While we don’t know with precision what the future of health might look like two decades out, we can look at signals in the market today—and disruption in other industries—to start to paint the picture.
Fundamental shifts in innovation tend to occur in seven-year cycles. By 2040, three of these cycles will have passed—each building off the other. To determine where health might be headed, we should start by looking back three innovation cycles and consider where technology has taken us. In 1997—three innovation cycles ago—the first hybrid car was made available to the public.1 We now have fully electric cars and routinely see autonomous vehicles being tested on the roads in many of our cities. The following year, the first robot-assisted heart bypass surgery was performed.2 Today, robotic surgery is the standard of care for many procedures. In 1999, the first complete music album by a major artist was made available over the internet in advance of its physical release.3 Today, it is hard to remember buying music on physical media. In 2000, the first rough draft of a human genome was announced—a $1 billion undertaking that took 13 years.4 Today, for less than $100, we can learn whether we have the specific genetic variants for BRCA1 and BRCA2 (the genes associated with an increased risk of developing certain cancers, including breast cancer and ovarian cancer). We can do this through the mail and without an order from a physician.
A future rooted in radically interoperable data and open, secure platforms
What can we expect during the next innovation cycle, and how will subsequent cycles build on that? We expect that radically interoperable data will lead to highly personalized or hyper-local, consumer-centric health. Consider this: Rather than scribbling out a grocery list on the back of an envelope, today we can tell a digital assistant what items we need and then send it to our mobile device. Taking that a step further, maybe groceries are ordered automatically based on the consumer’s personal preferences, health status, or nutritional needs. During the drive to the store, an app might warn our self-driving vehicle about construction and direct it to an alternate route…and estimate how long the drive will take. The next innovation cycle might combine that technology with radically interoperable data and artificial intelligence (AI). While we are sleeping, our device or digital assistant might determine the pollen count is too high for our scheduled morning workout. Before we wake up, it has already connected with other digital assistants and moved our afternoon calls to the morning so that we can work out later in the day when the air quality is better. A refill on our allergy medication will be placed before we wake up and delivered by drone before we leave the house.
Here’s another example of where technology might take us: Consider current smart homes that allow us to remotely adjust the thermostat, set alarms, and turn lights on. Cycle that forward to a hyper-connected bathroom where the mirror and other tech-enabled appliances process, detect, and analyze health information. Highly attuned sensors embedded in a bathroom mirror, for example, might track body temperature and blood pressure, and detect anomalies by comparing those vitals to a person’s historic biometric data. Maybe this smart mirror even plays a skincare tutorial reminding the user to apply sunscreen. Analyses conducted by a tech-enabled toilet might be able to spot bio-markers that would indicate a potential change in health status long before symptoms appear. Such information could help keep consumers in tune with their health and quickly spot issues that could indicate the early stages of illness or disease. Rather than picking up a prescription at the pharmacy, personalized therapies based on a person’s omics could be dropped off via drone when needed.
From B2C to C2B
Based on where we are now, we can be reasonably certain that digital transformation—enabled by radically interoperable data and open, secure platforms—will drive the future of health. We expect that the term health care will become, simply, health, meaning peoples’ physical health and wellbeing plus their social, mental, emotional, and spiritual health. And consumers will be in the driver’s seat.
Radically interoperable data and AI will empower consumers in ways that are difficult to imagine today. The consumer, rather than health plans or providers, will determine when, where, and with whom he or she engages for care, or to sustain wellbeing. Health systems, health plans, and life sciences companies have shifted some of their focus to wellness, but it is still the system that serves the consumer. In the future, care will be organized around the consumer, rather than around institutions, and consumers will serve themselves.
Today, we are seeing more consumers who are interested in sharing their electronic health records (EHRs)—46 percent would be open to sharing their EHRs with their health plan or a hospital affiliated with a university, according to the results of our 2018 Health Care Consumer Survey. Fewer people are willing to share this information with medical device manufacturers (35 percent), state/public health agencies (34 percent), or pharmaceutical companies (31 percent).
Trust is critical, and to build it, some organizations today are letting consumers own their data:
- Apple Inc. recently added a feature to its smartphones that can access the user’s collated medical records. Apple worked with the health care community to take a consumer-friendly approach, creating health records based on Fast Healthcare Interoperability Resources (FHIR), a standard for transferring electronic medical records.
