Why is 2020 a turning point for healthcare?

Healthcare is continuously undergoing paradigm shifts. But now, for the first time in history, the transformation is reaching the deepest foundations of the medical profession.

At the start of each year, we all want to know which trends will have the most dramatic impact. But these predictions often fail because they try to explain a complicated world using oversimplifications. In an effort to avoid this mistake, for the last few months I’ve been making observations and doing some analyzing in order to paint a picture of healthcare today. I’ve selected a few shifts that may be the start of meaningful changes.

Over the years, the border between healthcare and innovations, academic medicine, and tech gadgets has been vanishing slowly but surely. This became official in February 2019, when the World Health Organization organized the first Symposium on the Future of Digital Health Systems in the European Region. Furthermore, the WHO established a technical advisory group and roster of experts on digital health, engaging figures such as John Nosta. What some called “a marriage of public health and digital health” has opened new doors.

Prestigious universities such as Stanford Medicine or Johns Hopkins have digital health divisions and do extensive research in this field. The last European Health Forum put “disruptive technologies” at the center of the discussion. This is not just hype anymore. Digital transformation is finally considered a critical tool for addressing the most significant challenges facing healthcare today. And a great deal has already been achieved. To learn just how much, check out the book “Informatics and Telematics in Health. Present and Potential Uses”, published exactly 32 years ago by the WHO.

Digital therapeutics, a subset of digital health, are evidence-based therapeutic interventions driven by high-quality software to prevent, manage, or treat a medical disorder or disease.

We’ve been talking about the capabilities of apps, wearables, AI, and digitalization in general for years. After years of clinical trials and tests, now it's a turning point in healthcare. New solutions – developed with physicians and research centers based on medical evidence with proven benefits for patients – are entering the market. They are meant not to revolutionize medicine and healthcare, not to disrupt them, but to strengthen them. The number of health algorithms approved by the FDA is growing exponentially. The EU’s new Medical Device Regulation (MDR) classifies health apps as medical products to ensure patient safety. The new law will go into effect in May 2020. It shows the evolution of digital tools and their growing role in health care systems around the world.

What’s more, Germany has passed the Digital Healthcare Act to allow doctors to prescribe apps in the same way as medicines. Digital therapeutics help patients manage chronic diseases, improve their lifestyles, and exercise at home following personalized plans. For the first time, health insurers are reimbursing solutions focused on prevention and early diagnosis. A few years ago that would have been unthinkable, but today it is becoming reality.

Every step of big tech companies such as Amazon, Apple and Google into healthcare is reported in the media. In 2020, we can expect more headlines like “Google buys FitBit,” “Amazon launches Amazon Care,” or “Apple Is Going After The Healthcare Industry, Starting With Personal Health Data.” This is not surprising – healthcare is a crisis-resistant, continually growing sector of the economy. According to Deloitte, global health expenditures are expected to increase at an annual rate of 5 percent between 2019 and 2023. Despite enormous healthcare budgets, in some countries healthcare remains unfriendly, inaccessible, and unaffordable for many patients. With the use of new technologies, health and social care can be patient-oriented, continuous, intuitive, and available whenever and wherever patients need it - if only we manage to apply them in health systems in an appropriate and ethical way. And that is a huge challenge.

Let’s ask ourselves a simple question: How is it possible that in 2020 banking services are more user-friendly than care services? Which of these two are more important for people? It’s no wonder that big tech companies with perfect customer service are becoming active in healthcare. There’s nothing wrong with that, but on one condition: they must follow core values such as patient equality, fairness, compassion, effectiveness, quality, and respect.

Amazon’s and Apple’s moves and announcements addressing healthcare also motivate “traditional” health providers to change the status quo. Besides, healthcare institutions should analyze what makes patients unsatisfied with the care they get. Sometimes this can illustrate the factors that are opening doors for big tech, suggesting how to earn back patients’ trust.

Instead of replacing doctors, Artificial Intelligence will augment and support healthcare and medical sciences. Autonomous cars equipped with AI systems will not only be more comfortable, but have the potential to be safer. According to the WHO, 1.35 million people die in road crashes each year – the population of Prague or Helsinki. An additional 20-50 million are injured or disabled. The leading cause is human error. Similarly, a recent study by Johns Hopkins estimates that 250,000 people in the USA die every year because of medical errors.

