Four steps to global health

Tuesday, November 5, 2019

The World Health Organization (WHO) defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” According to Pratap Khedkar and Dharmendra Sahay of ZS Associates, writing in the Global Innovation Index 2019, at an individual or population level this goal can be broken down into four main areas: diagnosis, treatment, outcome, and wellness. As each of these areas continues to be influenced by the information revolution and technological progress, we should get closer to creating a holistically healthy population.

 

Here’s a closer look at the innovations transforming these four main areas of healthcare.

SOURCE: Global Innovation Index 2019

 

Diagnosis

To improve the way that patients are diagnosed, healthcare providers need to make tests and toolkits available to patients, have the medical skills to administer and interpret the tests, and be able to do so cheaply.

 

Thanks in part to the prevalence of smartphones and broadband, we can tele-diagnose patients and send the data to an interpreter rather than requiring patients to leave their homes.

 

Technological advancements are also streamlining the ongoing health tracking aspect of diagnosis by making follow-up tests, measurements, and other onerous parts of chronic conditions more convenient and less expensive.

 

Because it’s not enough to produce continuous data if the system cannot consume it, AI-based technologies are stepping in to digest the data. AI is “always on” and is looking for signals in data in a way that human reasoning might not be able to emulate, potentially making AI-enabled diagnoses more accurate and effective.

 

Meanwhile, AI-powered diagnoses could take the place of human-driven diagnoses in some cases. An algorithm might be able to detect pneumonia by listening to your cough on the phone, whereas a human would want to listen to your heart through your lungs. This is not just moving the process of diagnosing to a remote location but reducing the need for human expertise altogether

 

Treatment

AI can also help select the most effective treatments for patients. Providers are beginning to invest in specialized care—creating “focused factories” that treat a narrow problem repeatedly and drive costs down. Examples of this range from the Mayo Clinic in the developed world to Narayana Health in India.

 

Vertical integration—especially between payers, providers, and insurers—makes it worthwhile by aligning incentives so that cheaper treatments aren’t equated with revenue losses.

 

Increasingly, social determinants of health, which include attributes that drive 60% of your health and go beyond your genome and medical history, are making the enablement of health and wellness more effective in the long run.

 

For example, food insecurity and loneliness are bigger drivers of morbidity than drugs in the elderly population, and only a cross-sector entity would have the resources and influence to solve that.

 

Pharmaceutical drugs are a key aspect of treatment. One trend here is invention efficiency: drug development costs roughly double every 10 years. Can the development be sped up or automated?

 

A third of all AI investments in healthcare are projected to be in drug discovery, specifically using computer simulation to find better molecules faster. Companies are also beginning to leverage AI and data to reduce clinical trial costs and waste, though progress has been slower than desired. The other trend in drug creation is precision medicine, which focuses on increasing efficacy by designing treatments for a specific patient population.

 

Outcome

Pricing pressures in the US and the developing world are necessitating a shift to value- and evidence-based medicine. The overarching question is, are we getting good value for the countries’ total healthcare spending, and at what percentage of GDP is it affordable?

 

The value needs to include the obvious medical metrics such as disease indicators, morbidity, mortality rates, and lifespan. In the developed world, consumers need to be satisfied with the experience and patient-reported outcomes, as patients begin to demand much more than sick care.

 

The shift from cost to value is happening slowly because incentives aren’t well aligned. Healthcare stakeholders need an objective and comprehensive approach to evaluate the impact of treatment in the real world—not in an ideal, clinical trial world.

 

Wellness

We can expect to see continued taming of diseases during the next decade, but the WHO’s broader goal of well-being—and avoiding all of these interventions—is coming into focus in the developed world.

 

Will we soon be able to “predict and prevent” as opposed to “react and revive”?

 

The biggest wellness trends are in addressing social determinants of health—for example, identifying and eliminating food deserts and promoting vaccination penetration—and individual incentives, such as nudges for exercise, proper nutrition, and data collection.

 

Information technology plays a secondary role to the change management challenges that healthcare will face when turning its focus to wellness efforts.

 

The GLOBAL INNOVATION INDEX 2019 is the result of a collaboration between Cornell University, INSEAD, and the World Intellectual Property Organization (WIPO) as co-publishers, and their Knowledge Partners, Confederation of Indian Industry, Dassault Systemes, Sebrae, Brazilian Micro and Small Industry Support Services, and Brazilian Confederation of Industry.

 

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