Tomorrow’s health system, today: Pushing towards preventative and predictive healthcare

Imagine visiting your local clinic and, when asked what your symptoms are, saying, “None – yet.” The response would be a highly raised eyebrow.

In an inherently reactive healthcare system, we only visit the doctor when we feel ill. When we’re well, we don’t think about the doctor at all. And, until a problem arises, the healthcare system is largely inaccessible. But a new era of proactive healthcare is coming; one that keeps people healthier at home for longer through high quality medical insights and preventative, predictive care.

Preventative or predictive?

Preventative and predictive healthcare go hand-in-hand, supporting early intervention and health equity. However, in a data-driven healthcare ecosystem, it’s vital to understand how these terms differ.

Our survey of 550 leaders across the global healthcare, pharma, and medtech ecosystem found that, by 2030, 96 percent of respondents think patients will be so focused on preventative care and early intervention that many hospital visits will be unnecessary. Classic preventative measures include regular exercise, a balanced diet, and lifestyle choices that prevent the development of certain health conditions. In today’s digital world, preventative healthcare includes apps that measure health data, such as how many steps you walk and how well you sleep, to nudge and commend healthy habits.

Predictive healthcare centres on genetic sequencing and data tracking technologies, pulling on large chunks of clinical data to understand specific individuals or populations. This information can be used to identify who is at risk of certain diseases, and encourage them to seek treatment or make lifestyle changes. Currently, predictive tools are mainly used by organisations with advanced analytical and medical skills. However, data – especially health data – is fast becoming ubiquitous, as are the tools to analyse it. It’s now possible to order genome sequencing kits online, providing a complete picture of your genetic makeup. Huge swathes of data, teamed with increasingly precise algorithms, mean that individuals will soon be able to draw inferences from their own medical data.

The difference is in the data

Using a preventative healthcare app to make small lifestyle shifts to support good health is relatively non-intrusive. Predictive healthcare is more of a grey area, drilling down into detailed personal and population information to predict future health scenarios.

For example, when mapping genetic sequences to track rare hereditary diseases, clinicians may make ‘unintentional finds’. In the UK and the Nordics, patients can indicate whether to be informed of unintentional finds before diagnosis. In a healthcare system fuelled by instantly accessible, predictive data insights, this ethical safeguard is removed. Does this data belong in the hands of data subjects, who might be distressed by what they find? Who has the right to access this data? At what point does data become publicly available, and how will this impact services that the person receives?

Take health insurance. Consenting to share health data is like fitting a car with a telematics box, or ‘black box’, that tracks real-time metrics to ideally drive down insurance premiums. But while it’s part of the public psyche to let big tech companies mine personal data and track usage habits, there is unease around what happens to personal information within healthcare systems. In Denmark, the focus on protecting individual data above and beyond General Data Protection Regulations (GDPR) meant that a COVID-19 ‘Track and Trace’ app was redesigned to prioritise individual privacy over big data insights.

In contrast with the wariness associated with data-fuelled predictive tools, our research shows great confidence in preventative care. No less than 100 percent of Danish respondents believe that by 2030, patient focus on preventative care and early intervention will make most hospital visits unnecessary.

Clearly there is an element of mistrust around predictive healthcare tools. The way to build trust is to discuss the future of healthcare as societies and ecosystems in a place-based, population-focused approach. Technology giants, pharma, and medtech companies have a role to play in creating predictive healthcare solutions but must be driven by population needs. This means talking to healthcare providers and the target users of solutions at point of concept. What are the intended outcomes, and how can predictive measures support them?

The multi-billion-dollar question

Preventative and predictive healthcare can increase the effectiveness of early intervention, keeping people healthier for longer. The multi-billion-dollar question is how to embed the right operational and financial models to accommodate all stakeholders while maximising system-wide value. No one party can do this alone, but collaborating isn’t easy – over half of global survey respondents reported scepticism about ecosystem collaboration. Joined-up public systems in Denmark and Norway make these discussions easier but can also leave public-private partnerships out in the cold. These countries are now exploring Integrated Care Systems (ICSs), using the UK as a living case study of ICS implementation in action.

So, what will incentivise these all-important partnerships? How can the value of prevention and prediction be understood, communicated, and achieved in a largely reactive system? Our research uncovered four accelerators to create a new proactive healthcare environment that keeps people healthier at home:

• Connect the ecosystem to combine relevant technology, healthcare diagnostics, and community-based care with treatments developed by medtech and pharma companies
• Keep the patient and key stakeholders front of mind, differentiating through the experience. Without this, your approach will struggle to scale
• Always draw on data and match digital solutions to the person’s individual needs and ability, deploying digital with intention
• With a firm focus on the benefits for all stakeholders, unlock whole system value.

Predicting a proactive future

The future healthcare landscape uses a combination of tools, including preventative and predictive strategies, to best meet patient needs. Ecosystem stakeholders can drive change through pilots and trials that prove the value of prevention and prediction, paving the way to scalability. Once the benefits are clear, it’s much easier to catalyse change.

Preventative and predictive healthcare provide an antidote to outmoded reactive models. They also bring up difficult questions around data access and privacy, and the relationship between data subject and data handler. When data subjects also become data handlers, operational and financial models will be forced to change. One thing is certain – prevention and prediction are better than cure.