim of making the National Health Service more efficient.
Digital therapeutics and diagnostics are reshaping our understanding of specific conditions and helping tailor interventions for the individual. New technologies and machine learning tools could dramatically reduce the cost of providing healthcare. These applications allow for the democratisation of technology, allowing people to take charge of their own health. The positive repercussions could result in a move towards prevention and wellness – moving from a ‘treating the sick model’ to one where we are continually improving overall health.
A wave of innovation in technologies, from Google’s Deep Mind to start-ups looking at diagnostics and the big data angle, are now making great progress in providing new solutions. Amazon.com Inc. is starting to sell software that mines patient medical records for information doctors and hospitals could use to improve treatment and cut costs. The move is the latest by a big technology company into health care, an industry where it sees opportunities for growth.
NHS: Leader or a follower?
One of the areas of debate at the conference was around technology adoption in the NHS. The NHS app is scheduled to be launched Spring 2019 and is expected to transform how people themselves are involved with research, clinical trials, treatment and their own data. Patients can in fact opt in to contribute their own data to research. This is being heralded as a transformative move which is quoted as putting “patients firmly in the driver’s seat”. The NHS could have an important role to play worldwide, since it is the biggest single database containing data for the whole of the UK. The challenge is to mine the data and pack it in a user-friendly format to monetise it.
Prof Tony Young, National Clinical Lead for Innovation, NHS England, is very bullish. He is charged with innovating the NHS and he believes that part of the solution lies in injecting fresh thinking on tech (into the NHS), via partnerships with nimble tech start-ups and established large companies.
NHS Digital has launched a service allowing emergency medical personnel to pull information from shared care records when called to a mental health patient in distress. The National Record Locator Service enables paramedics and mental health nurses to find out whether the patient they are treating has a mental health crisis plan, by a means of helping inform their treatment. Future use-cases include end of life care, child health, maternity and cancer in an effort by the NHS to make data sharing seamless.
New challenges: Regulation and privacy checks
While these new technologies promise to revolutionise healthcare, they also create new challenges.
Practitioners and administrators in healthcare acknowledge the potential for AI to reduce costs but believe that regulatory concerns and customer acceptance will inhibit adoption. One of the biggest potential bottlenecks that could inhibit or derail AI development and adoption in healthcare is the availability of sufficient quantities of high-quality data in standardised formats. Information today is highly fragmented and spread across the industry, residing in diverse, uncoordinated repositories like electronic medical records, laboratory and imaging systems, physician notes, and health-insurance claims. Merging this information into large, integrated databases, which is required to empower AI to develop the deep understanding of diseases and their cures, is difficult. There are further challenges in sharing health-care data among hospitals, insurers, drug makers, and diagnostic companies. And, of course, there is the highly sensitive nature of the data itself.
Privacy is likewise a concern—who should have ownership of data, and what safeguards are needed to protect highly sensitive data, while putting it to use.
The Australian scheme ‘My Health Record’ has faced a lot of backlash under privacy concerns. It was meant to give every Australian with a Medicare card a digital record to store medical information unless they opted out. In November 2018 the government unveiled changes to the scheme to address a range of concerns about privacy, such as whether ex-partners would be able to access the records of their former partners, as well as extending the ‘opt-out’ deadline which has seen over a million citizens leave the scheme.
It will be interesting to see if the NHS uses the lessons learned from this example ahead of the launch next year.
Wait and Watch
While the push is to lower healthcare costs and mine new tech, questions remain about what patients really want and what exactly is real patient engagement. Wellbeing and mental health are increasing in importance in comparison to treatment and disease management.
In a recent study done by the University of Aachen, senior citizens were asked what technology they saw as being transformative over the past 70 years. While the industry saw this as new technology – smart phones, iPads — the senior citizens said they wanted either a social networking platform, or a dating site, because they recognised that as they age their networks decline and their priority was to keep those up.
It is clear the exponential pace of technological change in the next 10 years will surpass the advancements of the past decade. The lines between physical, digital and biological spheres are blurring and there needs to be higher integration and sharing of data.
Organisations will have to evolve and respond to changing patient and industry needs. It is clear the winners will be those that keep up with this pace of change, and those that adapt and adopt are likely to survive and flourish through this new age.
The discussion on the impact of health tech is far from over.
We will be publishing further commentary in the coming weeks. Please visit the Optimum website as well as our LinkedIn and Twitter feed to get regular updates.
Optimum Strategic Communications hosted its 10th Annual Healthcare Investor Conference in partnership with Bloomberg Intelligence on Tuesday, 16 October 2018 at Bloomberg’s new European Headquarters in the City of London. The conference, now in its 10th successful year, brings together the top executives and visionaries from the healthcare industry and the investment community to discuss and debate the latest trends set to reshape the industry far into the future. This year’s theme, The Future of Healthcare, looked at the impact of tech on healthcare and other trends shaping the industry.
Clive Cookson, Science Editor, Financial Times chaired the discussion on Health Tech – How is Tech transforming developments in healthcare, along with Paul Major, Fund Manager at Bellevue Asset Management, Tony Young, National Clinical Lead for Innovation, NHS England, Jackie Hunter, Chief Executive, Clinical Programmes & Strategic Relationships, BenevolentAI and Andrew Hopkins, Founder and CEO of Exscientia.
 Launched November 2018
 McKinsey report, 2017