The nature of the demand for healthcare is changing. Population, disease, and demographic patterns mean that the kind of healthcare that people need is different from what healthcare systems usually deal with. These trends mean that there will be a different approach, with the stress moving from the curative care that prevailed in the past, to the preventative care that is required in the future. The result will be a radically different form of healthcare that is simultaneously digital and personal.
A major factor behind this change is the empowerment of people using healthcare services. People now see themselves as much as consumers as they are patients. This is because people are more educated, more affluent, and more middle class, particularly in such emerging markets as the Middle East. They are far better informed than in the past. This makes them more demanding and more active. They are willing to seek the best option for their health issues, providing an incentive for healthcare providers to compete even more.
The disease pattern is also different from the past. There is now a higher incidence of non-communicable diseases such as cardiovascular ailments, cancer, diabetes, and mental health problems. Non-communicable diseases are chronic, which means that they often require long-term management. Today, affluence and an often inactive lifestyle mean that the prevalence of type-2 diabetes, for example, has risen in Middle Eastern countries. This leads to expensive, and complex to treat, long-term health issues.
Demographic trends are another factor. Life expectancy has lengthened in recent decades. That means there is a larger elderly population to care for with specific requirements that go beyond healthcare in traditional facilities such as doctors’ surgeries and hospitals. Coordinating care for these patients is as important as the type of care that they receive.
All of this means that there will be a different approach to healthcare. Already the impact of the shift from curative care to preventative care is being felt with notable stress on building more outpatient clinics, rather than large hospitals.
This transformation in healthcare will not, however, happen on its own. Rather digital technology and personalised healthcare will be two key enablers of change. Healthcare spending will also be dramatically different, and every part of the industry will need to change, from doctors, nurses, regulators, healthcare providers, and payers—be they governments, insurance companies, or individuals. The nature of providers will also change, with significant contributions from technology companies who could play as important a role as traditional medical and pharmaceutical players.
Enablers of change
The first key enabler, digital technology, will allow providers to deliver healthcare outside of facilities such as hospitals or clinics. Instead, healthcare systems can provide care through wearables and devices controlled by Artificial Intelligence (AI). For example, in the near future, you will be able to wear a shirt that monitors your heart rate and that sends the data to a virtual version of you (a so-called avatar) that contains your health history. In real-time, AI will derive lessons from these data, telling you what to do—whether in terms of exercise or nutrition. Another device will administer medication to you at the right time and in the right dose. The smallest change, and sign of trouble, will be detected rapidly, allowing for early and more effective intervention.
Healthcare providers will also use technology to conduct consultations through telemedicine. The tedious business of scheduling and travelling to routine medical appointments will become largely a thing of the past.
The result will be an improvement of health outcomes as vast amounts of data become available and are analysed. You will no longer have to participate in a clinical study to contribute to medical knowledge. You will just put on your wearable. Your data will be analysed centrally and anonymously, improving your healthcare and that of countless others.
The second key enabler, personalised medicine, will customise the delivery of healthcare to individual needs. Digital technology supports personalised medicine. A central aspect of personalised medicine is gene testing. This allows personalised medicine to start even before birth, with conditions identified before they manifest themselves. Such genomic testing gives people the chance to adjust their lifestyle to prevent the onset of disease, enhancing the shift to preventative care.
Personalised medicine is already contributing to making medicines more effective. At present, some 90 per cent of standard medicines are only effective for 30 to 50 per cent of patients. Personalised medicine leads to better outcomes as it uses genomic testing, medical history, and patient risk profiles to develop individualised treatments. The result in recent years has been a notable increase in some survival rates for particular cancers, such as myeloid leukaemia. Indeed, the greatest impact of these changes in healthcare will occur in precisely those aspects of medicine that are the most difficult and costly, such as oncology, haematology, cardiovascular, and central nervous system conditions.
Regulators in GCC countries can support the development of personalised medicine. They can develop a flexible regulatory framework to make it easier to receive approvals for these interventions. Regulators can release data that will facilitate the research that leads to more personalised medicine, with encouragement for the study of genetic diseases particular to the region. Governments can also assist by providing research and development funding and consider investing in promising applications.
This should encourage knowledge sharing among pharmaceuticals companies, healthcare providers, and researchers. There will also have to be reskilling and capabilities building for physicians and laboratory staff to be able to interpret genomic data. This can help to develop a GCC-based personalised medicine sector.
All of this has implications for the cost and reimbursement structure of healthcare. At present around 20 per cent of the population generates around 80 per cent of healthcare spending. The move toward preventative care encourages the 80 per cent to remain healthy, thereby, restraining the growth in healthcare costs. In particular, there could be financial incentives for people to take advantage of their ability to influence their own healthcare.
The healthcare of the future will be intelligent and personal. It will be characterised by continuous monitoring rather than occasional visits to medical facilities. People will be empowered to play an active role in their own healthcare, preventing illness rather than looking for a medical response. The result will be a healthcare system that can have better patient experiences, improved outcomes, and better-controlled costs.
Dr. Walid Tohme
This article appears in the March/April edition of Omnia Health Magazine. Other topics include AI in healthcare, patient safety, mobile healthcare and further updates around on COVID-19 from the healthcare industry.