“I think it’s really important, when you talk about the future of healthcare in terms of how it’s maybe going to be innovated or disrupted or transformed, indeed, is to think about why,” Lorna Ross told the virtual audience gathered for Future Human 2020.
Ross, the chief innovation officer at VHI Health & Wellbeing and recent star of RTÉ’s Big Life Fix, urged the audience to consider: “the imperative, the reason why transformation and disruption is so urgently needed in healthcare and the imperatives driving it.”
Of course, we want to prevent disease and, ultimately, elongate our lives by holding death off for as long as possible. But Ross warned that “we are adding years to our lives but not life to our years”.
“What we’re seeing is that people are living longer lives and, indeed, of the current generation, most people are surviving diseases that would have killed their parents,” said Ross.
Yet, she added: “What’s happening is we really are starting to encounter the loss of independence and, indeed, dignity at the end of life.”
This philosophical and ethical question is, as Ross said, “where society and medicine intersect and certainly something that needs to be considered and potentially innovated around”.
However, Ross acknowledged that the relationship between medicine and transformation is complicated.
“I’ve worked in healthcare innovation for about 15 years and it’s an industry that has a complex relationship with the idea of change. It’s highly regulated, it’s very risk-averse. It’s based on the principle of expertise and it’s quite institutionalised. And all those things make innovation very, very difficult.”
But for Ross, the incontrovertible need for innovation in healthcare leaves only two possible journeys for the sector: “It can either transform itself or we disrupt it from the outside.” The latter is what she foresees happening if healthcare tries to stand its ground as an immovable monolith, and there are three potential disrupters in particular that she explored.
1. Computer vision
“Computers can see, and not just see in terms of cameras, but they can recognise. They have kind of a digital brain,” said Ross of the emerging technology of computer vision.
This technology has easily identifiable application in any medical specialty based on image analysis and pattern recognition, such as ophthalmology, dermatology and radiology.
These specialisms can suffer from a challenge of scale, where there often aren’t enough trained experts to fulfil the needs of patients. Not only can a computer vision model be trained on that intelligence and deployed anywhere, it could be built with the highest level of expertise, the kind a patient could only access through an elite specialist.
Software, Ross explained, is becoming a new format in healthcare in that it is being turned into therapy itself.
According to Ross, digital therapy can be safer, faster, cheaper, more accessible and easier to scale. Instead of generic pharmacology treatments, digital therapies can be highly personalised to the individual.
“And it’s non-addicting,” added Ross. “It’s being used an awful lot in rehab, particularly around pain because of the opioid addiction. And we understand the significance of that and the implications and the impact on the individual.”
3. Digital biomarkers
Finally, Ross believes that digital biomarkers are “one of the most interesting things happening in disruptive diagnostics”.
Digital biomarkers are data points that can come from digital devices such as medtech or even just your everyday smartphone. This can include physiological data such as blood pressure, heart rate and temperature, as well as data on the subject’s emotional and cognitive state.
“Examples of this would be movement, sleep, isolation versus connectivity, the environment you’re in, your levels of stress and anxiety, if you have any obsessive compulsions, addictions, mood,” said Ross.
This has the potential to massively disrupt what Ross called the “sickness model of care”, where, essentially, you have to be sick before you can be diagnosed and receive treatment. Over the long-term, digital biomarkers could signal to an asymptomatic, seemingly healthy person, the red flags that could be early signs of disease.
“Think about something like gait analysis, for example. People are understanding that gait analysis is an early indication of Parkinson’s, potentially,” said Ross. “And if you think about sentiment analysis, an awful lot of understanding around psychological conditions – particularly around depression – is often linked to very subtle changes in tone, subtle changes in phrasing. And, again, algorithms can be calibrated to understand and to basically watch. It also helps to capture the progression and speed that these signals are becoming established.”
A new medical frontier
This last disrupter, in particular, could mark a revolution in healthcare. What Ross called “the new frontier of medicine”, whereby treatments are no longer just designed for those who are physically, unquestionably ill, but can be made for much earlier interventions.
“It’s a place where the future of medicine is going to be defined and determined,” she said. “The future of medicine will be an adjacent, alternative and autonomous model. It will not be the traditional model of care.”