When asked to write about the latest healthcare solutions, I initially thought to offer a review of the most interesting global technology trends.
After all, there are a wide range of fascinating, innovative products and practices that we can see in our laboratories and in our start-ups, with many of them having a potential impact on our lives and health.
I could also write about precision and regenerative medicine, progress in oncology and immunology, genomics, digital health, tele-medicine, how artificial intelligence can be applied to patient records, to predict, diagnose and manage the complexity of healthcare.
However, this has been done many times before. I want to share a point that in my opinion, is by far more interesting and impactful than the technology itself.
Of course, I am interested in new technologies, but it is because I see them just as a means to achieving something more important; their impact, the benefit provided to the patient, the citizen and the healthcare system.
"It is all about collaboration between different stakeholders, and creativity in developing new policies and business models beyond well-established practices"
The actual invention, development and launch of an innovative technology in healthcare, is not by itself a sufficient condition for success, as strict rules, risk adversity and resistance to change are deterrents for the community to gain real benefit from innovation.
Barriers to entry are the main reason why many potentially highly innovative solutions, remain at prototype level. The health sector is possibly the most resistant to the introduction of innovation and at the same time, one of the sectors that could benefit the most.
The health sector is characterised by established practices, business models and strong resistance to change which is motivated by caution for patients, strict regulatory approval, consolidated medical practices and economic interests.
Today’s innovation in policies, legislation and regulatory frameworks play a more important role than actual technological development, as far as the delivery of effective solutions to the citizen and to the patient is concerned.
This type of innovation should flow in parallel to research and development, and it is all about collaboration between different stakeholders, and creativity in developing new policies and business models beyond well-established practices.
There are several examples of fascinating medical innovations that may be ready to be implemented from the technological development point of view but require changes in policies, or at least a temporary derogation to existing policies.
Many examples can be mentioned, starting from the list of global healthcare trends I mentioned earlier.
Personalised medicine; the ability to use a patient’s genetic information to predict the effectiveness of the drug to be prescribed, tailored to their specific genomic profile is more effective, but has an unavoidable consequence - it reduces the market for the drug producer. The current system of rules that regulates clinical research and related investments is a deterrent to the introduction and marketing of custom-based patient solutions.
Access to patient data is another pertinent example. Anonymised patient data are the source that allows artificial intelligence algorithms to identify patterns important to improve medical practices. Surveys show that the public would be happy to make their own personal data available in aggregate form for research purposes. Despite this, in many jurisdictions, there is a very prohibitive legislative system that makes it impossible to process digital patient data.
Another evidence is the emergence of lifestyle-related illnesses (NCDs, non-transmissible diseases), today far more frequent than those transmissible (caused by infections). Cardiovascular conditions, metabolic diseases (such as diabetes) and neurodegenerative diseases (Alzheimer’s disease and Parkinson’s) and certain cancers are the main causes of hospitalisation today. Their causes are attributed not to pathogens, but to specific habits such as diet, lack of exercise, substance abuse, and stress. Technologies are ready to address this issue, and small investments in prevention may generate big savings and positive improvement of the quality of life. But the existing reactive model of healthcare systems (sick-care) is a deterrent to implementation.
In older people’s homes, a lower intensity but frequent care is what is needed, and it may be delivered through telemedicine, wearables, tele-monitoring solutions at a fraction of the hospitalisation cost. The technology exists, but its implementation is challenging, and policies, practices and regulations are the road block.
Even the way the procurement process in hospitals and government health departments are structured, through tenders open to competing suppliers, is a deterrent to innovation introduction. In fact, since tender is geared towards products already present on the market, the most innovative products may not yet be known to the procurement officers. Derogations to this process may be very effective in introducing innovation in a faster and wider way.
In conclusion, a government-led multi stakeholder approach to healthcare innovation is beneficial not only for the patients, but also for economic development.
Med tech investors will be keener to develop their projects in those areas where governments are more agile and ready to experience innovative delivery models, in derogation to established rules.
Technology will more easily develop and deliver benefit to patients, where governments learn how to lead multi-stakeholder partnerships, involving med-tech companies, regulators, researchers, healthcare providers, general practitioners and health insurance companies.