We believe that traditional health systems are unsustainable. As populations age and chronic diseases multiply, designing systems that treat patients as passive recipients, diagnose their diseases once symptoms have developed and intervene via expensive therapies is a path to ‘medical meltdown’.
In this situation, some systems are treating technological innovation as part of the problem, not the key to solving it. Yet the tools to create a smarter, more efficient approach are now on our doorstep. Genomic and other molecular testing can anticipate, classify and track disease as never before.
Digital tools can empower people, before they become patients, to live healthier lives, monitor their own health and even compete with each other to stay out of the hands of the health system. Or, once they become patients, to adhere to their treatment and manage their own disease intelligently. And these treatments no longer need to be prescribed on a ‘trial and error’ basis. Molecular diagnostics can discriminate between patients with similar symptoms but different underlying disease processes.
We are much closer to understanding the processes of aging, processes that in some people lead to one ‘disease’ in another a quite different clinical picture, opening up the prospect of treating the underlying senescence of cells. In some cases these cells can be replaced by stem cell-derived therapies. In other cases, inherited defects can be identified by gene sequencing and the faulty gene replaced (or potentially ‘edited’) to restore normal function.
At the same time, medical imaging is racing ahead, enabling earlier detection of abnormalities and real time tracking of the effectiveness of treatment, ensuring that ineffective treatments are replaced by others as quickly as possible. Adding up all these possibilities we see that it will ultimately be only in rare cases that diseases need reach such serious stages that in-patient operations and lifelong drug therapy are required. Health systems will have truly become smart.
The question arises: which systems will reach that smart state first? In some ways, the most developed of today’s systems will face the toughest barriers in making the transition. They have strong vested interests wedded to the old model and are typically fully spent looking after the serious late stage patients and those showing up at Emergency departments. And they often have no ability to shift money from one budget silo to another – for example to pay for expensive diagnostics that save much greater costs in the therapeutics budget – or to fund new digital tools to place in the hands of the patients themselves.
It may be some of the less developed countries that can more readily shift their investments into next generation solutions. They may be able to ‘leapfrog’ more developed economies, as is happening in some other sectors. Certainly they should strive to be as ‘smart’ as possible as soon as they can, rather than replicating the infrastructure and approach seen in their more ‘advanced’ neighbours. New Medicine Partners is committed to working with health economies to identify, sift and implement smart solutions to bring more sustainable health systems ever closer.