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Episode #2: The Future of Health

Life Sciences Connect

Our health systems today comprise of a collection of disconnected services which are designed to diagnose and treat people once they are ill, often at a stage where they require acute interventions. As populations and their health needs have grown, the gap between demand and supply has increased and health inequalities have grown. 

Only a small and shrinking proportion of countries health care budgets have been focused on prevention. As a result, there is limited resilience in our health care systems and the COVID-19 pandemic has exposed our health care systems and their ability to respond to such an event.

Imagine instead a future based around health longevity where prevention and early diagnosis is a central tenant. Sophisticated tests and tools that mean most diagnosis and care takes place at home and importantly the consumer is at the centre of the health model. Will the lessons from the COVID-19 pandemic enable such a Future of Health?

In the second episode of Life Sciences Connect, we explore how the COVID-19 pandemic has accelerated the move towards the Future of Health, where technology and data enable health care that is more personalised, predictive, preventative and participatory.

This episode is led by our host Karen Taylor. Karen is joined by John Haughey, Deloitte’s Global Life Sciences Consulting Lead and Sebastien Burnett, General Manager of ConvergeHEALTH Europe.

This episode explores:

  • How technology will be used to harness health data effectively and accelerate patient treatment pathways
  • How health data could be managed in the future by consumers, health care providers, employers, and other parties
  • The changing perceptions of health care on a national basis from the individual to wider health ecosystems
  • The impact of the COVID-19 pandemic on formal institutions, the adoption of new technologies, and the lessons learned for possible future pandemics

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    Karen Taylor (00:00:04): Welcome to “Life Sciences Connect”, Deloitte’s Podcast on the Life Sciences industry. This series features conversations with leaders from across the Health Care ecosystem sharing their insights on the critical issues facing the industry today.

    Karen Taylor (00:00:30): Hi my name is Karen Taylor, and I lead Deloitte’s Centre for Health Solutions, an independent research hub that supports Deloitte’s Health Care and Life Sciences industry teams. One of the most fascinating aspects of my job is being able to explore with industry leaders, their views on the Future of Health, the solutions they envisage will transform services and the impact this will have on people’s lives. At Deloitte, we envisage a Future of Health in which digital transformation enabled by interoperable data and open secure platforms will lead to a paradigm shift where health care revolves around sustaining wellbeing rather than responding to illness. It’s all too evident today that our health systems comprise of a collection of disconnected services designed to diagnose and treat people once they are ill and often at a stage when they require acute interventions. Planning focuses on the number of hospital beds, doctors, nurses and other resources plus populations and their health needs have grown, the gap between demand and supply have grown and health inequalities have grown alongside this. Only a small and shrinking proportion of most countries health care budgets has been focussed on prevention. As a result, there is limited resilience in our health care systems and the COVID-19 pandemic has exposed this lack of resilience of how prepared countries were to respond to such an event. Imagine instead a future based around health longevity, where prevention and early diagnosis is a central tenant, where the onset of diseases in some cases the diseases themselves could be delayed or eliminated altogether. Sophisticated tests and tools that means most diagnosis and care takes place at home and importantly, the consumer is at the centre of the health model. Interventions and care will be more predictive, preventative, personalised and precise but also less complex, less invasive and cheaper. Not only will consumer have access to detailed information about their own health but they will also own their own health data and play a central role in making decisions about their health and wellbeing. In the next twenty minutes, we will discuss the Future of Health, the impact that interoperable data can have on this future, the technologies to harness the data effectively and how this will help all the players in the health ecosystem to recover in the short term and the medium term and importantly prepare fully for whether the next peak or indeed any future pandemics. I am joined by John Haughey, Deloitte’s Global Life Sciences Consulting Leader and Seb Burnett, General Manager of ConvergeHEALTH Europe. Before we start, I would like to ask my two guests to introduce themselves. John?

    John Haughey (00:03:08): Yeah. Hi! My name is John Haughey. I work out of our London office for Deloitte and I oversee all of the work that we do in the Life Sciences space which covers Pharma, MedTech and Biotech and private health care on a global basis. Seb?

    Seb Burnett (00:03:24): Hi! My name is Seb Burnett and I am the general manager for ConvergeHEALTH Europe. Six years ago, we foresaw a trend around how data, health data and digital engagement was going to really drive forward the Future of Health and we built a business, NASA enabled business, called ConvergeHEALTH to help accelerate that reality.

