The heavy trends in the field of health
1. Increasing aging of the population and chronic diseases
As in the western world as a whole, the population’s lifespan is increasing and the base of the age pyramid is decreasing. According to the Swiss Federal Statistical Office , the proportion of young people (under 20 years of age) fell from 40.7% in 1900 to 20.4% in 2012, while the proportion of older people (over 64) rose by 5.8% to 17.4%.
At the global level , the current growth rate of the older population, at 1.9%, has become significantly higher than the total population of 1.2%. Chronic diseases are by far the leading cause of death in the world, accounting for 63% of all deaths.
2. The challenge of decoupling health costs from the quality of care
The Switzerland spends 11.5% of GDP for the health system . The share of health expenditure in gross domestic product increased from 11.0% in 2011 to 11.5% in 2012. Health expenditure totaled 68 billion francs in 2012, which is 5.3% more than ‘last year. This increase is attributable in large part to the 2.3 billion increase in hospital expenditure.
The United States spends $ 8,508 per person on health care, nearly $ 3,000 more per person than Norway, the second largest spender. 23 percent of US adults and 13 percent of adults in France either had serious problems paying medical bills or were unable to afford them. In the United States, an estimated 1.7 million patients develop infections while in hospital, and 99,000 die from sequelae.
3. The challenge of the shortage of doctors and caregivers
According to the Federal Office for Migration, between 750 and 1’300 foreign doctors emigrated each year to Switzerland between 2002 and 2009 . At present, the Swiss health system is totally dependent on foreign labor and the expansion of the hospital workforce would not be possible without immigration.
For access to health, more than one billion people worldwide do not yet have access to a health care system . There is likely to be a shortage of 230,000 doctors across Europe in the near future. The number of caregivers in 36 African countries is insufficient to simply provide basic immunization and maternal health services. The unequal distribution of caregivers is also becoming an important issue.
4. Innovation of technologies and data
Advances in health technologies and data analysis are helping to facilitate new diagnostic and treatment options. They can also help to contain these new expenditures by restructuring care delivery models and promoting more efficient use of resources.
The adoption of new digital health information technologies has become the driver of change in the way physicians, insurers, patients and other stakeholders in the sector interact.
In this area, electronic medical records, telemedicine, mobile health applications ( mHealth ), as well as electronic medical prescriptions will play an important role.
There is also a critical need to focus on security and data privacy to provide patients with the confidence they need in a context that is at the heart of their privacy.
What are the breakthrough innovations in health?
By a pioneering article in the prestigious Harvard Business Review, Clayton Christensen was already asking the question: “Will breakthrough innovations cure health?” (“Will Disruptive Innovations Cure Health Care?”, HBR ). Let’s see the weak signals of what will bring change in the next 3 to 5 years.
1. The influence on behaviors
The movement of self-measurement (” Quantified Self “) is in full expansion. The sensors launched by Nike ( Nike + Fuelband ) or Jawbone Up are now complemented by even thinner versions.
Airo offers a wrist sensor that takes into account not only movement, sleep and stress, but also nutrition by spectrometrically scanning blood.
Sensotrack , a Swiss product, is positioned in the hollow of the ear and also measures blood pressure, oxygen levels and respiration.
The Google contact lenses , still in prototype, intended to help people with diabetes by measuring continuously the glucose levels in tears.
Apple is already offering in the next version of iOS, HealthKit , a platform to integrate metrics and display a dashboard from which to monitor health settings on a daily basis, while offering the benefit of looking back at discounting trends. shaped over a longer time.
Incentives to health
These sensors are already revolutionary, but an additional layer reinforces the effects. Most of the proposed health applications incorporate what is called gamification or “ludification” in French. This approach makes it possible to “bite the hook” more easily individuals and influence their behavior to better adhere to a desired behavior in a sustainable manner.
This change in behavior is essentially the key factor in the success of treatments, particularly for weight loss, chronic diseases and antibiotic prescriptions, for example.
For diabetics, mySugr offers an app that is similar to a diabetes diary, providing immediate feedback to help stay motivated. This involves earning points for every registration made that helps fight a monster, diabetes. The goal is to tame this monster every day through challenges related to personal goals.
