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Future of Healthcare

Demographic changes are resulting in people living longer, and requiring more care for various chronic conditions as they do so, leading to growing demand for healthcare services at a time when providers are increasingly stretched financially.

By: Adi Gaskell, Katerva’s Futurist 

Healthcare systems around the world are currently facing unprecedented change and disruption.  Demographic changes are resulting in people living longer, and requiring more care for various chronic conditions as they do so, leading to growing demand for healthcare services at a time when providers are increasingly stretched financially.  Add to the mix the plethora of new technologies promising to disrupt the sector, and the demands of patients who have experienced these technologies in other walks of life, and healthcare is needing to change at a time when it often has to run just to stand still.

The UK’s House of Lords (the upper chamber) published a report into the future of the National Health Service that attempted to build upon previous strategy documents and outline the evolution of healthcare in the coming years.  The report was the culmination of numerous evidence-gathering sessions, with the great and the good from across the country submitting their thoughts and evidence.

This resulted in 34 recommendations being given for the transformation of the service, from a transformation of general practice to a long-term workforce strategy.  What is noticeably absent from the report are the grand, sweeping visions that one might observe from perusing the technology press, with robot caregivers and AI-driven diagnostics.  Instead, the report bemoans the failure of the care.data platform a few years ago and timidly argues for greater public engagement around data in healthcare.

Turning the tanker around

That doesn’t stop many advocating for a brighter future for the sector.  For instance, a second report, from consultancy firm Arthur D Little (ADL), argued that the future of healthcare would be one characterized by precision.  It argues that advances in genomics, big data, artificial intelligence and gene editing herald the promise of a future driven by personalized medicine.

This is in many ways a future that is already materializing, with the proportion of personalized treatments approved by the FDA growing to 40%.  The company believes this is only going to improve, especially as the medical industry is able to utilize a wider and deeper array of data on our health and wellbeing to craft new treatments.

“The development of ultra-targeted treatments will lead to a wave of patient population fragmentation characterized by an increased number of marketed treatments and a smaller number of patients targeted per treatment,” they argue. “This will have consequences for drug developers, payers, and providers.”

This in turn will precipitate various new business models emerging, and a more collaborative approach to treatment than is often the case today.  It might even require hospitals themselves to be restructured to be fit for the new procedures that a personalized world would require.

“Advances in genomics are leading to more precise targeting, treatments are shifting from symptomatic to curative, and digital advances and AI allow for real-time monitoring of patient health,” Arthur D Little continue. “These and other leaps forward demand a rapid evolution. Hospitals are examining their approach to care, staffing, and facilities. Drug developers are experimenting with new commercial models.”

Realistic change

The distinction between the two reports is stark, and one could well argue that the House of Lords report was primarily driven by those working in the sector, with the ADL report penned by those who wish to change it.  What is perhaps clear, however, is that healthcare is a sector that both needs to change, yet struggles tremendously to do so.

Tuck Business School’s Vijay Govindarajan argues that focusing on technology itself is perhaps the wrong approach.  In Reverse Innovation in Healthcare, he and colleague Ravi Ramamurti explore what lessons healthcare providers in the west can learn from India and other low-cost countries, which have managed to provide high quality care at scale and to budget.

The work borrows heavily from the likes of CJ Prahalad’s Fortune At The Bottom Of The Pyramid, which helped to make global celebrities of the Aravind Eye Hospital and the Narayana Health group headed by Devi Shetty.  Govindarajan highlights five core principles that he believes will be key to successful transformation of healthcare:

  1. A driving purpose to deliver ultra-affordable, yet high quality healthcare
  2. A hub and spoke configuration that sees most care provided in the community by lower cost professionals, with highly specialized hospitals then providing more expensive treatments
  3. Enthusiastic adoption of technology
  4. Shifting of tasks so that routine procedures are performed by lower skilled professionals rather than clogging up the time of doctors
  5. An intense culture of cost consciousness, with waste removed whenever and wherever possible

There is clearly a pressing need for things to be done differently, but as research from Harvard points out, perhaps the leadership in the field is insufficient to make the change happen.  It’s noticeable that most of the more innovative approaches to healthcare have come from organizations who have started from the ground up.

“Overall, our results indicate that the CEOs of large public hospitals such as those included in the NHS do not bring about changes in hospital performance, a result that stands in stark contrast with earlier findings relating to the private sector and to smaller public sector organizations,” the researchers explain.

They argue that this is often because most CEOs are health industry veterans, and therefore lack the experience of operations in other sectors that are so often the bedrock of innovation. Indeed, research shows that organizations are far more likely to change when they hire ‘outsiders’ to lead them.  It’s clear that the mandate to change undoubtedly exists, yet the act of changing remains fiendishly difficult for the industry to pull off.  In the remaining articles this month, some of the biggest changes affecting the industry will be explored, from preventative care to the deployment of AI.

If you loved this article–our ‘Future of’ series will explore new topics released weekly every Thursday–stay tuned!