    Karen Taylor (00:03:44): So, the Future of Health does envisage a move to a much more predictive, preventative, personalised and participatory future where health is designed around consumers. A lot of our predictions have been looking quite a way into the future. But what we have seen is an increase, an acceleration in the adoption of the technologies that makes the future that much closer. John in your view what is it you are seeing? And what do you think is important about achieving that future?

    John Haughey (00:04:19): Well I guess just to sort of go back a little bit Karen. A few years ago, we put together a piece on the Future of Health. We were trying to look at 2040 to make some predictions about what was going to happen in that timeframe. What we have seen with COVID-19 is that the future has been teleported to now. So, everything that we were talking about around virtual care, around remote patient monitoring, a number of changes that we thought we would see in the health system have actually arrived through the necessity of the response to COVID. I guess the other thing that we have seen is you know normal periods of delivery have been massively concertinaed and things that would normally have been achieved in maybe years, have been achieved in sort of days and weeks. I think that sort of massive change in not only in the health system but also in the private sector side means that people are going to be a lot more aggressive about delivering on the Future of Health because in the ‘new normal’ – which is a phrase I hate – but it is the reality that is going to be an absolute necessity.

    Karen Taylor (00:05:35): And Seb, obviously one of the things that underpins the future is the massive amount of data that is available. We had to pivot very quickly to a new way of delivering health care systems to adopting technology particularly in the interface with patients. We have almost done that without looking too much at the data. Is there a time now to sit back and think about how we make better use of that data to make sure those decisions we take are grounded in a reality?

    Seb Burnett (00:06:10): Thanks Karen. Yes, I do think there is. I think we have made these brave past changes to pivot to these new technologies. I do think that data is going to create a much greater opportunity in the future. It’s not just thinking about the data you collect from clinical practice but also thinking through other types of information, data that allows you to kind of quantify and really personalise your interaction with that patient as a person. So, if you think around some of their genomics profile for instance, some of the way they are feeling and the environment that sits around them. If you think about how you really need to be able to treat a patient and support a patient for the future, we need to take all these different types of data into account to really make sure that you are encouraging them to act in the best way. And often you are going to see more behavioural insights and behavioural nudging that is going to start becoming really important in the future to make a real change. While a lot of treatment in the past has been focused on how the drugs work in specifics regiments or treatment pathways, I think we need to start looking at personalising not just only the medicine that we give patients depending on their makeup but also personalising how we interact with them, something we call precision engagement in general. I think the other point is very interesting as well but I think will be accelerated by COVID is around who owns and who gives access to use of this data. So at the moment a lot of this information has been captured and used by the physicians in the hospitals but I do wonder if the future world will see a devolution to the consumers owning their data and the consumers and patients working out who they share it with and what services they share it with as well.

    John Haughey (00:08:05): I think one of the big things that has changed – certainly we have seen a big uptake in people becoming a lot more interested in their health and monitoring that through various wearables that are available these days. What’s happened now through COVID is that, that now requires everybody to be aware and to be in control of how they are managing their wellness and their health and I guess that is what we were waiting for in really getting to a point where you have got critical mass to really change the Future of Health. Now COVID has made that happen. Everybody continues to be aware and I think that actually gives them momentum to really see a profound change in the way the health is delivered at a national and local level.

    Karen Taylor (00:08:57): It also, does it not bring in the issue of health inequalities and how supported people are in all shapes and forms to be able to respond to this understanding of their own health. I mean health literacy, digital literacy, we are asking a lot of some people whereas others are likely to be much quicker to embrace this. How do we ensure that we do not increase health inequalities as a result of this use of technology and people looking after their own health?

    John Haughey (00:09:35): I am hoping that what we will see is a real move back to community-based care and local community hubs starting to sort of develop around there in order to recognise, help and deliver against some of the inequalities that we see at a local level. That’s obviously going to take time and it is going to need investments to make it happen but I think we are going to have to have something which is a lot more personal to the local needs of the population in whatever area you live.

