One of the biggest global challenges we face today is healthcare delivery. In terms of health-adjusted life expectancy, progress has slowed to a near stop despite increased spending globally; even more concerning, life expectancy has actually dropped for the second year in a row in the U.S., the first time in more than half a century. It is obvious that a new paradigm in healthcare is essential, and new ideas such as the Value Paradigm—which is the fundamental reworking of healthcare in which the shift towards outcomes puts the patient at the center of the healthcare navigation system—could be the new frame by which healthcare not only becomes less costly, but more efficient for healthcare providers, payers and most importantly, the patients. There are many areas in healthcare that must be improved upon. With $8 trillion projected to be spent on healthcare this year globally—and an astounding $18 trillion projected to be spent on healthcare by 2040—and little to no increase in desired outcomes, it is apparent that the healthcare industry is becoming conversely more expensive and less effective. In order to reverse this trend, there are several key areas that need to be overhauled, including: Basic Research. While research within the healthcare industry today is seeing many new and exciting transformative discoveries, basic research is often overlooked and underfunded in favor of complex innovations. A vast majority of key proteins, for example, have yet to be discovered, and funding for basic research has continued to decline, seeing a 20% decline in real dollars from NIH over the last decade. Without a refocus on basic research, treatment for today’s biggest diseases such as diabetes and obesity will not receive enough research and healthcare costs will continue to rise. Physicians and best practices. With varying levels of knowledge and expertise, many physicians don’t have the means by which to acquire knowledge on new innovations and best practices. It is crucial, therefore, to create clinical pathways that can provide up-to-date education and disseminate new findings to physicians around the world, regardless of location or other factors. Cost of early intervention. With chronic conditions such as diabetes, obesity, and heart problems continuing to plague large populations, prevention and early intervention are key to reducing the severity of these diseases. However, with the high cost of healthcare, many people are forced to delay their care, preventing them from obtaining the proper drugs and screenings needed to treat their condition and ultimately leading to deterioration of health and even death. This inability to afford early intervention treatment is also costly for insurance companies. In the case of diabetes, for example, someone with a low case of diabetes costs about $1,000 per month; once the diabetes has progressed, however, cost expenditures increase to $4,000 to $5,000 per month for the company. Healthcare outcomes must be measured. Despite vast amounts of money being funneled into the healthcare industry, very little of it goes towards measuring outcomes. In order to move towards a more value-based paradigm, however, it is crucial for data to be collected and outcomes to be measured in various areas in order to understand whether we are seeing true success and where we can improve. Measuring outcomes in patients needs to be standardized. In order to define and measure outcomes, the process by which to measure the progress of patients needs to be standardized based on factors such as specific disease and sub-categorization of diseases, demographics of those involved in the study and comorbid conditions. While the outcomes will ultimately differ based on individual factors of the patient, it is crucial for the process to remain the same. Technology can be used to measure progress and outcomes. With technologies such as the Internet of Things and the Cloud, new models of engagement can be created to not only help lower cost and provide assistance for patients but also keep track of data on a consistent and standardized basis that payers and doctors can then use to measure patient outcomes. Measuring, standardizations and outcomes need to be measured based on different timelines. While populations of today have a high degree of chronic conditions that are already in full swing, as science advances, future generations will most likely be able to prevent against these chronic conditions. Therefore, the outcomes and standards we measure for treating already-existent conditions in patients will need to be different from the standards against which we measure future—and hopefully healthier—populations. Bioinformatics is key to the future of the healthcare industry. In order to arrive at a more precise diagnosis and generate better outcomes for all patients, focus on tearing down silos within healthcare and opening up the flow of information is crucial to eventually creating predictive care pathways where patients can receive accurate diagnoses and treatment plans even before being evaluated by physicians. Silos in healthcare need to be torn down. In order to optimize the flow of data to follow patients from primary care to hospital to nursing and everything in between, silos within hospitals need to be torn down and collaboration at all stages of healthcare needs to be achieved. Once you begin correlating information on patients from radiology, pathology and genomics and bring all factors that make up the health profile of an individual into one setting, many of the mistakes that are made in individual silos can begin to be reduced and healthcare delivery and best practice can be optimized due to the collaborative work of each healthcare professional. With focus on bioinformatics, predictive care pathways can be created. Once a substantial mass of data has been collected on patient pathways and outcomes, companies can begin developing deep algorithms that can read patient records and predict future treatment plans and prescriptions for future patients before they even see a doctor. Sharing patient data within healthcare leads to improved outcomes. In an academic hospital in Europe, studies found that 30% of cancer patients were either over or under diagnosed and/or over or under treated for their disease. By having various silos across the data share data with each other through the use of technology, however, they saw a massive improvement of cost for the outcome.
The views presented in this article are the author’s own and do not necessarily represent the views of any other organization.