May 24, 2019
Healthcare in the year 2040
CEO Steven Collens shares his thoughts on what the healthcare system will look like 20 years from now. This article was originally published in MedCity News.
One day, a doctor will reach out to you before you even know you’re sick.
That’s the future we see coming to life in the technologies emerging from the healthcare innovation community.
One of the most interesting dynamics we see at MATTER — coming both from entrepreneurs developing novel technologies, as well as from large providers, payers and life sciences companies exploring new ideas — is the beginning of a fundamental shift away from the episodic, reactive and impersonal healthcare paradigm we are in today.
Episodic to anytime, anywhere
Most people today interact with the healthcare system for brief periods of time, and then disappear off the system’s radar until the next time they set foot in a doctor’s office, hospital, pharmacy or other care site, or when a home care provider comes to the house. It’s always been that way, and in a world where health insights come exclusively from human interactions it always will be that way.
We are starting to see changes, however, as a result of sensors and software that can harness data from people in real time, mostly passively, regardless of where they are physically. It won’t be long before next-generation wearable devices will be able to provide accurate, real-time blood pressure, EKG, blood oxygen level and respiration rate. The healthcare system will effectively follow us around all the time. Rather than checking in with our physician based on a predetermined schedule, we will rely on our devices to triage most issues before ever getting to a healthcare professional. We’ll be continuously monitored by sensors, triaged by software, and will see a healthcare professional only when necessary.
Reactive to predictive
Today, healthcare is delivered reactively. You have a stroke or a heart attack, and the system tries to repair the damage. First something goes wrong; then we notice that something has gone wrong; and then we hope the professionals can fix it. We are the most reliable warning systems we have today, and we generally base our decision to seek treatment based on how we feel, or how we look to others.
If we were really good at this job, we would notice that something was starting to go wrong hours, days or weeks before we experienced any material changes to how we felt or how we looked. We’ll never be that good — but machines will be. By analyzing the data that they will collect from us in real time, they will alert us that something might be starting to go awry before we or any physician would notice. Rather than waiting until we have a stroke to see a doctor, the system will notice that we are very likely to have a stroke in the near future and send a healthcare intervention to us that might stop the stroke from happening at all.
Impersonal to bespoke
Healthcare today is based on averages and norms. We know that someone who is obese, smokes and has high blood pressure is more likely to have a stroke than someone with none of those risk factors. But the tools to analyze risk factors and stratify people are blunt instruments. We don’t have enough information about individuals, or the ability to analyze the data efficiently, so these population-level views are the best that we can do.
That’s changing. It is becoming easier to collect and analyze a stew of various “omic” data and combine it with phenotypic information to enable a future of truly personalized health. For example: Rather than a woman learning that her weight means she is at higher risk of a heart attack, she will learn that, based on a potpourri of individual data, she has a 21 percent greater chance. Her treatment recommendations will also be tailored to her specifically, and might include a combination of medications, nutritional changes and behavior modifications unique to her individual situation.
Change is coming
Today’s healthcare model works well if the goal is to manage an acute condition, like a sprain, stroke or heart attack. It is not, however, a good system if the goal is to keep people healthy or manage long-term, chronic conditions. By 2040, the system will be optimized for those things. We will have an anytime, anywhere healthcare system that is predictive and bespoke, and that allows us to achieve better health outcomes at a lower cost.
In the four years since MATTER opened its doors, we’ve seen significant leaps in the technologies needed to make this fundamental shift a reality. But what’s needed to get to that state by 2040 involves more than just technology advances. We need a shift in the economic structure of healthcare which is, in many ways, a far more complicated challenge. Our acute-care-focused system reflects exactly how we pay for care — and that needs to change. The single greatest driver of innovation will be the shift away from a cost-plus healthcare model to one where the economic incentives of providers, payers, employers and individuals align around delivering the highest quality care at the lowest cost.
We see small examples of this incentive loop every day. For example, the introduction of financial penalties around 30-day readmissions have spurred many entrepreneurs to think about how to keep people from returning multiple times to the hospital. If the penalties were more significant, there would be even more demand for these solutions, and we would see even more innovation in this area. (I’m not advocating for more significant penalties, just pointing out the real-life examples of where we see new economic incentives sparking innovation.)
The overall economic framework won’t shift overnight, or even in the span of a few years. But it must continue to evolve, and by 2040 we should be in a position where healthcare economics encourage innovations that keep people healthy, manage their chronic conditions, and do so more efficiently than our system does today.
Achieving this vision for healthcare in 2040 will require creative new collaborations that bridge policymakers, industry, investors and startups. At MATTER, we bring together a global community of more than 200 cutting-edge startups, hospitals and health systems, universities and industry-leading companies to solve the right healthcare problems in the right ways. Together, we are building the healthcare system of 2040.