    Seb Burnett (00:10:08): And to add to that, I think there is obviously going to be a need to focus on that kind of local population needs for all. But also, I do think – and this is something I have been thinking a lot about recently – is that health and wellness have become much more personalised around what you as an individual want. I think the current pandemic is going to change what people value in terms of health and wellness as well. So, this is an assumption based on talking to many people but I think a lot of people in society often have kind of decided that health and wellness is around your weight and how you looked. But I actually think more and more people have started to think about other ways of managing their wellness and their health. You see a lot of people started to talk about the energy they feel on a daily basis. You start to think about people who start to try and understand about how they can actually increase their longevity kind of more than they probably did in the past as well. I wonder, coming out of this pandemic, whether there is going to be more thought around how you use your immune system and your response to new viruses, new cold and things that potentially we didn’t focus on as much in the past. And I do wonder – and I am not quite sure where this is going to go yet, whether there is going to be a shift of focus on a personal level around where and how you see yourself improving your health. Obviously, that’s different to how the health care system would be looking after you, but I think in the combination of the two is going to become really really important. I think that the consumer or the patient will end up taking more responsibility, more accountability for the health in countries where the public health is the predominant way of getting treated.

    John Haughey (00:11:55): Yes, I think that is a great point Seb in that if we look at cost of health care at the moment, they are no longer sustainable. The model as it currently works is broken and we have to look at how we are going to get to affordable health care to all to a point, Karen. Seb’s point around wellness and wellbeing – just given the level of knowledge now that people are sort of pulling into or learning about their own particular circumstances means that we do have the potential to move away from what, at the moment, is currently a break-fix model to something which is more proactive on the part of the individual.

    Seb Burnett (00:12:38): I would be interested to see also a little bit around how we continue to keep some of this thinking up-to-date with some of the scientific advances that are happening at the moment. Because there is a lot of science going on at the moment that is kind of driving forward our thinking around how our bodies work and specifically, I have been reading some books recently around ageing and actually how do you change your lifestyle to slow down ageing as well. Again, going back to the point around inequality in health care, how do you make sure that education, how do you make sure that that thinking and understanding reaches all of the population and reaches the population at the right time to be able to make the right impact, to drive that longevity, because if you can drive longevity as a person you slow down some of the diseases that are caused by ageing. The science is still evolving very fast in this. So, a very interesting area but I think it is going to evolve a lot in the next kind of two to five years.

    Karen Taylor (00:13:46): I completely agree. I think this sort of era about health longevity and understanding how ageing works and how we can actually do something to improve our chances of ageing well. Evolving our health care so that it is about heath and not sickness has really come to the fore as result of all of that new science. But also, some of the by-products of what we saw in our report on how AI is helping with drug discovery. And that’s not only helping to find new treatments, potential treatments for COVID-19 but also it is showing how ageing and ageing cells does impact our ability to be resilient and to respond to diseases. One of the things coming out of that is going to be how we treat those people that have had a bad impact of COVID-19 and they will need some support for their immune system. We need to improve everybody’s immune system but certainly that in turn will lead to a healthier ageing. The discussion we have just had has made me really think about what we are taking about here is that there is a lot of data around, we are getting a greater understanding from science, we are getting a greater information from genomics, from life style and behaviour and data, but data is only data unless we make it turn into insights. How can we use technology to turn that data into insights that will help us realise that Future of Health?

    Seb Burnett (00:15:26): I think the first point is around, we covered it earlier, making sure that data is interoperable. So being able to get access to the different types of information and data that you have and bring that and merge it altogether is going to be critical. One of the things we have learnt is that the more different types of data you bring together – be it genomics information, clinical information, environmental information – the more personalised you can really understand and drive from those insights. The big kind of breakthrough technologically that we are seeing kind of in the moment is a rapid advancement of AI technologies to bring together and drive insights from that data. AI has been around for many many years. I studied it in university, I am not going to tell you how many years ago, but unfortunately the processing power wasn’t big enough to actually make use of all these different types of data. We needed to have high-powered machines. Now there are all these new players that come into market that have cloud based technologies that allows you to process huge amounts of data to try and signal and drive insights, through all that information that suits your business needs. So, I think AI is a real driver from a technology point of view once you have pulled all that information together.

    John Haughey (00:16:48): I come at it from a slightly different angle Karen in that normally the type of organisations that I work with are very much recognises being in the Life Sciences or Health Care space. What we are starting to see now is that every company is a health care company. If you look at the Back to Work challenges that a number of employees have, that is going to require a level of knowledge about employees that has never been held by employers before – just on their personal health and how they are going to operate. There are of course the bigger technology players – the Googles, the Amazons – that are definitely moving into various areas of the Health Care space. They bring some fantastic assets to be able to help translate the huge datasets that we now have available to us. Those things are only going to increase. I guess the big challenge we are going to have is the ethical issues about access to that data and how that data is going to be used. Because as much as there is potential for some fantastic good to come out of the experiences that we have had in COVID, unfortunately there is a downside of that as well – whether we need to protect whether that is from a privacy perspective or from a cyber perspective. We need to be careful that the pace at which we have moved in the last few months, we maintain the positive elements of that but protect the individual at the same time.

