The emerging trends in healthcare
Dr Robin Clark
As we put another year between us and the Covid-19 pandemic, Dr Robin Clark, medical director for Bupa Global and UK, examines the emerging trends in healthcare influenced by the pandemic and what this means for our future care delivery.
Since 2020, digital transformation in healthcare has continued to accelerate faster than forecasted, driven by the changing expectations and behaviours of both patients and healthcare providers.
The Covid-19 pandemic also triggered unprecedented levels and adoption of innovation. For example, the messenger RNA (mRNA) used in Covid-19 vaccines is now being used to develop vaccines for diseases such as HIV and malaria and scientists are exploring its use in cancer treatments.
Given the now indisputable links between the environment and human health, Bupa, the NHS and other healthcare organisations have set the goal of becoming net zero by 2040.
This will mean they will need to re-examine and re-organise everything from supply chains to delivery of care and disposal of waste to enable them to reduce greenhouse gas emissions.
Volumes of preventative screening and routine care are still reduced and this is likely to lead to a steep rise in the diagnosis of non-communicable diseases, including cancers and diabetes, as well as the worsening of existing conditions.
While there is some investment in reducing these backlogs, it will take years and may limit investment in modernising services.
Against this backdrop, we see five trends emerging in the future healthcare landscape:
1 Empowered individuals taking control of their health
There is a continued trend of people empowered to take greater control over the decisions and actions affecting their health.
The driving force behind this will be the digitalisation of healthcare and increasing availability of personal health records (PHRs) controlled by the individual themselves.
Although PHRs are not new, technologies are now enabling a significant shift in the power balance of health data ownership.
For example, patients can now access their health records via the NHS app and, in future, they will be able to review their GP records more comprehensively than ever before.
And Apple has recently allowed iPhone users to privately share selected health record data with trusted partners.1
Personal devices
People will collate health data in their personal devices from their homes, connected devices and public and private health records.
This will give them one easy-to-access, longitudinal picture of their health status and they will be able to select what data they want to share and with whom.
This trend indicates a future where the current concept of who ‘owns’ data is different. In the future, digitally savvy individuals will want to have a greater say in their medical decision-making.
As patients’ involvement in their care grows, so too will their expectation for tools which allow them to access quality and satisfaction ratings for hospitals and doctors.
While they increasingly use these tools, they will be prepared to switch doctor or hospital because they have information on who provides the highest quality care.2
Organisations such as Bupa and the NHS will need to take responsibility for developing these tools and clinicians will need to make sure that they are using these tools to allow the sharing of information.
2 A shift from one-size-fits-all healthcare to personalised health via digitally enabled pathways
The digital-first approach to healthcare, accelerated by the pandemic, will result in the development of seamless easy-to-access customer journeys with pathways.
At Bupa, we are already enabling this through our digital GP app, our remote skin assessment service using smartphone and a dermatoscope to check potential cancer symptoms, and our condition-specific specialist centres which give patients all initial diagnostic tests and scans in the same appointment for a diagnosis and, if it is not cancer, be given the all-clear on the same day.
There will be a focus on the whole person and a holistic approach to health. This shift from a transactional patient-provider experience to a more holistic approach means that individuals will have greater opportunity to prevent health issues before they arise and manage disease.
It will also help improve the quality of life for individuals with chronic medical conditions. The hope will be that this can mitigate the increasing ill-health burden.3
3 Access to large-scale data will be essential to most effectively manage the health of individuals
Individuals’ health data can be collected from many different sources, including health records, test results, claims data, social media posts, data from wearables and home monitoring devices.
The healthcare industry is being transformed by collecting this data and allowing computer analytics to find patterns that humans cannot.
With access to more information, patients will benefit from:
Improved clinical outcomes at lower costs through early intervention and individualised treatment plans;
Real-time disease monitoring and surveillance;
Preventive healthcare through the anticipation of potential negative health events and preventive interventions;
More robust risk prediction for individuals;
More sustainable healthcare due to a reduction in unnecessary interventions and efficient use of resources.
4Precision medicine has the potential to remove significant waste from the healthcare system
Precision medicine, using genetic or molecular profiling, means that person-specific information will be known about:
How an individual person’s body works;
What represents a health risk for that person;
The peculiarities of a given pathogen or tumour affecting that person;
How any treatment might affect both person and disease.
It will give patients more accurate and detailed individual diagnoses and will enable quicker delivery of the right intervention, whether curative or preventative, at the right time.4
While it may be expensive in the short-term, over time, it is likely to benefit all healthcare stakeholders.
As well as giving patients faster access to the treatments they need, it will be able to avoid the risks and costs of incorrect or inappropriate interventions, improve outcomes, reduce waste and offer better value for money.
Not only will it help avoid inappropriate, often expensive, treatments, it will cut hospitalisations for serious adverse reactions.
This will ultimately allow for more effective use of healthcare resources.5 And it will foster a focus on outcomes, as this is needed to implement precision medicine effectively
5Within the context of rising costs, the expectations and needs of ageing populations will drive significant change in how the health of older people is managed
The population is ageing. Globally, there are 703m people aged 65 or over, a number projected to reach 1.5bn by 2050.6
And, as the ageing population increases, so too does the cost of care, not least due to an increase in multimorbidity and age-related conditions – including neurodegenerative diseases such as dementia.
We are now seeing more discussions about ageing across the healthcare sector and wider society – for example, about the changing meaning of ‘working age’ and the effects of a lengthy retirement on mental and physical health.
There are also changing perceptions about end-of-life decision-making and we are becoming more aware of the significant impact that climate change will have on the health of vulnerable populations.
Older people are calling for better quality of life in their later years and they want healthcare services provided close to home and their loved ones.7 The next generation of older people will be the first to be frequent and comfortable users of technology.
Research is also driving a proliferation of emerging innovations to aid the diagnosis and treatment of neurodegenerative diseases.
There has also been an acceleration of research into treatments to help people remain healthier for longer and technologies to help older people live at home for longer.
We need to consider how to support older people during retirement and beyond. The changing healthcare landscape and emerging digital and data technologies will create the demand and opportunities for products and services that make life-long care more affordable.
What this means for clinicians
We need to be ready to adapt to new ways of delivering healthcare. Developments in fields including genomics, artificial intelligence, digital medicine and robotics will begin to change the roles of clinical staff to ensure safer, more effective and more personal care for our patients.
We will need an increased level of digital literacy to support our patients in making informed healthcare choices enabled by technological advances. This digital transformation makes it an exciting time to be in healthcare.
Never before have we had access to so much information, both in terms of helping us achieve the best possible clinical outcomes for patients and demonstrating the quality of care we offer in the independent sector.
We also need to recognise that while some patients will embrace the new technology as it evolves and opportunities that it offers them, others will be more cautious.
We need to consider appropriate use of personal medical data and how we demonstrate this, as well as the benefits of technologies, to make sure that we do not disadvantage those who are wary or less computer literate.
References
1. Empower your patients with Health Records on iPhone. Apple, accessed 2021
2. A consumer-centred future of health. Deloitte, 2019
3. The shift from transactional to whole person care (WPC). ICF. (2020)
4. Doing well? Fulfilling the promise of precision medicine. Economist Intelligence Unit. 2020
5. Cost-effectiveness of precision medicine: a scoping review. Kasztura et al. Int J Public Health, Dec 2019; 64(9): 1261-71
6. Our world is growing older: UN DESA releases new report on ageing. United Nations Department of Economic and Social Affairs, published October 2019
7. Long-term care workforce: caring for the ageing population with dignity. OECD, accessed December 2021
