- Personalized diagnostics can now put patients at the heart of healthcare.
- Large-scale data analytics will further the power of patient diagnostics.
- Public and private sector must collaborate on the technology and subsidies need to make patient-centric care a reality.
For more than a century, healthcare institutions have been built around the concept of delivering care in a physical setting. As our knowledge and understanding of diseases improved, care became segregated based on different disease areas. This led to the creation of medical specialization and specialist clinics and wards: oncology, gynaecology and cardiology, to name a few.
Today, with incredible advances made in diagnosing and treating diseases, we can unravel the complexity of human biology to understand what makes us unique and centre these specializations around an individual’s exact needs. For example, we know there are 250 to 300 types and subtypes of cancer, which allows doctors, with the help of sophisticated diagnostic tests and tools, to identify the drivers of the disease and better predict how well a patient is going to respond to a particular drug.
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Such level of detailed information is invaluable because it enables us to determine how to address the health needs of every individual patient – to identify, treat, and even pre-empt. To prevent something before it even happens. Think about the power this has to transform humankind forever. With personalized care, the patient is no longer a passive recipient of medical procedures – but at the very centre of healthcare systems.
While legacy structures and systemic inertia have resulted in slow uptake of personalized healthcare, Singapore, Australia and Japan are some of the countries in the Asia-Pacific region that are pioneering its adoption.
Power to the patients
The pandemic, which has amplified underlying vulnerabilities in healthcare, has ushered in its wake the urgent need to course-correct ailing healthcare systems. The system redesign that has been on the horizon for years has now been catapulted to the top of policy-maker agendas. As nations in the region recover from the pandemic, more attention will need to be paid to overhauling local health systems rather than making superficial improvements.
I believe we will see the convergence of several forces within healthcare that will place diagnostics at the core of this new ecosystem. The use of analytics on large-scale population data will bring about a shift from volume-based, episodic care to personalized healthcare, and incentivize stakeholders to introduce improved, patient-focused outcomes. Ultimately, it will become an ecosystem that breaks down silos and creates more opportunities for public and private players to collaborate and bring patients into a new era.
To do this, we need to:
1. Leverage digital tools as enablers for patient-centric care
The accelerated adoption of digital technologies brought on by the pandemic has shown that such tools can support the delivery of better patient care. In an analysis commissioned by Roche Diagnostics in Asia Pacific, both patients and providers have shown greater willingness to use digital health services, especially for remote consultations with the use of telemedicine and in chronic disease management.
The use of self-diagnosis apps follows a similar trend in the non-digital environment as seen with the growing use of patient self-testing for COVID-19 and the introduction of self-sampling for cervical cancer screening. As a result, digital tools will no longer be used just for collecting data from trackers and wearables, but will continue to see an uptick in the future as patient self-testing and screening become routine.
On a macro level, digital technologies will help to improve the overall performance of health systems by ensuring effective and efficient care. Health system waste due to inefficiencies is not a problem restricted to low- and middle-income countries; across OECD health systems, 20% wasted healthcare expenditure accounts for over $1.3 trillion per year. Leveraging data and digital technologies can help reduce this amount, with even a relatively modest reduction of 30% totalling approximately $400 billion per year.
Critically, in order to support the uptake of such technologies and to generate real-world evidence, health systems will need to create an environment that enables data interoperability in a safe and secure manner, allowing individual data to scale up into population data sets that enhance policy decisions.
2. Incentivize better patient care
Rewriting the rulebooks of healthcare will allow us to place value where it matters the most – with the patient.
While COVID-19 created a sandbox environment that encouraged experimentation with different tools and models to support patient care when the world came to a standstill, we must not revert to the old ways. Truly patient-focused care will remain elusive unless we incentivize healthcare providers to offer preventative, proactive and personalized care.
Supportive reimbursement policies, such as enabling patients to access subsidies for teleconsultations, and financing models that spread out costs among different stakeholders instead of placing the financial burden on a single payer are key to unlocking greater access and driving the sustainable adoption of digital health solutions. In a highly fragmented region like Asia-Pacific, while many health systems have introduced reimbursement frameworks for the use of digital health solutions, others are yet to do so.
3. Recognize the value of diagnostic information
As recommendations from the latest Lancet Commission on Diagnostics suggest: “Countries should develop a national diagnostics strategy based on an integrated and tiered network, including an evidence-based essential diagnostics list (EDL).” This means the role of diagnostics would be formalized at every step of the healthcare journey – from prevention to diagnosis to treatment monitoring – with patient information safely and seamlessly integrated across all levels of the healthcare system to reap the benefits of proactive and personalized care.
The time has come to rethink healthcare “costs” as investment. Instead of looking at healthcare spend from the simplistic view of increasing funding for diagnostics, we need to recognize that when the comprehensive value of diagnostic information is captured, it has far-reaching implications for patients and societies.
For patients, it means decisions are customized to their needs. For health systems, it means earlier and effective interventions, subsequently leading to cost savings and the efficient use of resources. For policy-makers, it offers evidence-backed guidance to decision-making based on larger data sets.
The Diagnostics Journey Atlas paints a picture of how diagnostics deliver meaningful impact to healthcare systems and can lead to improved health outcomes. There is no doubt that the road to revamping incumbent financial structures will be long and not without its challenges. Nevertheless, all countries can benefit from rethinking value assessment frameworks.
How is the World Economic Forum bringing data-driven healthcare to life?
The application of “precision medicine” to save and improve lives relies on good-quality, easily-accessible data on everything from our DNA to lifestyle and environmental factors. The opposite to a one-size-fits-all healthcare system, it has vast, untapped potential to transform the treatment and prediction of rare diseases—and disease in general.
But there is no global governance framework for such data and no common data portal. This is a problem that contributes to the premature deaths of hundreds of millions of rare-disease patients worldwide.
The World Economic Forum’s Breaking Barriers to Health Data Governance initiative is focused on creating, testing and growing a framework to support effective and responsible access – across borders – to sensitive health data for the treatment and diagnosis of rare diseases.
The data will be shared via a “federated data system”: a decentralized approach that allows different institutions to access each other’s data without that data ever leaving the organization it originated from. This is done via an application programming interface and strikes a balance between simply pooling data (posing security concerns) and limiting access completely.
The project is a collaboration between entities in the UK (Genomics England), Australia (Australian Genomics Health Alliance), Canada (Genomics4RD), and the US (Intermountain Healthcare).
We’re at a pivotal moment in healthcare history. For decades, diagnostic tools that have contributed to improving patient care have been on the fringes. It has taken a pandemic to bring visibility to their critical role, but we can no longer afford to ignore their value. By harnessing the power of such innovations and enabling greater access to life-improving and life-saving diagnostics, we can collectively realize the vision of a better, healthier world.