In November 2017, we launched the report ‘The future awakens: Life sciences and health care predictions 2022’. Our intention was to provide an unashamedly positive and provocative view of how the world may look in 2022, if the constraints that many believe impede adoption of innovation can be overcome (see video below).
The report acknowledges the increasing pace and scale of innovation in healthcare over the past three years or so, and how new science, automation and robotics will impact the future of work. It also highlights how these developments will impact the life sciences and health care industries’ business, operating and financing models.
Here are six predictions for 2022 – both evolutionary and revolutionary.
In 2022, individuals are better informed about their genetic profile, the diseases they have, or may develop, and the effectiveness of health interventions. People are also more engaged in improving their own health, and their expectations of health care are high for themselves and their loved ones.
Patients are true consumers; they understand they have options and use information and data about themselves and providers to get the best treatment at a time, place and cost, convenient to them. The adoption of technology is keeping people connected and active and helping to reduce the cost of health care. This ‘democratisation’ of health care has arisen as a natural extension of the evidence seen in 2018 where biometric data and disease signs are being sent wirelessly to clinicians and people are monitoring their own activity and vital signs data, aided by an explosion in the use of health apps and wearables.
Indeed, the global market for wearable medical devices and remote patient monitoring systems is expected to reach $612 billion in 2022. As medical-grade wearables become less of a novelty, the next generation of monitoring devices, from ingestibles and implantables to imbeddables (Figure 1) that can track and monitor how people are responding to treatment and the wider environment, will take centre stage.
Figure 1. The rise of the quantified self
In 2022, a growing number of healthcare services are delivered more effectively at home or in outpatient ambulatory facilities and patients with complex and acute inpatient needs are treated in ‘smart’, digitally-enabled hospitals. Clinical roles have been optimised and staff are using cognitive technologies to deliver more seamless, integrated care, designed around patients’ needs.
Providers have established a data-driven, real-time understanding of patient flows and acuity to inform workforce planning, and are leveraging technologies to optimise care delivery, patient experience, staff deployment and the management of back office services. This has enabled health care providers to reduce unit costs and improve outcomes based on a holistic population health management (PHM) approach. In 2018, PHM is already being implemented in several high-income countries, with the objective of reducing health care costs by decreasing the burden of chronic diseases and increasing support for preventive health care. Indeed, the market for PHM software and services is projected to grow to $34 billion in 2020, up from $14 billion in 2016 (a compound annual growth rate [CAGR] of 25%). At the same time there are a growing number of ‘smart’ hospitals (Figure 2) elevating the patient experience through digital technologies, helping patients navigate the care process from pre-admission to post-discharge and hospitals to monitor the use of resources via RFID technology.
Figure 2: The development of the smart hospital
In 2022, pharma uses a lean operating model to generate funding for R&D and deliver more cost-effective medical innovations. The ‘industrialisation’ of pharma has led to productivity increases across functions and geographies. Companies have moved through three phases of evolution – first codifying and standardising processes, then automating them, and now deploying artificial intelligence (AI) and machine learning to increase productivity still further (Figure 3). This step change has improved compliance materially and enhanced the predictability of core processes.
Already in 2018, some medical devices are ‘made to order’ based on specific patient geometry, using technologies such as additive manufacturing (3D printing), which has resulted in improved outcomes. Many pharma companies are investing with AI developers to automate drug discovery and a host of digital technologies are creating ‘always on’ supply chains that provide better efficiency, visibility and customer service. The US global personalised medicine market is forecast to reach $2.4 trillion by 2022 at a CAGR of 11.8% – more than double the projected 5.2% annual growth for the overall health care sector.
Figure 3: The three phases of the industrialisation of life sciences
In 2022, health care data is a national infrastructure priority and critical business asset attracting significant funding. Real-world data (RWD) is providing the information needed to enable researchers to develop more precision medicine and clinicians to predict patients’ responses to treatments. Clinical guidelines and experiences have been turned into computer algorithms to support clinicians and payers to find the best treatments. Pharma companies are using RWD to develop better treatments, launch them faster and price them according to improvements in health outcomes.
