Future of healthcare

www.shapingtomorrow.com

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Presented by:Mike Jackson

ChairmanShaping Tomorrow


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HIV/AIDS emphasizes need for continuous scanning

Lag of +10 years in translating clinical research into clinical practice

10:90 Gap - 90% of research spending on 10% of the illnesses

Neglect greatest health issues

Results - continuous reactive planning


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Predictive

Preventive

Point of care

Precise

Panoramic

Personalized

Participatory


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Current Hospital

Source: Shortell, S., and Kaluzny, A. (2000). Health Care Management: Organizational Design and Behavior (4th ed.).


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Pharmaceuticals

Hospitals

Healthcare Technology

Diagnostics

Biotechnology

Nutrition

Medical Devices

MedicineAcademia

Physicians

Nurses

Public Health

The Patient Will Become the Nucleus of Healthcare

Patient


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Horizon 2010 2025Centers of Care

Institutions Clinics, surgery centers & hospitals

Home Avatar, online, “smart” technology

Gatekeeper Primary care physicians AI via portable electronic diagnostics and automated “care”

Genetics Simple - Testing for simple disorders reaches affordability critical mass ($350/profile)

Universal - Testing, treatment and prevention is mainstream including reproductive health

Implants & Prostheses

Manmade materials surgical repair materials, drug delivery, and synthetic biochemical materials

Regenerative biochemical process and technological advances (regenerative organs, artificial haemoglobin, etc.)

Longevity Degenerative 80 to 90 years, aging and metabolic breakdown

Nearly non-degenerative 125+ years, increased quality of life

Hospitals Treatment center for disease - LOS in days

Teaching center for patients,– LOS in hours

Source: Updated from Coates, J., Mahaffie, J., and Hines, A. (1997). 2025: Scenarios of US and global society reshaped by science and technology.


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Sub-specialists

Specialists

Primary Care Doctors

Physician Assistants- PAsRegistered Nurses- RNs

Med Techs

Consumers

Health care providedat lower levels in the pyramid


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Smaller

Easier to use

Faster

Cheaper

Earlier in the disease cycle

Less invasive

Home/location based

All rights reserved


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Economy – back to basics

£/€/$ - pharmaceutical costs

Vaccine to regulated prevention

Nursing & physician shortages

Graying population

Enhanced graduate medical education

Technology - health extender

Greener health delivery

Pay for performance/outcomes

Incentives for healthy living

Short Term

Sources: IBM and PriceWaterhouseCoopers


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In vitro blood protein diagnostics

Major organs or cells secrete protein blood molecular fingerprint

Single cell analysis

Blood fingerprint will report organ status, distinguish health from disease, and which disease

All rights reserved


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HapMap £/€/$ of human genetic variation (disease diagnosis)

“Gene Chip”– multiple gene examination

Personal genome sequencing direct-to-consumer (DTC)

Identified origins and causal relationships of complex diseases

“Epigenetic" factors linked to diseases, heritability across generations

Stem cell transplants

Human reproductive cloning


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Nanomedicine

Nanobots

Nanorobotic therapy

Nubots

Nanosensors

Bionanobots

Nanotechnology

All rights reserved


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Smart clothes› Sense body functions

Smart bathroom› Evaluate body fluids

Smart kitchen› Prepare body nutrients

Smart house› Elderly can live at

home


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Remote 3D diagnostics

Robotic-assisted procedures

Minimally invasive surgeries

Global access to experts


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Sentara Hospitals achievements:

• Multi-site access to Intensivists

• 25% reduction in ICU hospital mortality rate

• 17% decrease in ICU LOS

• 20% increase in ICU capacity created by shorter ICU LOS

• 26% reduction in hospital costs for ICU patients

Electronic ICU (eICU):

Source: Pronovost, P. (2002). “Imagining the ICU of the future.” The National Coalition on Health Care and The Institute for Healthcare Improvement. All rights reserved


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“Neuroprosthetics” - brain implants to prevent disease

Health avatars capable of artificial thought

Bionic eyes/ears/limbs/organs

Bionic everything!!!

Where does this leave pharmaceuticals?

