By Karen Taylor, Samrina Bhatti and Krissie Ferris, Deloitte Centre for Health Solutions
Over the past few months we have been developing ten predictions for our report, ‘The future unmasked: Predicting the future of healthcare and life sciences in 2025’. The predictions are brought to life through a number of ‘portraits’ imagining what the experience of individuals might look like in 2025, together with examples of the evidence available today to predict tomorrow. We also consider the key constraints that will need to be overcome to realise our view of the future and look at the impact that the COVID-19 pandemic is having on shaping each prediction. This week, we have launched the first two of our ten predictions: ‘From health(care) to healthy ageing’, and ‘Better public health drives better productivity’. This week’s blog provides a short history of the evolution of our predictions reports and selected highlights from our first two predictions.
COVID-19 accelerating the future of health
‘The future unmasked’ is our fourth report in our predictions series. In our 2014 report, ‘A bold future?’ we looked at what the world might look like in 2020. We were deliberately provocative and optimistic, recognising that the health system was changing quickly but that organisations were struggling to understand how to respond effectively and build a sense of urgency. In 2017, our report, ‘The future awakens’, focused on the world in 2022, again presented an optimistic view of the future while recognising that many in our industries were sceptical about overcoming entrenched constraints. Our 2018 report, ‘A bold future for life sciences regulation’, was focused on regulation in 2025. It imagines a new regulatory paradigm in which regulation is seen as an enabler as opposed to a constraint, with more collaboration to support adoption of innovations.
As might be expected, some of our previous predictions have been realised earlier than we might have expected, others were overtaken by events and some have still to materialise. However, none of our previous reports envisaged the impact that the extraordinary COVID-19 pandemic would have in accelerating the future of health by at least ten years.
The predictions that we are making in 2020, imagining the world in 2025, have inevitably been informed by the emerging evidence of the impact of the COVID‑19 pandemic on individuals, the economy, society and the health system. Throughout 2020, the pandemic has made an indelible impact on our healthcare and life sciences industry, with immeasurable levels of human loss and lasting changes to the way people perceive health risks. There has also been a growing appreciation and understanding of the contribution made by life sciences and healthcare organisations, and a new era of collaboration and trust between all parties to identify and implement solutions.
Traditional boundaries have become more porous or even removed, creating the opportunity for new healthcare behaviours, new business and funding models, and more effective collaborations among stakeholders, leading to new combinations of services offered by incumbents and new entrants. Crucial enablers include our improved knowledge of the role of genomics AI and digital health; the availability of new skills and talent; access to robust, interoperable data, analytics and insights; and new approaches to regulation and funding linked to value-based outcomes. Overall, we believe that these enablers will help deliver a future that is more predictive, preventive, personalised and participatory.
From health(care) to healthy ageing
The COVID-19 pandemic has raised people’s awareness on the risks posed by having a long-term chronic condition and the importance of our immune system. The pandemic has also shone a spotlight on the impact that SDOH have on people’s chances of contracting and surviving the novel coronavirus. It has highlighted that a main barrier to improving healthy longevity is a variation in the levels of understanding of the interconnected contributions to wellbeing and healthy ageing made by smoking, diet and physical activity. Moreover, during 2020 we have seen some parts of the population use this understanding to take charge of and improve their health and wellbeing, while others have increased unhealthy behaviours. This suggests that data, information and understanding alone is not enough and different groups of the population will need different motivators, incentives and levels of support to improve their health and wellbeing.
Improving health behaviour
In 2025 we envisage a world where increasing numbers of the population have unparalleled insights into their health and behaviours, from access to their genetics and health data, and through using apps and sensors to track and monitor their physical and mental health. For some, virtual health coaches, digital twins and digital health technologies will help make a difference to their own health (with an emphasis on digital inclusion) to drive behaviour change and reduce health risks. Individuals are also prepared to invest their own money in therapies that will help them age well, incentivised by insurance companies and other payers in response to evidence of healthier lifestyles.
Figure 1. Individuals will be able to use a number of resources to embrace their own healthy ageing
Better public health drives better productivity
The COVID-19 pandemic has highlighted gaps in most countries’ public health systems, including the need for a more robust, appropriately funded, national public health infrastructure. By 2025, we envisage that public health systems around the world will receive a higher percentage of healthcare funding. National statutory public health organisations will be accountable for maintaining and building a robust and responsive infrastructure, with a well-qualified workforce and modern data systems and mutually beneficial partnerships within and between countries and multiple stakeholders, including non-traditional players. Public health systems will have access to trusted, real-time, population and epidemiological data underpinned by intelligent AI-driven national screening and vaccination programmes.
Figure 2. A more resilient public health infrastructure will help protect the public, prevent disease and prolong healthy life expectancy
We believe that the pandemic has been a watershed moment in creating the social and political will to raise the profile and priority given to public health. In addition, it will redress the current drastically uneven distribution of public funding provided to public health prevention and promotion activities. Public health authorities now have the challenge to tackle the infodemic, increase access to accurate information about mitigation strategies, including the all-important COVID-19 vaccine, and instil confidence in the public about how they can protect themselves and other people. Vaccination campaigns and other health promotion strategies will also need to been co-created, based on strong public engagement and nudge interventions.
Tackling antibiotic resistance
One important public health issue that has had a lower profile during the past year, but is extremely important, is the ever-present and growing threat of antimicrobial resistance (AMR). Given next week is World Antimicrobial Awareness Week (WAAW; 18 to 24 November), we thought we should use this blog to also highlight this crucial public health issue.1 In particular, we consider that by 2025, there will be an overt internationally focused agreement on appropriate use of antibiotics and collaborative strategies to reduce antimicrobial resistance.
What we know today is that AMR is a silent pandemic, killing at least 700,000 people per year and concerns have grown that the COVID-19 pandemic has increased inappropriate use of antibiotics usage. If public health systems are to prevent disease and combat AMR, they need to focus on building a workforce that is well versed in the role and use of antibiotics (effective prescribing behaviour), and educate the public. One solution is to transform the imbalance between clinician knowledge and public expectations in point of care diagnostic testing that distinguish between bacterial and viral infections. The huge explosion in research and development for COVID-19 tests should be capitalised upon to drive the development and improve the use of such POC tests.
Our predictions continue to have an intentionally provocative and positive slant, as we contend that being optimistic is necessary if we are to be able to respond effectively to the health challenges we face across the world. More importantly, there is a huge body of evidence available today, some examples of which we feature in ‘The future unmasked’ report. These examples illustrate that the constraints that many highlight as preventing innovation and progress have been overcome by some organisations and what is needed is to identify and learn from good practice and adopt these approaches more widely. This is why we are quietly confident that overcoming these constraints and achieving the future we envisage is possible.