Insights shared at DTU in Copenhagen to kick off an Exec Education module on innovation in healthcare. Drawn from the Future of Health events in 2015, Future of Surgery in 2016 and the new Future of Patient Data project initial view, these combine multiple shifts for the next decade as seen around the world. In the DTU event, the priority issues for the next decade were seen to be AI driving efficiency, the rise of machines, individualised medicine, the impact of data, changing business models, predictive analysis and conservative regulators.

1. The Future of Healthcare | An Emerging View
Insights from Multiple Expert Discussions Around the World
Dr. Tim Jones | Programme Director | 24 August 2017

2. Future Agenda
The Future Agenda is the world’s largest open foresight program
that accesses multiple views of the next decade
so all can be better informed and stimulate innovation.

3. Looking Forwards
Organisations increasingly want to identify and understand
both the anticipated and unexpected changes
so that they can be better prepared for the future.

4. The Future of Healthcare

5. Data’s Impact on Health
Better use of data and technology has the power to improve health,
transforming the quality and reducing the cost of health and care services. It
can give patients more control over their health and empower carers.

6. Deeper Collaboration
Partnerships shift to become more dynamic, long-term, democratised,
multi-party collaborations. Competitor alliances and wider public participation
drive regulators to create new frameworks for open, empathetic collaboration.

7. A Data Marketplace
Data is a currency, it has a value and a price, and therefore requires a
market place. Ecosystems for trading health data is emerging and
anything that is information is represented in a new data marketplace.

8. The Rise of Machines
The growth in the intelligence and capabilities of machines presents both a
threat and an opportunity. Greater automation frees up time, but also has
the potential to threaten more jobs in managerial or administrative roles.

9. Gene Editing
Equipped with greater understanding of the individual’s genetic disposition and
new intervention technologies, we can proactively edit genes and undertake
minimally invasive surgery to reduce the need for major surgery in later years.

10. Individualized Medicine
We are going to be leaving population medicine – where one size fits all
– in favour of individualized medicine. Implicit in this is that
the patients will increasingly drive their own care.

11. New Trust Relationship
The adoption of many digital technologies within
integrated health and care systems will require the
development of a new trust relationship with the citizen.

12. Limiting Healthcare Access
Several economies where universal access is the norm are looking at ways of
limiting use. Options such as co-payment for all treatments or a maximum
number of (non-emergency) visits per year are increasingly debated.

13. Cost of Cancer Drugs
The average benefit from the 50 most recently approved cancer drugs in
the UK is 3 weeks of extra life – at and average cost of around $70,000.
In cost constrained systems, continuing such support is being questioned.

14. India Setting Global Standards
India is demonstrating an innovative approach to healthcare challenges and has
proven design solutions for low-income populations. These solutions will be
applied to higher income economies with even greater efficiency benefits.

15. Personal Data Stores
Patients will not only access their data, but also own it. The adoption of
personal data stores lead to universally accepted credentials and share data
with multiple partners so that patients can receive personalized services.

16. Decentralized Secure Data
We need to decentralize health data because the more it’s amassed,
the more likely it’s going to be hacked. Centralized ownership of
medical records is increasingly seen as a security risk.

17. Internet of Me
The combination of increasing computing power and digital health leads to the
Internet of Me: Patients get information that is highly customized to who they
are and treatments become more effective through greater personalization.

18. Human Touch
As service provision and consumption becomes ever more digital, automated
and algorithmic, those brands that can offer more emotional engagement
and human-to-human contact become increasingly attractive.

19. System Change
For many, implementing digital health technologies requires a
whole system change. Such a transformation is more difficult
to implement when an established healthcare system is in place.

20. Conservative Regulators
As legislators and funders of healthcare tend to be risk averse, there is a
regulatory desire for certainty with a continuous concern about unintended
consequences of change. Regulators may therefore slow adoption.

21. Resistance from Healthcare Professionals
Change from clinicians and professionals in health often have the least
appetite for change – it is often viewed as a threat to roles and responsibilities.
Dialogue around new innovations is key to overcoming resistance.

22. Creating Pull
One of the most effective leavers to encouraging adoption of digital will be
the ‘fear of missing out’ on gaining a competitive edge in cost and quality.
Creating pull as well as push will be pivotal for wider patient data sharing.

23. Personalised Healthcare
For the privileged few with access, personalised healthcare tailored
around individual medical and pyscho-social needs provides therapies
that are better aligned with specific rather than generic profiles.

24. Digital Autonomy
Increasing access to more personal and group data allows individuals to take
informed views on their health. As information is decoupled from the
professions, the public become more specific about their needs.

25. Data Prioritisation
An increasingly digital healthcare system is driven by access to credible data
that is prioritised above the noise. The value of such key data increases
as its ability to unlock opportunities and improve diagnosis rises.

26. Shifting Risk and Responsibility
Business becomes more actively engaged in the wellbeing of its employees and
society. Greater responsibility for health is incentivised by tax breaks and
reimbursements designed to share risk, with lessons taken from elsewhere.

27. Sustainable Healthcare
With limited resources, rising demand and escalating costs, decoupling
healthcare spend from economic growth is a global challenge. A more
sustainable, integrated model may emerge from beyond the US/EU.
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28. Incentives in Flux
Budgetary pressures continue and reimbursement models will need to change.
There is greater emphasis on paying healthcare providers based on measurable
outcomes, rather than simply for the number of procedures they perform.