- Ciitizen is a start-up working to give cancer patients access to their own medical records. The company is developing technology to make it easy for patients to access electronic versions of their labs, genetic test results, and images, which they can share with doctors, researchers, and their broader care team. That level of sharing could help cancer patients connect to relevant clinical trials and potential lifesaving therapies.
This all signals to the potential paradigm shift of the health care consumer taking control of their health.
The emergence of information markets
Over the next 20 years, all health information will likely become accessible and—with appropriate permissions—broadly shared. Ensuring the privacy and security of personal health information and technical issues have kept interoperability from evolving to this point, but blockchain and other sophisticated security modalities could keep information secure. Once data security is resolved, consumers themselves can manage, sell, and potentially even market their health information.
Consumers will control this enormous pool of health information. Innovators could develop information markets that take personal health information (e.g., blood tests, medical exams, genomic and genetic information) and aggregate it to build virtual models of each consumer. If these consumer models are housed in the cloud, the information could be sold to companies that configure clinical trials, for example.
Stakeholders in 2040
The changes now taking place in health care are driving the industry toward large-scale disruption that is impacting both traditional and emerging players. The traditional sectors that now make up the health care ecosystem will likely look completely different by 2040. The lines will blur and we will see greater cooperation. Here’s a look at how we see the roles of stakeholders evolving:
- The future of clinicians: While traditional health care jobs won’t change much on the surface, they will be radically different. Doctors, for example, will continue to focus on the health and wellbeing of their patients, but their roles will change. They will make decisions in concert with technology, augmented with up-to-date data about the specific interventions that are tailored to the patient’s uniqueness. Even though clinicians won’t perform work the same way, nothing will replace the importance of humanity, empathy, and compassion—all of which are critical to enhancing health and sustaining wellbeing.
- The future of hospitals: While hospitals will always exist, the patients who use them will be different. Rather than focusing on general medical issues, hospitals will be places where only highly complex and specialized procedures are performed. Localized health hubs will provide more routine care and services. Rather than simply helping patients manage their care, health system leaders will be focused on enabling their wellbeing.
- The future of health plans: Successful health insurance companies will connect consumers to their health care. Along with paying claims, or even perhaps instead of, health plans will connect consumers to health systems, physicians, and wellness programs. In retail, AI helps map buying habits of each customer. That information is then used to generate highly personalized (and effective) marketing messages. The same thing could happen in health care. Using AI, health plans could help individuals make informed choices about the type of health coverage they buy. Highly predictive technology like this might leverage a much broader set of interoperable data sources and streams, which could help health plans improve the health and wellbeing of individuals and populations.
- The future of life sciences companies: Enabled by personalized technologies, pharmaceutical companies will be able to deliver tailored treatments to individuals, focusing on an “N of 1.” Mass-produced drugs—and the facilities in which they’re made—could become a thing of the past as pharma companies harness consumer data to create personalized treatments. Additionally, medtech companies will become the vehicles to deliver many of these personalized treatments, collecting vital signs and other crucial biometrics. Direct-to-consumer medical devices are already driving change in the market.
- The future of regulators: Federal and state regulators could become partners rather than traffic cops. Regulators understand that they can be a catalyst, rather than a barrier, to improving access to higher-quality, more affordable health care.
- The future of disease: We won’t be able to eliminate disease, but technology might help reduce the volume of disease and lessen the severity. We will be able to identify disease earlier, intervene proactively, and better understand disease progression to help consumers more effectively sustain their wellbeing.
As we embark on the future of health—a time where exponential change can accelerate the pace of disruption in the marketplace—I look forward to the promise that technology, innovation, and data hold. It will be truly exciting to see what the next health innovation cycles deliver as the most impactful trends in health come to the point of convergence.
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1 US Department of Energy (https://www.energy.gov/articles/history-electric-car)
2 National Center for Biotechnology Information, US National Library of Medicine (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3831835/)
3 Rolling Stone magazine, August 30, 1999 (https://www.rollingstone.com/music/music-news/david-bowie-to-release-entire-new-album-online-255118/)
4 National Human Genome Research Institute (https://www.genome.gov/10001457/2000-release-working-draft-of-human-genome-sequence/)