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New year, new trends: What to watch for in healthcare in 2019 (Part 1)

Tags: public health

As we start a new year, every company and healthcare professional starts to think about what innovations the new year could bring. While some have very positive and innovative results, there are also risks we have to consider. Below, I’ve listed what I think are the five trends to watch in 2019.

1. Putting patients at the centre of our healthcare system

The patient perspective has been one that has been discussed for a long time, and is slowly becoming a normal part of any health-related project, whether that’s a clinical trial, designing a new hospital, or when designing healthcare policy. The mantra of “nothing about us, without us,” has taken hold, and is being used in very different parts of the healthcare system, with the same objective of ensuring that the patient/end-users voice is heard. At a systems-level, the Ministry of Health and Long-Term Care in my home province of Ontario, Canada set up the Patient and Family Advisory Council to help advise the province on healthcare priorities and ensure the patient voice was heard. At a hospital/provider level, Kaiser Permanente has 400 patient advisers serving on more than 50 patient advisory councils, ensuring that the patient voice is included at all parts of the care journey. From their website:

Advisers are brought together as local and regional councils that offer input and guidance in areas such as facilities design, leadership structure and physician hires. They often shadow a patient (with the patient’s permission) to better understand the care experience. Some councils have committees that focus on specific topics, such as maternity and child care, transgender issues, breast cancer experience and visiting hours.

Designing and implementing a patient engagement program does require work from all stakeholders involved. This excellent journal article in Clinical Trials by Bray Patrick-Lake delves into this in more detail, and provides recommendations for all stakeholders, research sponsors, and patient groups to provide practical advice when implementing this sort of initiative.


2. Using data effectively to improve outcomes

In almost every health-care setting, data is underpinning every conversation. Questions such as “where are the test results,” “have you had this test before,” and “how can we predict if this person will be back in the emergency room,” are ones with clear implications for healthcare providers, and with the power of data, can help improve outcomes for patients while simultaneously lowering costs for providers. One estimate from March 2018 suggested that around 30% of the world’s daily data production is healthcare data – lab test results, medical images, biopsies, medical claims, academic research, etc.

However, healthcare is still at the nascent stages of the Big Data Revolution. In industries such as banking, algorithms and models are already used to understand behaviours, and to predict what you will need next. Did you buy a new gym bag this January as part of your new years resolutions? In about a week (or less) you can expect emails from the same seller for new gym t-shirts, shorts, and other apparel to go with your new bag. However, we don’t have that same level of sophistication in healthcare (yet). Data exist in separate silos, with primary care records not liaising with hospital visits, and while your doctor might write a prescription for a medication, they have no way to see if you actually took the drug they gave you.

Once all these systems are integrated and able to talk to each other, the power is incredible. Healthcare providers will be able to map out the patient journey to understand how patients experience the healthcare system in the real-world, rather than just through their understanding of their role in the patient journey. With this, we will be able to answer questions like “how many patients visit their primary care doctor prior to going to the emergency department,” and “after discharge from the hospital, how many patients go back to the emergency without seeing another healthcare professional?” Some of these questions we might be able to answer now, but with limitations. With a truly integrated system, we will not only be able to map out the patient journey, we will also be able to then overlay these on existing patients to predict their likelihood of developing certain outcomes. If we know that 75% of the time, patients with conditions A, B, and C develop diabetes within 5 years, we can launch interventions to help them before they develop these outcomes.


3. Disrupting existing care paradigms

One of the biggest companies in the world made a huge splash last year by moving into the healthcare space. Amazon’s move to acquire PillPack, as well their filing of a patent to allow Alexa to pick up a cold or cough, shows they have a very ambitious targets for their role in the healthcare industry. To quote this article from CNBC:

So imagine you have a sore throat. You let Alexa know, and it responds by asking if you want to book an appointment at the doctor’s office or get a virtual consult. You pick the virtual option, and the doctor through Alexa asks you about your symptoms. It decides to send a courier to your home with a tiny portable device to do some basic tests for things like strep throat. The strep test is positive, so the virtual doc sends over a prescription for an antibiotic. (We’re assuming that all the Amazon services are fully compliant with privacy and other laws.)

The idea that Amazon already owns a lot of these services, or that they could likely acquire the missing pieces, shows where they think the healthcare system is going. And to be fair to other innovators in the space, they aren’t the only company pursuing this objective. Maple is a Canadian company that allows you to connect with a doctor using your phone, tablet or computer, all from the comfort of your own home. In 2019, we can expect more providers to start offering this as an option to an in-person visit, especially for follow-up visits for low-risk patients.

Come back next Monday for Part 2!

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