    Seb Burnett (00:18:21): There is probably an interesting point around that in terms of where we see the future is going because currently as a consumer, as a patient I don’t own my data. It was captured by a number of different organisations across the world and they use it ethically or within the right constraints in which they want to use it. There is some work that has been done by Tim Berners-Lee around a project called Solid. The idea here is that you actually start to aggregate all the personal information about a person to a single area a pod then it is chosen who you share it to and with and for what purpose. I think this is an interesting model that if it does take off it will provide a real ability for patients and consumers to own their data and how it is used. They can choose more easily and more readily whether they share it for research purposes and specific research purposes which will advance science, I think is noble in certain ways.

    Karen Taylor (00:19:28): It’s all very well saying that people can decide who they want to share their data with but people have to trust that the data will be used in the right ways. Before COVID there was definitely a concern about people wanting to share their data. We did a big consumer survey across Europe and around about 50% people were willing to share their data with others, other than their main health care provider. A lot of people assumed that the data is being shared but when there was a quick straw poll as a result of COVID, an increasing number of people were just willing to share their data if it meant that they were protected and they could resume normal life sooner. So, there is something about when we keep talking about owning own data, what do we mean by owning own data and what are the situations that needs to be in place to encourage people to share it and for people to not just take it but use it?

    Seb Burnett (00:20:29): I actually think a lot of it is around the value you get for sharing your data and the direct value you would see. So, there is a lot of research that says that when you are using mobile apps or whatever it is, you get instant value back you see the value coming back to you as a person you put more value in that transaction. I think it is the same with sharing your data. If you see something you get back, for instance if I share my data with LinkedIn and they give me personalised preferences around articles I want to see. I am seeing direct value come back. So, I am more inclined to share some of my data with them. The problem we have always had within the health care domain for research purposes and outside of direct clinical care is that we generally don’t see the value back as a patient or as a person to myself. I bet if you went and asked the same patient or a cohort of patients that have had a disease, let’s say breast cancer for instance, I suspect you will see a larger proportion of them that are willing to share that data for research purposes because they recognise the value it could drive for others, or them, or their friends, or their families in the future. I honestly think it is about value transfer because inherently as people we want to see something back to the risk we have taken or the transaction that we have created.

    John Haughey (00:21:56): I think as a result of COVID that may have been the thing that has changed in that the value transfer Seb that you talked about there is very much on an individual’s level around what do I get back from this. We all have had a lot of conversations, discussions about purpose and it is a topic in many many organisations around affiliating to particular purposes. What COVID has done has actually opened people’s eyes to the transfer of value being at a family level or at a societal level as opposed to an individual level. I think that may change significantly trust around data and what it is going to be used for. Obviously, it needs to be defined in a way that they can understand and then they know that value is going to be derived from it at a greater level. If the industry or the health care system can help articulate that, at an individual level, there is massive promise for what we can actually do from a research perspective and from an information provision perspective around that data.

    Karen Taylor (00:23:11): What does all of this mean for the future of our health care institutions like hospitals. The focus during this pandemic has been on the hospital response, equipping the hospital to be able to respond to the increased requirements as a result of this COVID-19 pandemic. They have done a fantastic job. Their resilience has been amazing. They responded, they worked in different ways, they have changed the way the hospital operates. They have learnt that they can use technologies in ways that they were previously resistant to. So where will this take them? Where do you see the more formal institutions going in this Future of Health?

    Seb Burnett (00:23:58): As we talked about before, I do think that trying to get access to more information and more data around the patients has become more and more important around how you treat them. It’s not just around clinically what they are presenting with, but also around how you actually take into account some of their behavioural aspects of that patients and really kind of nudged them to follow the right treatment pathway. I am actually a big believer that we are going to see a very different way of treating patients and I think digital technology is going to really accelerate this. What I mean by that, is that we have used kind of predominantly drugs or surgeries in the past when we get to that kind of reactive care but I am a firm believer that actually looking at nutrition, looking at exercise, looking at other aspects of wellbeing has actually become a much much more important and a much more prevalent way of supporting patients across a variety of different diseases. I know for instance in the UK we have already started looking at some of those in some treatment pathways and it has become more embedded as a part of that. I do believe that having a better understanding of that patient in that situation at that point of time using data we will be able to support a better way of driving that personalised treatment pathway. And I do believe that digital technologies will also drive that kind of nudging and that kind of precision engagement that’s going to help to follow through on that as well.

