COVID has highlighted the differences in healthcare affordability across the globe, with a glimpse into what the future of medicine could look like if we don’t act.
Healthcare is usually a slow-moving industry, and mostly for good reason. In medicine, patient safety and evidence-based practice are king. Researchers, clinicians, innovators and the MedTech and pharma industries must perform rigorous clinical trials and navigate complex regulatory environments, to bring new drugs and devices to market.
But I think we can all agree that in 2020, time moved differently. For healthcare innovation to combat the COVID-19 pandemic, we have seen an extraordinary rate of change. In Australia, we embraced telehealth, and implemented robust contact tracing infrastructure in a matter of weeks. Globally, we have seen new technologies and new vaccines created, trialled, and rolled out in record time.
COVID has thrown the strengths, weaknesses, and challenges of our global health system into sharp relief. It has also highlighted the differences in healthcare affordability across the globe. It has given us a glimpse into what the future of medicine could look like if we don’t act.
With these experiences fresh in mind as we begin 2021, we’d like to pause and consider what the future should look like.
There’s no need to discuss technologies available in high versus low income countries – because inequalities in health access exist in every country. The way we see it, to create the optimal future we need to start with the basics: affordable and efficient healthcare, no matter where you are in the world.
Affordability
The COVID crisis has been a stark reminder of global disparities in access to affordable care – with patients in high- and low-income countries alike sometimes forgoing medical treatment citing risk of financial ruin. To ensure we don’t see disparities grow, we must focus on value-based and inclusive healthcare. For example, antiviral drugs have effectively been able to cure hepatitis C since 2011 however the wholesale price of the drugs averages around USD$1000 per pill. Requiring 1-3 pills per day for 8-12 weeks, a treatment that radically improves the lives of those who can access it, is out of reach for people in countries without robust subsidised medical systems. Improving affordability of care should be the most crucial goal for health innovators, policy makers, and clinicians going forward.
Additionally, we must be vigilant that advancement of technology actively works to narrow the gap between the rich and the poor and doesn’t leave the most vulnerable behind. Innovations should be designed, with affordability built in, to deliver the highest quality care for the lowest possible cost. For example, Ellen Medical Devices’ Affordable Dialysis System, has been designed with cost effectiveness in mind. While standard dialysis systems can cost up to USD$100K, Ellen Medical Devices’ system is priced at USD$500 and runs on just dollars per day. A focus on innovations that reduce healthcare costs rather than add to them is required.
Lastly, researchers and health innovators should be prioritising large unmet health needs with the greatest impact, either through the severity of the disease or the size of the affected populations. Non-communicable diseases (NCDs) such as heart disease and kidney disease increasingly contribute the greatest burden of disease in high and low-income countries. While it is difficult to tear our attention away from the current infectious disease outbreak, NCDs are responsible for 70 per cent of deaths worldwide. By focusing our efforts on creating affordable, scalable, accessible treatments for these challenges, researchers and innovators can improve the lives of millions of people worldwide.
Efficiency
The future of healthcare is going to rely on technologies that support efficiency of care. We have all seen the reports of hospitals around the world overburdened and at capacity due to the COVID pandemic. Embracing evidence-based technologies that increase the efficiency of care will future-proof our health systems for similar situations when they arise again.
For example, harnessing routinely collected data for use in randomised clinical trials could transform clinical research. It could provide insights into long-term effects of treatments and increase the generalisability and applicability of results which can sometimes be affected by the burden involved in the collection of research-specific data.
Additionally, with the rise of smart MedTech, advanced data processing, machine learning and AI, start-ups like Evidentli and 23Strands are emerging rapidly. They are working to accurately mine knowledge from real-world patient data and turn them into real information that can help healthcare providers to make decisions.
We’d like to encourage and facilitate more clinicians and researchers to embrace and trial these technologies to understand their effectiveness and their potential role in supporting clinicians to make accurate and timely decisions. Collaboration between research institutes and start-ups is critical in this work and is a key focus of the health incubator currently in development at The George Institute.
Lastly, to get the best out of efficacy-driven solutions, we need to work on improving the flow of information between clinicians, hospitals and patients. We can do this by:
1. Recognising patients and their families as critical members of the care team and give them the tools they need to manage and improve their health.
2. Embracing electronic health records as a tool for improving the flow of information between everyone in patient care – clinicians, support workers, patients and their families.
3. Putting patient experience at the centre of healthcare design, in order to simplify the healthcare system and improve the patient journey.
There are big changes coming, and they are coming quickly. Next on the horizon in Australia are improved adoption of electronic health records, AI and machine learning, connected smart medical devices, increased use of robotics, and platforms that facilitate research like the Join Us Register.
These will have incredible benefits, and some will bring us closer to the efficient and affordable healthcare model that we need in the future. But we need to be mindful of inequalities in our system, not just in Australia but around the world, so that affordable, efficient healthcare is accessible to all.
