Health in 2040: 10 archetypes that could define the future of health

By Doug Beaudoin, principal, Deloitte Consulting LLP

Twenty years from now, we predict that the health care system we know today will look completely different. We are already beginning to see the early stages of this transformation. Health care consumers are starting to demand greater transparency, accessibility, and personalization…and that trend is likely to continue. Consumers will want automated, actionable health insights that come from smart artificial intelligence (AI) applied to interoperable data that is seamless and integrated across all platforms and applications. Many consumers will shop for modular and personalized health coverage and will receive care (mostly) where they are.

A wide range of companies—from inside and outside of the health care sector—are making strategic investments that could be the foundation for a future of health that is defined by radically interoperable data, open and secure platforms, and consumer-driven care. These organizations illustrate early innovations that can help personalize health care, enable consumers to make more informed decisions about their health, and leverage AI and other emerging technologies to harness and share data.

Consider some of the announcements that companies have made in just the past few months:

• Amazon Web Services announced the formation of Comprehend Medical, which uses natural language processing to mine unstructured medical text from electronic medical records (EMRs) and other patient data.¹ The company says the data could eventually help consumers make more informed decisions about their own health and improve patient recruitment for clinical trials.
• During the Exponential Medicine 2018 conference, executives from Human Longevity, Inc. outlined their Health Nucleus program, which maps out a participant’s entire genome. For about 15 percent of participants, the program identified actionable responses that could increase their life expectancy from one to nine years.²
• Apple, Inc.* is moving toward a device-enabled future in which consumer devices not only play a greater role in health care, but also put patients in control of their health information. The company’s Apple Watch Series 4 wearable device, for example, includes an EKG sensor that can alert the wearer to irregular heart rhythms.³ Apple’s HealthKit platform provides a central repository of each user’s health and medical data, and the CareKit framework for apps helps users understand and manage their medical conditions. Apple’s ResearchKit framework could help medical researchers gather data.
• DeepMind, an AI research firm Google acquired in 2014, recently said it is using Google’s scale and experience to create an AI-powered app that can assist nurses and doctors. This app could wind up being similar to Google Maps, but instead of helping drivers get from Point A to Point B, it could help clinicians navigate clinical pathways.
• Microsoft Healthcare says it intends to combine cloud computing, machine learning, natural language processing, omics data, and AI to tackle cancer.⁴ The company’s researchers expect the technology to help oncologists sift through mountains of biologic research data to determine effective, individualized treatment.
• During a conference, the CEO of Bind Benefits explained the concept of “on-demand” health coverage, which his company is making available to self-insured employers. Copayments are priced on a sliding scale based on quality outcomes and the setting where care is delivered.

These examples point to a broader shift in life sciences and health care that is only beginning to form and signal a new future of health. I expect the pace of innovation in this sector is going to accelerate in 2019.

Jump ahead 20 years…How will innovation play out?

We don’t expect to have eliminated disease entirely by 2040, but by using actionable health insights driven by interoperable data and smart AI, we should be able to identify illness early and intervene much more quickly. This can pave the way for a future focused more on well-being rather than treatment.

Largely replacing the traditional industry segments we have now (health systems and clinicians, health plans, biopharmaceutical companies, and medical device manufacturers) we expect new roles, functions, and players will emerge. We expect the future of health will be made of three broad segments. Within these segments, we envision 10 sector-agnostic archetypes:

Data and platforms can generate the insights needed for personalized, always-on decision-making in the new health ecosystem. These archetypes can serve as the backbone for the health care ecosystem of tomorrow.

1. Data conveners: Data-gathering organizations will have an economic model built around1. aggregating and storing individual, population, institutional, and environmental data. These data can be used to drive the future of health.

2. Science and insights engines: Some organizations will likely have an economic model driven by their ability to derive insights and define the algorithms that power the future of health. These organizations will likely conduct research, develop analytical tools, and generate data insights that go far beyond human capabilities in care delivery.

3. Data and platform infrastructure builders: This new world of health will need infrastructure and platforms that can serve highly empowered and engaged individuals in real time (someone will need to lay the pipes).

Well-being and care delivery represent new virtual and physical communities that can provide consumer-centric delivery of products, care, wellness, and well-being.

4. Health product developers: The economic model of these organizations is driven by their ability to enable well-being and care delivery. While there will continue to be organizations that develop products, those products won’t likely be limited to pharmaceuticals and medical devices. They can also include software, applications, and wellness products.

5. Consumer-centric health (virtual home and community): Along with companies that develop health products, other organizations can provide the structure that supports virtual communities.

6. Specialty care operators: Two decades from now, we will likely still have disease, which means we will still need specialty care providers and highly specialized facilities where patients can receive care.

7. Localized health hubs: While there will be some specialty care, most health care will likely be delivered in localized health hubs. Localized health hubs can serve as centers for education, prevention, and treatment in a retail setting. Additionally, local hubs can connect consumers to virtual, home, and auxiliary wellness providers.

Care enablement includes the connectors and facilitators that can make the new health engine run.

8. Connectors and intermediaries: These are the logistics providers that will run the just-in-time supply chain, facilitate device and medication procurement operations, and get the product to the consumer.

9. Individualized financiers: Unlike the health insurers of today, these organizations will create the financial products that individuals can use to navigate their care. These organizations will likely offer tailored modular and catastrophic care-coverage packages. They can drive reductions in care costs by leveraging advanced risk models, consumer incentives, and market power.

10. Regulators: While we will still have regulators, we probably won’t view them as governmental traffic cops. They will set the standards for business transactions. The regulators of the future can influence policy in an effort to catalyze the future of health and drive innovation while promoting consumer and public safety.

Tomorrow’s consumers can expect the exponential changes I’ve outlined above—and they’ll vote with their feet and their wallets. Legacy stakeholders should consider whether to disrupt themselves or isolate and protect their offerings to retain some of their existing market shares. We anticipate that successful companies will identify and compete in one or a few of the new business archetypes above, taking into consideration their existing capabilities, core missions and beliefs, and expectations for the future.

For more on our vision for the future, visit our resource hub where you’ll find articles, videos, podcasts, and more.

* Apple, Apple Watch, CareKit, HealthKit, and ResearchKit are trademarks of Apple Inc., registered in the US and other countries. A view from the Center blog is an independent publication and has not been authorized, sponsored, or otherwise approved by Apple, Inc.

^{Endnotes
1. Amazon Comprehend Medical overview, https://aws.amazon.com/comprehend/medical/
2. Exponential Medicine 2018, November 5 session, http://www.gregoryschmidt.ca/writing/exponential-medicine-day-2-2018
3. Apple Watch Series 4, https://www.apple.com/apple-watch-series-4/health/
4. How Microsoft computer scientists and researchers are working to ‘solve’ cancer, https://news.microsoft.com/stories/computingcancer/}

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