For example, in 2018, the Internet of Medical Things is already a reality, creating vast amounts of data (Figure 4), faster and more detailed than ever before (the world’s data volume is expected to grow by 40% a year). Blockchain-like technology is being deployed to keep patient data safe, including the adoption of world-leading standards of security and encryption and a mechanism to enable real-time checking of how data is being processed, when data has been used and for what purpose. AI systems are being deployed to help pharmaceutical companies prevent drug-drug interactions and help clinicians interpret diagnostics. Accessible portals are enabling clinicians to apply power cloud-based computing to health and medicine in order to:
Figure 4. The explosion in sources of health data in 2018, coalescing around the patient
In 2022, insights from human genetics, precision and personalised medicine, have transformed health care, bringing value through innovative biotechnology and requiring the health system to move from looking at the average patient to looking at the individual patient. AI has revolutionised health care through mining medical records, designing treatment plans, speeding up medical imaging and drug creation. Outcomes-based payment strategies are common for treatments where patient populations and endpoints are well defined.
For example, Deloitte’s 2017 benchmarking study, Getting real with real-world evidence (RWE), found that many biopharma companies are starting to invest in RWE capabilities and are exploring a number of use cases. The results of the survey indicated that 54% of respondents had a project underway to develop and/or significantly improve this capability, with 33% saying they had a RWE capability. Meanwhile, the regulatory approval of CAR-T cell therapy in 2017 marked a fundamental shift in the treatment of blood malignancies and is expected to propel the industry of cell immunotherapy into a new era.
In 2022, the health care landscape has changed significantly with non-traditional health care players using their brand, engineering expertise and knowledge of customers to disrupt the health care landscape. These new entrants have partnered with traditional providers to deliver a more customer-focused experience of health care. Many companies have realised that only by working together can they succeed, requiring new skills, behaviours and standards to be adopted in each organisation with more porous boundaries, especially around data sharing.
In 2018, tech giants are already venturing into healthcare with technologies such as ‘Voice’ and smartphone technologies transforming patient monitoring and diagnostics; home genetic testing kits have been approved by the US Food and Drug Administration (FDA). Indeed, during 2016 the FDA cleared 36 smart devices, with connected blood glucose monitors and devices incorporating heart rate sensors dominating the list. The increase continued in 2017. Of particular note was the FDA clearing 23andMe to sell its direct-to-consumer genetic test kits.
Our predictions look to a world five years from now where countries are: benefiting from new information and insights about health care; understanding what works and what doesn’t; and comprehending how new innovation, collaboration and automation can improve the cost effectiveness of service delivery. Each prediction shares three key enablers that are critical to its realisation and will impact the pace of change:
In 2018, the future of health care is more challenging, and the possibilities more exciting, than ever before. The need for strategies and judgement to shape our health – whether as a health care provider, life sciences company, clinician or patient – is also higher than ever. While our six predictions are an optimistic view of the future, we recognise that many in our life sciences and health care industries are sceptical about the constraints and, therefore, the pace of change. We contend that being optimistic is necessary if we are to respond effectively to the health challenges from a growing and ageing population and the tidal wave of chronic diseases that we face.
Karen Taylor is the Research Director of the Centre for Health Solutions at Deloitte, which she established in November 2011. The Centre is the research arm of Deloitte LLP’s life sciences and healthcare practices. By using both primary and secondary research and rigorous analysis to drive unique perspectives, the Centre seeks to be a trusted source for relevant, timely, and reliable insights.
Her recent reports include: The future awakens: Life sciences and healthcare predictions 2022; Time to care: Securing the future for the hospital workforce in Europe; Vital Signs: How to deliver better healthcare across Europe; Pharma and the connected patient: How digital technology is enabling patient centricity and Deloitte’s annual report on Measuring the return from pharmaceutical innovation – A new future for pharma R&D 2017. All of these highlight the growing role of partnership working between health care providers and the life sciences industry and feature key enablers to transform service delivery and patients’ experience of care: the role of digital and other advanced technologies; the workforce working differently, and the standardisation of systems and processes.
She is a long-time member of the Institute of Chartered Public Finance and Accountants and was, until January 2011, the Director of Health Value for Money Audit (VFM) at the National Audit Office (UK); with extensive experience in leading research into healthcare and life-science issues in the UK and internationally.
In 2002 she received an OBE for her work on Health VFM. She has been a Non-Executive Director at Dartford and Gravesham NHS Trust for the last seven years where, after chairing the Board’s Quality and Safety Committee for six years, she now chairs the Audit Committee.