As the start up, investment, and innovation communities convene this week at the J.P. Morgan Annual Healthcare Conference and as the future of “smart” comes to life at CES, we thought over what the “smart” means for health care and how innovation can help solve some of the world’s largest health challenges.
As incomes increase in societies around the world, so does access to modern medicine. As these societies move beyond addressing basic human needs such as food, clothing, security, and shelter, they look to establish health systems to allow their citizens to live longer.
In recent years, the growth of the number of treatments for disease has been awe inspiring. In 2017, the FDA approved more drugs than any year in the past two decades. At the recent Singularity University 2018 Exponential Medicine Summit, we were stunned to see the amazing array of innovation in health. Artificial intelligence (AI), regenerative medicine, robotics, autonomous drones, blockchain, radical interoperability, digital reality, and countless other exponential technologies on display at the Summit that could disrupt everything we understand about health and wellness.
While we celebrate the innovations of modern medicine, there is an ominous shadow that is being cast: cost. If the $3 trillion spent on health care in the United States was ranked, it would be the fifth largest global economy. By 2022, health care expenses worldwide are expected to reach $10.059 trillion. Some of the most modern therapies require such significant out-of-pocket expenses that they are sometimes well beyond reach. US employee health care cost has increased 75 percent from 2006 to 2018. In that same period, wages have only increased 25%.
All the while, life expectancy in the United States has decreased over the past few years and according to US Centers for Disease Control (CDC) Director, Robert R. Redfield, M.D., “Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide.” A recent analysis by Deloitte looked at the social determinants of health (SDoH) and Medicaid payments. The article concluded that states who look to incorporate SDoH into their health care payment policies can better address the socioeconomic barriers their citizens face, improve citizens’ health, and reduce avoidable health care utilization and spending. The step-by-step strategies outlined in this article can help states begin their journey toward achieving these goals.
So where could the exponential technologies beginning to take hold have the most impact? With social and environmental factors influencing upwards of 60 percent of health outcomes, we wondered how communities could be restructured to be organized around a disease using these technologies. According to the Deloitte Center for Health Solutions research, 80 percent of hospital leadership is committed to developing processes that systematically address social needs as part of clinical care. But much of that activity is ad hoc, and working to influence health at the community level continues to be a sporadic effort at best. The question is why? And what is likely to happen with the arrival of exponential technologies in health and society?
We have known for years that school, work, and community-based health education programs have an impact on public health and society. But now in a digital world where social media abounds with billions of people around the planet interacting and sharing experiences, it’s possible to also use digital communities to help combat disease. With AI processing the boundless social, personal, clinical, and claims data, patients could become empowered consumers and knowledgeable enough to help prevent some diseases. With the rise of digital therapeutics and diagnostics—enabled by enlightened regulators that are willing to keep the doors of innovation open while maintaining safety and evaluation—might we have technologies in the palm of our hand that could help in the future?
We are now working on the next generation of such virtual health solutions at Deloitte, with providers and patients able to interact, wherever and whenever they need to, in order to address health and disease in its earliest stages. The idea of communities rallying together to address disease is an idea we are calling “Smart Health Communities.” We think this is a concept that communities when augmented by new technologies, can move health and wellness back to where it begins—where we reside and live.
Take aging. The global geriatric care market is forecast to exceed $1.4 trillion by 2023. But what if these costs could somehow be offset? What if a community of seniors could take advantage of tools, platforms, systems, and frameworks that enable them to stay on a path to health and wellness and stay economically and socially productive? Beyond the potential benefits of purpose and happiness, there could be a financial and economic argument to be made for an elderly population that is more productive.
The same could be said for substance abuse. If everyone who needed care received it, the spend on drug treatment could reach $250 billion. This doesn’t even begin to include the economic impact in terms of lost earnings and productivity from early deaths and disorders. Digital technologies could help mitigate this impact if offered via already existing treatment programs or health systems. Consumers could have access to virtual reality tools to help them manage pain and reduce the use or of opiates and digital tools could predict when substance abuse issues are emerging. It is possible that this new model is not only more cost-effective and affordable, it could also build trust by offering patients 24/7 access, with the tools and support always there when they need it. The potential for impact is on all levels—not just a technological one.
Platforms developed for these communities can take advantage of such digital and exponential technologies as Internet of Things (IoT), augmented and virtual reality, and AI, with data then leveraged to make informed decisions. An engagement model can be tailored to that community that is citizen-oriented, social, connected to care, and enabled by scalable technology. It can also combine behavioral and clinical science, yielding evidence-based and substantially improved outcomes. And ultimately, these models can fundamentally redesign how sections of society work together to drive healthier communities.
Often innovation can be blamed as a driver of health care expenses, but that got us thinking further – what if these innovations could be used to completely redesign not only health systems, but the communities we live in? What would happen if technology helped address health care’s grand challenges by stopping disease where it starts? That would likely force us all to rethink the role of technology in society and the role of health in a digitally enabled community. These “Smart Health Communities” would have to rely upon exponential technologies, which by their definition get exponentially cheaper year over year and could indeed become incredibly afforable for communities, even the poorest ones. It may not be possible to deliver vaccines to remote villages with conventional transportation, but it may be possible with automous refridgerated drones. Communites ravaged by high sugar, low nutritional food choices, may be able to use social networks to help citizens find healthy, affordable choices as food deserts are associated with both education and location.
Using exponential technology to help make communities healthier could be the next step on the health care continuum. Yes, it may be the amazing role of technology in the operating room and in the treatment of disease that has grabbed the headlines so far, but if those same underlying technologies could build healthier communities to begin with, that may be one of the most revolutionary innovations of all.
 2019 Global Health Care Outlook: Shaping the future, Deloitte Global
 Addressing social determinants of health in hospitals, Deloitte US Center for Health Solutions
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