2. Patient empowerment
Algorithms for guidance using the patient’s own data become more and more sophisticated. This makes it possible to reduce the uncertainty to a point where certain decisions can be made without necessarily having recourse to the specialists and to reserve this visit only in the necessary cases.
Biosense uCheck for example allows to have a portable laboratory using a calibration of colors taken by the camera of his smartphone.
Scanadu (device and software still in test) will diagnose a priori symptoms to know in principle when to go to the clinic and when we can wait without consequences.
SCiO funded participatively on Kickstarter can scan materials, food, and any physical object. The famous ” tricorder ” of Star Trek becomes a reality. A true portable spectrometer, it offers everyone an instant information on the nature of the object through their smartphone. Food, drugs, plants, and more can immediately be analyzed and recognized to see the striking demo.
Social health networks
Everyone knows, more than ever, patients are looking for information on the internet. Today they organize themselves to better know what treatments they use, what are the clinical trials and the latest scientific discoveries to better understand how this fits into the context of their experience.
Note that all this is not without highlighting risks. Of course, one has to trust medically and scientifically irrelevant opinions, and that’s the least. The major challenge is the collection of data by third-party organizations such as pharmas and insurance companies for whom this data is gold. In this context, the role of the public authorities is of paramount importance and they will certainly have to seize the issue quickly.
3. The orchestrated care
Opportunities for communication and remote interaction offer new channels for patients to connect with physicians and health experts. This allows first to obtain medical advice and assessments, then with video and other sensors, these virtual appointments can offer a level of care sometimes sufficient for a large part of cases. Of course, this must also lead to in-person visits that are still necessary and can even be increased in time and quality if the previous cases are treated more simply.
The HealthSpot booth is a sort of medical kiosk that dematerializes a visit to the doctor. Patients interact with healthcare providers certified through high definition videoconferencing as well as a series of connected medical devices that transmit biomedical information in real time.
The Goderma service allows to receive the diagnosis of a qualified dermatologist within 48 hours. The process is simple: upload a photo of your skin problem, answer a few questions and submit your request anonymously. The application is received and reviewed by a dermatologist and the transaction is entirely online until payment. If the dermatologists can not properly evaluate the case, the transaction is canceled and refunded.
GiraffPlus is a European project aimed at increasing the autonomy of people at home. The home robot is equipped with sensors and a “Skype” interface to interact with people. The system still under development is also paying special attention to ergonomics to keep the interaction as empathic as possible.
The Frauenhofer Institute also offers a robot that complements people with difficulties for certain domestic tasks or communication in the event of a fall.
The electronic medical record (known as Electronic Health Record EHR ) has for several years been a promise to provide a personal space around the patient, secure and to give access in a quick and easy way to his health data by avoiding repeat painful and expensive tests, make mistakes, waste precious time in transfers.
The Geneva medical file project MonDossierMedical.ch proposes to store the patient’s health data in a highly secure manner and make it available to different healthcare providers. The admitted health professionals can update the information but it is the patient who gives access through a digital key. The computerized patient record at the hospital level is also linked to this project to allow a more global follow-up.
Several other countries have similar plans, such as Austria, Estonia and the Netherlands in Europe.
As we can see, the world of health is constantly evolving through the redistribution brought about by people’s new habits, the challenges of aging and the economy, as well as the possibilities opened up by new technologies.
All this may seem very attractive and it is certain that the potentials are enormous. However, it seems necessary to adopt an iterative approach and continuous learning. This should lead us to prototype more concepts before launching the first head in these areas with serious consequences. Let’s also think that the set of opportunities offered often has a flip side too.
Two things keep coming back to mind: data protection and reappropriation, and the openness and sharing of data relevant to research and public health. . What about private interests? And value capture by intermediaries whose commercial principles are not to the benefit of their customers? What about transparency, more informed choices, and the benefits of greater openness? A recent report from the UK National Health Service also analyzes these aspects of greater openness of health data.
In this area as in many others, the user must remain at the heart of the process and his digital privacy protected. It is therefore imperative to start small, test the ideas and see what brings value to the patient who must remain the first beneficiary.