All rights reserved


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Source: Woodman, J. (2007). Patients beyond borders, Singapore Edition: Everybody’s guide to affordable, world-class medical tourism.


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Full-scale simulation model of human physiology, diseases, behaviors, interventions, and healthcare systems

Uses advanced methods of mathematics, computing, and data systems to determine best treatment option and cost-based analysis

Simulation Models


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Schizophrenia

Intuitive Empirical Precise

Intu

itiv

eE

mp

iric

al

Pre

cis

e

Depression

ChronicBack Pain

Osteoarthritis

H5N1 Influenza

Multi-drug Resistant TB

Migraine

Alzheimer’sDisease

Obesity

Allergies

InflammatoryBowel Disease

Lupus

Osteoporosis

SARS PulmonaryEmbolism

HIV/AIDS

Cystic Fibrosis

ProstateCancer

Stroke

Heart Attack

FAP/HNPCC(+)Colon Cancer

Appendicitis

AbdominalAortic Aneurysm

AsthmaPneumonia

Kidney Stone

Type 1 DiabetesHER2/Neu(+)Breast Cancer

Gaucher’sDisease Fractures

Strep Throat

Extent of Understanding of Mechanism Causing the Disease

Ext

ent

of

Tre

atm

ent

Eff

icac

y

Multiple Sclerosis

Future Current

Source: Christensen, C., Grossman, J., and Hwang, J. (2009). The innovator’s prescription: A disruptive solution for health care.

2015 20252010


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Life Span increase to 125+ years

End of life issues – patients choose when to die:

› Immediate – informed consent based on degenerative metrics

› Future – informed consent based on non-health social factors


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Mental Model 1 Mental Model 2Curative Preventive

Pharmaceutical Complementary

Western Medicine = The Health System

Western + Contemporary = The Wellness

System

Nutrition based Nutrition focus

Institution based Home/Location based

Face to face treatment Space to place treatment

Government responsibility to health

Individual responsibility mediated by government

Information control by professional experts

Open system informationSource: Marsh, N., McAllum, M., Purcell, D. (2002). Strategic foresight: The power of standing in the future.


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Patient-centered care

Partnering

Patient safety

Information & communication technology

Public health perspective

Culture values orientation

Innovation by design

Global mind set

Strategic foresight & leadership

All rights reserved


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LEVELS OF UNCERTAINTY

1. A Clear-Enough Future

2. Alternative Futures

3. A Range of Futures

4. True Ambiguity

Each level of uncertainty requires a different strategic approach

Effective strategy is not “one size fits all”

Source: Courtney, H. (2001). 20/20 foresight: Crafting strategy in an uncertain world.


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DIABETES & OBESITY

2025 ScenarioPre-

diabetesTotal

diabetes

Not diagnose

d

Cost

The Frog Didn’t Jump 65M 50M 15M $351B

We Did the Best We Could 50M 45M 10M $395B

Caring Communities & Access to Health Care

45M 40M 1M $345B

Evolving Systems with Enlightened Leaders

35M 28M 0.3M $220B

Source: Rowley, B. and Bezold, C. (2006). “The futures of US health care: The case of diabetes & the paths for

eliminating health disparities,” Institute for Alternative Futures.


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New value innovation strategies

Global healthcare outsourcing - shift service delivery variables

From “push” to “pull”

› Current – providers “push” out service delivery options

› Future – providers “pull” in patient behavior to determine service delivery options

Eating Facilities

ArchitecturalAesthetics

Lounges

Room Size

Availability ofNursing Staff

Furniture andAmenities in Rooms

Hygiene

Patient Safety

Price

Room Quietness

AverageHospital

SpecialtyHospital

ValueCurve

Low High

Relative Level

Ele

me

nts

of

Pro

du

cts

or

Se

rvic

e

Gift Shop

Source: Richardson, V. (2009). Adopted from Kim, C., and

Mauborgne, R. (1997). “Value innovation: The strategic logic of

high growth.”


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Continuous Horizon Scanning

Future Issues Brief(s)

Leadership/Foresight Training

Scenarios Planning

Roadmap Analysis

Strategic Action Plan

Future of healthcare

Health & Medicine

Transcript of Future of healthcare