    John Haughey (00:25:39): Yes, I think it is going to fundamentally change the system on a number of different levels. Technology is certainly one of them. If we look at just something like virtual consultation which I think a lot of people were fearful of is going to change the whole doctor patient relationship and was something that we were not expecting to have massive penetration over the course of the next couple of years, although it was definitely going to come. What we have seen is that being taken on by necessity and I just cannot see given the efficacy of it has now been proven that we are going to get roll back. In the adoption of technologies that we have seen, we very rarely see health systems going backwards. If they actually prove something and believe in it then they will adopt at scale and I think there are lots of technology solutions that we have seen put in place very very quickly just to ensure that the medical staff have necessary visibility and ability to actually monitor whether remotely or other. And I think those are then going to become a common part of the health care pathways that we have. I guess what I will like to see after this, unfortunately in the world we live it’s very unlikely that it will happen, is a harvesting of the lessons learned that we have seen on a national basis across the different care settings, whether primary, secondary or tertiary, and then to really start to apply lessons which have really made a significant difference in the delivery of care.

    Karen Taylor (00:27:23): John, this is a question for you as to whether we want to look into or mention the role that the pharma industry has had in this and especially the opportunity to change its reputation as a result of the fact that it is collaborating, partnering and putting aside the normal, the more – and I am going to use the word insular – approaches to things to work together to find a treatment. Is there something around that as part of what the future might look like with that much greater collaboration, cooperation not just for vaccines but for antibiotics for all of those threats that are global threats to the health of the nation?

    John Haughey (00:28:14): Yes, I think you know it has been very heartening to see the level of collaboration that existed in all parts of the industry but I don’t think ethos of the industry has actually changed or we have witnessed an evolution of that. I think for people that work in this industry what we have seen is what the norm is for why people actually work in this industry. I am very heartened that actually the world on large now has been able to see the good that pharmaceuticals, MedTech, health care companies actually bring. The visibility not only of organisations coming together in areas that they would have never came in before, in ensuring that from a purpose perspective there is consideration being given to not only the needs of the home nation but also what is happening in Africa or poorer parts of the world and really seeing sort of social enterprise being at the fore of the response of the Life Sciences industry.

    Karen Taylor (00:29:26): And Seb, do you want to add anything on Life Sciences response?

    Seb Burnett (00:29:04): Just very quickly I think that had this pandemic hit five years ago, maybe less, I think we wouldn’t have been able to deal with some of the aspects more slowly. Think around how quickly we were able to profile the virus itself – that happened within days. There are companies that are using AI to try and target molecules and target treatments which happened very very quickly. And the speed with which we got into clinical trails for this was fascinating and very very fast. I do think that the technology we talked about and the data availability that we talked about at the beginning of this podcast has enabled us to be able to deal with it faster. It will be really interesting to see what the level of technology and digital research has put into place to be able to speed up responses to similar things that may happen in future as well. So, we can actually react even faster. We don’t have to go into lockdown as long. There is still going to be probably 9-12 months before we get a vaccine out there. Can we make that faster in the future by use of technology? We shall see. I suspect the answer is yes but it will be interesting to see how much investment and effort is put into that going forward.

    Karen Taylor (00:30:58): Just thinking about everything we discussed, is there one thing you would want to say about the Future of Health?

    Seb Burnett (00:30:36): So, I have spent many years working in the data analytics and the AI space and I am often being called a data hippy in the past as well. But for me it is around being able to get high grade, high quality wwe call multi-model data. So, some information around – DNA, genomic profile, some clinical background and your environment - and being able to try and bring all of that together around a person I think will speed up and support research for the future and kind of which will exponentially increase (in spin). So, for me being able to kind of have those deep high quality multi-model data around individuals will be what I think will make the biggest difference from a research point of view but also then from a treating and clinical setting point of view.

    John Haughey (00:31:55): I think in many countries COVID has just shown how far we are away from having truly digital health. I think a number of governments are now making interventions in order to change that and what I would really like to see is true digitisation of health care on a national level with open data and proper consent mechanisms in place to ensure that we can use all of the longitudinal data that we have available to us on a country-by-country level in order to drive wellness in the population across all economic groups.

    Karen Taylor (00:32:38): Okay. I just would like to say thank you to John and Seb for their contribution to this discussion and sharing their insights and also to our listeners. I hope you will join us for our next podcast. Thank you. 

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