An Industry on the Brink of Exponential Change: Health in 2040 | Deloitte US has been saved
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By Doug Beaudoin, vice chairman, US Life Sciences & Health Care leader, Deloitte LLP
My colleague Janet Foutty, chairman and CEO of Deloitte Consulting LLP, and I just arrived in San Diego for Exponential Medicine 2018—an immersive and mind-expanding week devoted to exploring the future of the industry. We will be leading a panel discussion focused on just that: an exploration of what the future of health might look like two decades from now. While we don’t know with precision how the future will play 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:
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:
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.
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/)
Doug Beaudoin is the Chief Information Officer for the Deloitte US Firms, leading all facets of technology. He is responsible for strategy, applications, infrastructure, support, and execution, and he is passionate about applying his client service and technology background to accelerate innovation in Deloitte’s portfolios and drive virtualization and digital transformation advantages in the marketplace. Doug is instrumental in the transformation of technology at Deloitte into a worldwide community of technology professionals working across member firms to serve Deloitte and drive synergies and efficiencies across our network. Beaudoin spends time working with major clients discussing technology strategy, trends, and leadership. He is a member of the Deloitte US Management Committee and serves as a Deloitte advisory partner to two large health system clients. With 30 years of experience in areas including the Life Sciences and Health Care industry, Beaudoin has advised many of the industry’s market leaders on their most strategic and transformative initiatives, driving shifts enabled by technology. Previously, Beaudoin served as Vice Chair and US Life Sciences and Health Care (LSHC) Industry Leader for Deloitte LLP, leading the overall strategic direction for the life sciences and health care practices, including audit, consulting, tax, and advisory services. He also served as Deloitte’s Health Care Global Leader and US LSHC Consulting Leader, as well as the Consulting Leader for the Deloitte Private client channel. He worked closely with Federal Health and served as a Deloitte advisory partner for several federal clients. Beaudoin’s deep IT experience includes large-scale digital implementations and technology transformation projects for both commercial and government organizations, incorporating the convergence of data and platforms. He led the development of Deloitte’s proprietary ConvergeHEALTH hybrid healthcare solutions business, directed at transforming the health care system toward health and wellness powered by radically interoperable data for personalized and seamless consumer experience. Beaudoin holds a Master of Health Administration from the University of Ottawa and a Bachelor of Arts degree from the University of Western Ontario. He serves on the Boston board of City Year.