29. Collective Action to Control Chronic Disease
To stem the runaway costs of treating chronic diseases, multiple stakeholders
collectively seek to halt key conditions: Remote monitoring, educational
programmes and focused budgets are all integrated around common aims.

30. Ambulatory Centres
Small, local walk-in centres become popular for care and light interventions.
They reduce major hospital demand and provide cost savings for the
system while also helping patients avoid the ‘taboo’ of hospitalisation.

31. Surgeon as Supervisor
More pervasive robotics, increased automation, augmented reality and
artificial intelligence all combine to take over more expert surgical actions -
leaving the surgeon to stand back and be available in case of an emergency.

32. The Changing Nature of Privacy
As privacy is a public issue, more international frameworks seek to govern the
Internet, protect the vulnerable and secure personal health data: The balance
between protection, security, privacy and public good is increasingly political.

33. Universal Healthcare Data Access
Information silos are connected via third parties able to unify, mine and
discover new insights. Integrated public and private datasets provide holistic
views of the individual and value shifts to decision-making analytics.

34. Generative Manufacture
In-theatre printing of bio-materials brings multiple opportunities
for the 3D building of biological tissue and bespoke organs.
We create replacement parts that are made from our ‘own’ cells.

35. Simulated Learning
Virtual reality, remote robotics, simulation and gamification all change how
healthcare professionals and wider teams gain skills, become familiar with
new approaches and help them to rehearse complex procedures in advance.

36. Challenging Models
Increased access to personal health data will challenge existing
healthcare models focused on stereotypical conditions. In the future
several governments expect personalized diagnosis to be commonplace.

37. Genetic Profiling
Key is the wider use and reduced cost of genetic profiling. With the growth of
organizations providing hereditary genetic information commercially, more
people can see future conditions early and so take preventative action.

38. Getting Closer to the Patient
New digital technologies providing tailored advice mean that healthcare
systems are designed more for the patient’s convenience, at home, and less
around expensive, over-stretched facilities such as hospitals.

39. AI Driving Accuracy
It will become common for patients to chat with artificial intelligence health
advisers through messaging apps - As more people use these services, the more
data is collected and therefore the more accurate diagnosis can be.

40. An Information Business
Data and data exchange have emerged as the ‘new currency’ in
health care, and will become a major force in redefining relationships,
transforming the industry into an information-driven business.

41. Data Gaps
In many instances, health data does not yet follow the patient, creating gaps
in coverage and leading to fragmented, uncoordinated care that diminishes
quality and drives up costs. In the future, these gaps will disappear.

42. Individual Custodians
As more information is available to the individual, many people are
able to make more informed decisions about their health because
they can become custodians of their own health records.

43. Personal Data Sharing
The sharing of personal health data with patients in established systems
will give them greater control over their own wellness. Patients will increasingly
need to trust in the sharing of their own data with others.

44. Combining Data Sets
Picking the data worth sharing and matching it with the most appropriate
platforms around specific issues, conditions, demographics or public vs.
private healthcare systems is seen as the most pragmatic approach.

45. Predictive Analysis
As we move to real-time synthesis of multiple data platforms we will gain
improved accuracy and speed. Predictive analytics and genetic profiling
together create more connected prediction and drive hyper-personalization

46. Public Concerns
Public concerns around the unregulated of use of data are growing and,
unless controlled successfully, as apps become more popular, fears around how
personal data are stored used and shared will become more pointed.

47. Proprietary Data
A significant challenge to progress in healthcare resides in the barriers
and restrictions that derive from the treatment of medical care data
as a proprietary commodity by the organizations involved.

48. Stewards and Security
Despite the increased enthusiasm for patient data and the adoption of EHR,
insufficient attention is being paid to security. With more prominent cyber-
attacks, we will trust our data only to those with the highest levels of security.

49. A Public Good
Broader use of healthcare data requires not only fostering data system
reliability and interoperability but also addressing individual data ownership
and the extent to which data should constitute a public good.

50. Public Benefit vs. Personal Risk
In linking and sharing more data we will increasingly weigh public benefits
against personal risk. The potential harm from unauthorised release of
confidential data will be a conundrum for many in the healthcare sector.

51. Elective Prevention
Equipped with greater understanding of the individual’s genetic disposition
and new intervention technologies, we proactively edit genes and undertake
minimally invasive surgery to reduce the need for major surgery in later years.

52. Greater Evidence
Wider generation and sharing of data shifts the scale, type and accuracy of
evidence used to make decisions. The best procedures become more visible
and are better supported by payers and the wider health industry.

53. Wearable Data
Ubiquitous wearables with embedded monitoring and diagnostics unlock
inaccessible patient data. This enables real-time preventative healthcare
solutions, greater personal responsibility and a realignment of insurance.

54. Small and Distributed Surgery
With the democratisation and digitisation of personal health data, surgical
support shifts to more local systems for earlier, minimal intervention. Providers
correspondingly become smaller, de-centralised and more outcome focused.

55. Informed Consumers
More informed and demanding patients become partners in their own
healthcare. Equipped with a wealth of personal diagnostic and monitoring
data, consumers challenge regulators and healthcare companies to improve.

56. Changing Business Models
Driven by new approaches for emerging markets and vertical integration on
pivotal issues, new business models emerge. Wider insurance in India, frugal
innovation and more government focus on prevention act as change catalysts.

57. Future Agenda
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