The future of diagnostics: Technology driven personalised and preventative healthcare in Europe
By Dr Aiden Hannah, Deloitte Centre for Health Solutions and Karen Taylor, Director, Deloitte Centre for Health Solutions
Diagnostics play a pivotal role across the entire healthcare continuum from screening, detection and prognosis to patient stratification and condition monitoring. Earlier access to diagnostic tests can help avoid serious adverse health outcomes and the higher cost of late-stage or unnecessary treatments. This week’s blog summarises our latest report, The future of diagnostics: Technology driven personalised and preventative healthcare in Europe, which explores the evolving role of diagnostics in shaping new clinical pathways and how the adoption of disruptive diagnostic technologies can help healthcare systems transition from volume-based to value-based care. We envisage a future in which diagnostics are crucial drivers of more predictive, preventative, personalised and participatory (4P) care.
Why diagnostic services in Europe need to change
The diagnostics industry comprises a wide range of devices and tests, from high value relatively low use imaging tests to low cost and high use in vitro diagnostic (IVD) tests. Our research considered diagnostics across this spectrum, including IVDs, imaging machines and digital products, apps and software. Our report draws on an extensive literature review, interviews with 40 key stakeholders, survey responses from 250 diagnostics companies, survey responses from 751 front-line clinical staff (clinicians) and insights from Deloitte colleagues.
Models of diagnostic service delivery have remained largely unchanged in Europe for the past 50 years. Tests have traditionally been performed in hospitals and centralised laboratories, often following a referral from a primary care practitioner or hospital specialist. Prior to the COVID-19 pandemic, demand for diagnostic services (including imaging, pathology, endoscopy and genomics), was increasing at a faster rate than available capacity. The disruption caused by the pandemic exacerbated pre-existing backlogs, strengthening the need for change.
However, the pandemic also catalysed innovation across the healthcare and life sciences industry, accelerating the development and adoption of new diagnostics and shifting the location of diagnostic testing out of hospitals and centralised laboratories and closer to the patient. Among our surveyed clinicians, 57 per cent said that they were seeing this shift and 77 per cent of our surveyed diagnostics companies reported that their products were already part of this move. Furthermore, 93 per cent of surveyed clinicians consider that adopting new diagnostic technologies will improve their ability to diagnose faster; and 83 per cent say that they will be able to obtain a diagnosis that isn’t possible with existing technology.
The challenges in product development and adoption
Appreciation of the central role that each of these diagnostics plays in European healthcare has increased substantially in recent years, but diagnostics companies still face many challenges in the design, development, funding, regulation and adoption of new products. Our research identified six overarching challenges that diagnostics companies face in the development and adoption of innovative products (Figure 1). These challenges have highlighted the need for radical transformation of diagnostic services.
Figure 1. Diagnostics companies face six overarching challenges in the development and adoption of innovative products
Overall, the top challenge diagnostics companies faced in bringing a new diagnostic device to market was the variable digital infrastructure in healthcare (51 per cent of respondents). Furthermore, data sharing was seen as the one most important change needed to improve diagnostic services. Additionally, over 44 per cent of companies ranked healthcare cultures and attitudes to technology enabled digital transformation and the regulatory approval process in the top three challenges they face. Solutions to these challenges are explored in detail within our companion report, Reforming diagnostics: Turning challenges into enablers.
A new diagnostic paradigm enabling 4P medicine
Disruptive technologies, science, and advanced informatics are coming together to transform the way we prevent, diagnose and treat disease. Diagnostics are no longer just about detection but play a pivotal role across the entire continuum of healthcare, from screening and diagnosis to patient stratification and treatment monitoring. New diagnostic technologies can transform care pathways and improve patient outcomes through faster and more accurate diagnosis, leading to earlier and more targeted interventions.
Among the clinician respondents to our survey, 63 per cent considered that as the healthcare sector transitions from a focus on acute intervention to one centred around prevention and wellness, the future of diagnostics will look somewhat different in 3-5 years’ time, but two-thirds think it will look ‘a great deal’ or ‘totally’ different in 6-10 years’ time (see Figure 2).
Figure 2. The likely evolution of how diagnostics will look in 3-5 years and 6-10 years
Source: Deloitte analysis of Sermo survey of 751 clinicians. Question: As the health sector transitions from a focus on acute intervention to one centred around prevention and wellness diagnostic technologies will likely evolve; how different do you envision the future of diagnostics?
Our clinician survey respondents expected a variety of technologies to improve the efficiency and effectiveness of diagnosis in the next 3-5 years, with the most likely areas being telehealth (83 per cent), AI (75 per cent) and biosensors (74 percent), but far fewer expected to be using cloud or quantum computing see Figure 3. However, over the next five years diagnostics companies are likely to introduce a range of technologies into their portfolios to improve the management and security of health data, such as cloud computing (96 per cent of companies) and AI (97 per cent). Moreover, blockchain, nanotechnology, virtual/augmented reality, quantum computing and digital twins are also likely to be introduced by over three-quarters of our surveyed companies during the next five years. These differences in expectations suggest that the industry has a crucial role to play in educating providers and payers about the benefits of these newer technologies.
Figure 3. Technologies that clinicians believe should improve the efficiency and effectiveness of diagnostics in the next 3-5 years
New diagnostic pathways will be crucial drivers of the future of health
Prediction, prevention and early diagnosis will be central to the future of health, a future that will be driven by transformational and disruptive diagnostic technologies. While diagnostics companies are well-positioned to drive the future of health, they cannot do it alone and will require partnerships with consumer technology and specialised digital health companies. Collaborations will also be essential in designing new value-based payment models that reward all partners for health outcomes and better management of prevention, early detection and wellness.
Our research identified crucial trends that will shape the future of diagnostics, including:
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- widespread adoption of biosensors and a growth in the use of companion diagnostics
- increased adoption of liquid biopsies and minimum residual disease monitoring
- direct to consumer testing
- automation
- the transformation of pathology and radiology using AI and advanced analytics.
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Conclusions
Healthcare systems across Europe are in a period of transition, shifting from largely reactive and episodic models of care that are increasingly costly and inefficient to operate to models of care that are more personalised, preventative, participatory and predictive. Enabled by innovative technologies, these models can deliver better value for patients and the healthcare system. Disruptive technologies are also changing ways of working across the health ecosystem, helping to bridge the gap in workforce numbers and democratise access to healthcare.
Diagnostics companies can capitalise on the opportunities arising from these changes to become insightful partners in clinical pathways, helping to deliver more patient centric, value-based care. These developments have the potential to transform the diagnostics industry, with ramifications across the value chain, affecting patients, providers, clinicians, scientists, laboratories and the biopharma industry.
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