People sometimes make mistakes. It seems that AI is far less likely to be wrong and has the ability to learn quickly. We should make the best of these unique capabilities. More precise diagnosis and clinical processes can save thousands of lives. The time will come when autonomous cars will replace those with human drivers. In medicine, where there is no room for inaccuracy, we can expect a rise in the number of algorithms embedded in technologies. Just as nobody claims that self-driving cars will reduce the number of accidents to zero, it would be naive to predict that AI will definitively solve the problem of medical mistakes. But even a decrease of a few percent is worth the effort.

Along with voice assistants replacing keyboards, consumer AI technologies will be complemented with human-like emotions. For example, Alexa can already express feelings such as disappointment or excitement. In health applications, chatbots will learn how to imitate emotions such as concern, worry, compassion, and empathy. Is this the right way to go? That is another question.

Health is at the top of the hierarchy of human needs. However, it has a different meaning for different people, depending on their circumstances. For one person, health is a drug needed for a child who lives in a rural area; for another, it is a quick diagnosis when a fever develops in the middle of the night. But there is something that connects these needs: the element of time. Care and help are needed at the moment pain occurs or when unusual symptoms cause anxiety. Sometimes all the patient needs is the knowledge necessary to make the right decision.

For those who are healthy, health is well-being, a feeling that their health is under full control. This feeling of calm can be provided by wearables, which monitor vital signs and are integrated within the Internet of Things. The smartwatch market is expected to grow by about 16.2% each year (CAGR). The quantified-self or self-monitoring trend is driven by the desire to live healthier and longer. That is why it will snowball in the coming years.

By the way, who wouldn’t like to receive an end-of-the-year summary like the ones from Facebook or Spotify? Something like “Your health in 2020” or “the healthiest day of the year,” or “healthy rituals that helped you to stay in shape”. No matter what we do with knowledge like this, the possession of it already has value.

For years, doctors have been tempted by visions of more comfortable and efficient work. Electronic medical records should have stopped the tyranny of paper files, making information more accessible. Promises driven by digital hype have led to enormous expectations. The reality is disappointing: screens separate doctors from patients, and keyboards lead to physicians’ frustration and burnout. In 2020 we face the task of restoring trust in technologies.

Some innovations can help to address the problem. These include voice recognition applications, algorithms able to recognize keywords during a conversation with a patient and add relevant data to the EHR, remodeled EHRs summarizing the most crucial health facts and trends on a single screen, embedded alerts, and preliminary health assessments carried out in the waiting room. A collaborative effort towards building the doctor’s office of the future has begun.

Today, AI seems to promise more than it can actually do. Let’s cool down and focus on how this new tool can be used to improve medicine and healthcare. Asking the same clickbaity questions about whether AI will replace doctors or start treating patients autonomously brings no value to the discussion. The biggest challenge is to agree on what we want from AI and to achieve it.

Digital health is increasingly pervading daily life, whether it’s a smartwatch detecting atrial fibrillation, an app measuring the quality of sleep, or a fitness tracker counting the number of calories burned. Some of them have come a long way, from gadgets to advanced medical devices. Nonetheless, in healthcare, equity and equality matter. We are already seeing a change in thinking about what sustainable healthcare technology means. Especially now, when humanity is experiencing new threats, such as climate change, we should think and act following shared values such as “health for all”.

We’ve seen how technologies can divide and change societies. The coming years are bright for innovations that will help those in need, not only those who can afford them. Universal access to the internet and smartphones has created new opportunities. Information – available everywhere – is the most valuable resource in healthcare. It gives people the power to manage their own health and helps to close the gap between needs and the capacity to address them.

July 2017. The State Council of China released the “New Generation Artificial Intelligence Plan”, intending to become a leading AI power. February 2019. The USA announces the American AI Initiative to promote and protect national AI technology and innovation. France, Germany, the UK, Japan, and many other countries have rolled out or are working on AI strategies. This is not a “nice-to-have” but an essential factor in maintaining a competitive advantage.

AI is the most valuable of all resources today, determining a country’s economic power. And it has similar value in healthcare. Startups around the globe are taking the challenge to develop breakthrough technologies. This accelerates advances in medicine and strengthens research. Healthcare – once defined by harsh regulations and occupied by the monopoly of big pharma – is now opening up for new players. As a consequence, it is becoming one of the most innovative and lively sectors, an exciting place to invest.

A reasonable, evidence-based approach is essential in healthcare as in no other industry. In 2020, a balance between new digital technologies, science, the tradition of medicine, patients’ and medical workers’ expectations, and core values can begin to shape a better environment for the further evolution of healthcare.

BL/EN/2020/01/23/2