Breakthroughs to Empower Patients

One of the themes that emerged from our discussions about barriers in healthcare is that people do not have early and sufficient access to knowledge to form healthy, life-long habits and health decisions.

Moreover, the healthcare system treats people as “patients”, nor consumers or individuals.

But at the same time, we are living through a technological revolution that is empowering individuals, including in healthcare. Think everything from online hospital reviews to apps that provide health stats in real-time.

@ymedan, @AlexandraW, @katebatz, @nastyahaut, and @Jun_Suto, when we look two decades, what do you think are some of the breakthroughs we can expect (and potentially incentivize) that will empower patients?

For one, in 2 decades we won’t use the term “patients” to denote empowered humans.
It all starts and ends in early education of healthy lifestyle habits and making healthy food and clean environment widely accessible and affordable.

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I agree! Although I know some people, here in Europe anyway, are also wary of healthcare becoming too much of a market and don’t like the idea of people becoming “consumers” of healthcare. I think it could mark a positive shift - in power and decisionmaking - from healthcare providers to healthcare consumers.

That also goes to the discussion about healthcare being a business and current incentives prioritizing treatment over healthy living and prevention.

@JameyEdwards, @PTD3, @OnDigitalHealth, can I ask your input on this, as entrepreneurs and innovators? What are some of the breakthroughs you expect in the next 20 years that will empower power in the healthcare system?

I think the breakthroughs in healthcare will come via better, more specific information, for the patients, caregivers, and healthcare providers.

With the advent of sensors, wearables, and Internet of Medical Things (IoMTs), patients will have real time access to their general health condition, most likely via physiological vital signs transformed into information patients and caregivers can easily understand and act upon.

This same information, if warranted due to chronic disease or co-morbidities, could be monitored via AI assisted algorithms and alert healthcare providers prior to health conditions worsening or becoming critical. You can imagine health systems preferring to manage the flow and influx of patients this way, by making more efficient use of capacity and allocation of medical resources.

I can see AI being used to assist in rapid diagnostics. This could go a long way to treat patients faster with the right protocols.

Although some patients (or consumers) will feel more empowered with technology to monitor and manage their own health, humans by their nature are not all rational beings. We can see it with the vaccination rates for Covid. So hoping to see humans proactively care for themselves with better nutrition and exercise, is utopian thinking in my opinion.

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If we want to change anything we need to change people’s minds. Here in the US we are fighting an existing system steeped in the in-person visit with reimbursement and policy all centered around hands on body as the “gold standard.” And let’s be honest, these systems are like biology and want to survive and spread. This creates a huge headwind. We need some creative destruction in healthcare.

If we were to build a new healthcare system from scratch today, it would look totally different from the current system. We need new digital first care models that guide a patient to the appropriate level of care which match cost to acuity and better manage resources and the patient experience. We need better tools in the home from remote patient monitoring standpoint (think hospital at home) and a redefinition of a health system from bricks and mortar to an integrated care delivery platform where place is just one aspect of the broader continuum. I also think about the potential to create precision care teams that assemble expertise from across the world to treat a specific patient’s co-morbidities or genetic makeup.

The real breakthroughs will be not so much in the tech (we have all the tech we need to create tomorrows healthcare system today), but in the policy and regulations that drive the behavior (or how the tech is used) of the clinical teams. These can affect huge paradigm shifts in how patient’s can access their data (wouldn’t it be cool if patients “owned” their data and just granted access to the treating physician?), and what we incentivize clinical teams to do (maintain health vs treat acute illness), etc…New models of care are truly where the big advancements lie. Turning being healthy into a true part of a new “lifestyle” supported by policy and economic incentives would be a game changer. Imagine a tax break for leading a healthy life (eating well, exercising certain # of times per week, progress on weight loss or blood sugar management). The economic rent on society of avoidable illness is huge.

COVID lead to the rapid adoption of digital health tools, but there was no new whizbang tech that drove it. We used tried and true technologies to implement new care models catalyzed by a global pandemic. But as the pandemic waned, despite people discovering that it is easier, more convenient and of similar quality to do a telemedicine visit, we all slid back to in-person care, waiting in waiting rooms, taking time off work, paying for parking…because doctors couldn’t figure out how to get reimbursed for telemedicine…We need to treat the illness, not the symptom, and the illness is the existing system and model of care which arguably is the toughest thing to change. It will take courage, conviction, political mettle, new methods of training in medical school and more.

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Totally agree.
For me, digital health is all about empowering individuals to self-monitor and adjust one’s lifestyle to stay healthy. This is the ultimate manifestation of biofeedback

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Thanks for your comment, @JameyEdwards! It sounds to me that we want to shift from a healthcare system that is disease-focused to one that is health-focused.

@JeffQuintero, @riyamehta9001, @ahmerinam, @farhan, @marta, I’d like to ask for your input here to help us ideate on potential breakthroughs that could accelerate that change?

A good first step in embarking on pragmatically changing any complex system would be become familiar with some of the tools that can assist in gaining situational awareness. This is where systems thinking becomes useful.

I’m not convinced that we have a coherent shared understanding of a situation that can be acted on in a meaningful way. The parable of the blind men and an elephant comes to mind.

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Thanks for your comment, @farhan! Could you elaborate? How could/should systems thinking be applied in medicine and health?

@acoravos, it would be great to get your thoughts on this discussion as well! I know HumanFirst is working in virtual healthcare - how do you see patients being empowered in the next 20 years?

Agree on shifting from patients to humans. Would love to catch more disease and conditions before people cross into becoming ‘patients’.

It should become more important to make sure that clinical trial endpoints and care outcomes actually matter to patients: https://www.karger.com/Article/FullText/509725. Would love to shift to more quality of life measures in addition to some of the traditional ones (e.g., survival… did you die).

It’s also going to be important to think through data governance and data rights issues as we best power individuals (more here: https://www.thelancet.com/journals/landig/article/PIIS2589-7500(19)30001-9/fulltext).

And as sensors / wearables / tech becomes more integrated into the healthcare industry, we’ll likely need to think differently about security practices (e.g., here’s a cybersecurity hippocratic oath for connected tech: https://www.jmir.org/2019/3/e12568/, and also thoughts on why software-bill-of-materials will be critical: https://www.nature.com/articles/s41746-021-00403-w).

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Thanks for your comments, @acoravos! I think feeds neatly into some of the breakthrough ideas for empowering patients our Health Brain Trust has come up with:

  1. AI-powered (predictive) model that collects data from biomarkers, body scans, sensors, wearables, and user input. Contextualized to culture, place, and individual needs and wants. Integrates deep learning to predict preventable acute care. Enables users to understand their health at any time, make a plan for their health, receive actionable insights, and avoid sick-care.
  2. Google Maps for health. Health marketplace that frees health-related demand and supply from ZIP Code restraints.
  3. Hospital at home. Inexpensive, holistic home-based biolab that integrates virtual diagnostics and prescription along with data infrastructure and workflow.
  4. Data portability. Could be a blockchain, a digital passport, or a device under the skin that stores one’s health data. Would need to be safe against biohacking.

@marta, @TSeoh, @JameyEdwards, @a1m2r3h4, @adel1, I’d like to ask you how you would prioritize these 4 ideas? Which ones do you think are the most promising, most audacious, and - importantly - most in need of an XPRIZE competition?

As more patient health data is captured, providers have been testing how to best use the information to improve treatments. In this report, discover how health systems are transforming the patient process with real-time data sharing.

Thank you for all the insights you’ve shared here! This breakthrough discussion has fed into our prize sketches for:

  1. Digital Twin
  2. Mental Health