Deloitte Life Sciences and Health Care recently launched its vision for health in 2040. While some may think that this perspective about the future of health seems fantastical, Deloitte believes that there are sufficient signs and signals in the marketplace of the model that it describes beginning to emerge.
"Let me give you an example, 20 years ago we just sequenced the first rough draft of the human genome and it took 13 years to do and cost $1 billion; we never would've imagined 20 years ago that we could spit in a tube for less than $100, mail it in, and in a short period of time find out whether or not I have a certain genetic variance," Deloitte Consulting Life Sciences and Healthcare Practice Principal David Betts said.
"But we can do that today," he said. "So we have to suspend a little bit of disbelief, but at the same time there is enough plausibility and signals in the marketplace that give us the confidence to put this idea out there."
Radically interoperable data
So what does Deloitte predict will happen in health by 2040? Predictions include radically interoperable data will lead to highly personalised or hyper-local, consumer-centric health; the next innovation cycle might combine that technology with radically interoperable data and artificial intelligence; all health information will likely become accessible and – with appropriate permissions – broadly shared; and the traditional sectors that now make up the healthcare ecosystem will likely look completely different by 2040, the lines will blur and the industry will see greater cooperation.
First, Betts discusses how radically interoperable data will lead to highly personalised or hyper-local, consumer-centric health, and how the next innovation cycle might combine that technology with radically interoperable data and artificial intelligence.
"What we mean by radically interoperable data is that we imagine a world in which we can collect and convene a variety of data sources and data sets from different aspects of a consumer's life and that they are willing and able to share that data like financial status, behavioural health status, health status, their environment and activity, we can pair that up with data that describes more fully what's going on with weather and population health," he said.
The industry would use that data to drive very personalised recommendations, or nudges, to an individual to help them sustain their well-being, he said. If the industry is able to bring together a much broader and disparate set of data about an individual and the environment in which they're living, Deloitte believes the industry can use that data to develop more insight about their health that allows them to better manage their own health journey.
"So, in a world where we have a highly sensorised environment, where sensors are ubiquitous, always on and relativity invisible, we can gather data about an individual's activities, their health status and the environment in which they live, and through this radically interoperable data and open and secure platforms, we can use AI to enable a hyper-empowered consumer to own their own journey of health," Betts said.
This would allow the industry to do a couple of things, he said. First, the industry could predict and be proactive about changes in health status.
"And second, we can be proactive about sustaining well-being," Betts said. "Imagine if your virtual assistant knows you were out late last night and had more wine than you maybe should have and you have a scheduled workout for the day. What if we could provide a personalised care mechanism and supplements to get your body back in line with a healthy state?"
And rearrange the person's schedule so it doesn't have the individual working out at what the provider expects to be the height of pollen count for the day, but rather moves the person's schedule around proactively to position the workout in the afternoon when it's meant to have rained for 30 minutes and the provider expects the pollen count will be lower, Betts said.
"This radically interoperable data, open and secure platforms and AI, empower and engage consumers to more proactively own their own journey of health," he said. "Consumers are choosing to participate in this kind of environment because by sharing their data, they get value in exchange."
Broadly shared data
Betts has much to say on the prediction that all health information will likely become accessible and – with appropriate permissions – broadly shared.
"What we mean by this is that the data available around an individual and what we consider to be an individual's health data will be much broader than we might think about it today," he said.
"We're thinking of data that goes beyond the boundaries of a record of some transactional treatment, to a longitudinal, real-time understanding of an individual's biology, biochemistry, their genome and microbiome together with data about what's happening around an individual, we get a much broader, more complete real-time view of an individual's health, and consumers will be able to own their own personal health data."
Deloitte sees signals of this in the market today where one can aggregate their health data on their smartphone, connected watches or fitness trackers, to create a valuable data set that potentially could give them valuable insight, but also, potentially, be valuable to organisations focused on identifying new insight, treatment and intervention protocols and algorithms.
"As owners of that data, consumers control with whom, when and how they share that data with physicians, health organisations, product developers, science and insight developers, and healthcare providers," Betts said. "And you can imagine a world in which we have a highly secure mechanism for choosing how, when and where I share my data and with whom."
Extracting value from sharing data
Betts said he can, potentially, rent out a digital copy of his biology to a researcher and, if he has a rare disease, the researcher can perform in-silica tests for potential new treatment options and interventions. Therefore, he can extract value through that data sharing and no longer be just subject to someone else having access to his data. He can choose when, how and where he wants to use it. This is a fundamental shift from how the industry thinks about health data today, he said.
"In order to bring that world to life, you can imagine a world in which broad access to that data is a necessity," he explained. "And so, organisations that can build a level trust about how they use that data by providing value for that data, will be successful in this kind of a world. We move from a world just focused on fixing an issue, to one focused on preventing and getting ahead of diseases and promoting well-being. It's a fundamentally different model."
And finally Deloitte said the traditional sectors that now make up the healthcare ecosystem will likely look completely different by 2040. The lines will blur and industry professionals will see greater cooperation.
"The traditional players in the healthcare ecosystem today will be forced to evolve as the landscape becomes more consumer centric," Betts said. "We're moving from what has traditionally been a business to business healthcare model, actually past a business to consumer healthcare model, to a consumer to business model."
So the roles that different industry players will play will need to evolve accordingly, he said. The industry will stop thinking about siloed sectors of the healthcare ecosystem and will begin to see the blurring of lines between those sectors and the creation of what Deloitte thinks are different archetypes of businesses that can be successful in this future industry.
These take on three major categories: Data and platforms become one category of the industry ecosystem; organisations focused on care and well-being delivery; and a third category that includes the connectors and intermediaries - those organisations focused on financing well-being, connecting the various players logistically, and those standards-setters and regulators that create the framework within which competition takes place.
"These are not traditional models of the industry as it stands today," Betts said. "This will not only drive new sources of revenue and value, but also eliminate and force organisations to compete on a different basis than they do today. Therefore, we believe the lines will blur and we'll see greater cooperation and competition across various archetypes in order for organisations to be successful in this environment."
Essentially, the traditional roles that are played in today's healthcare ecosystem are disrupted in a significant way, Betts concluded.
Consumers treating the routine
"Some of it is automated, some is democratised and decentralised," he said. "So much of care delivered today is highly algorithmic and predictable, that we believe we'll get to a point where we don't need the intervention of a high cost, highly trained individual to treat the most algorithmic and routine situations."
For example, imagine if a child has an ear infection, the parent knows it's an ear infection, and the parent generally knows what she needs to treat it. What if she had an at-home diagnostic that would simply confirm her diagnosis, and through open and secure platforms grant her access to the treatment, and even deliver it directly to her doorstep?
"I could access the kind of necessary treatment without the engagement of a highly trained, highly specialised, expensive individual to confirm something that is very routine and algorithmic," he said. "This is the type of world that we envision."