The future unmasked Predicting the future of healthcare and life sciences in 2025 The future unmasked | Predicting the future of healthcare and life sciences in 2025
Contents Foreword
Foreword 1 Welcome to our report, The future unmasked: life sciences and healthcare predictions 2025. These predictions have been informed by emerging evidence of the impact of the Trends in life sciences and healthcare 2 COVID‑19 pandemic on society and the health ecosystem. They have also been Ten predictions shaped by our research insights including our global 2040 Future of Health campaign.1 1. From health(care) to healthy ageing 4 The unprecedented nature of the pandemic is having an indelible impact on our industry, with unimaginable human loss and lasting 2. Better public health drives better productivity 8 changes to the way people perceive healthcare risks. There is also a new appreciation of the contribution made by life sciences and healthcare organisations, and a new era of collaboration to identify and implement solutions. Moreover, all stakeholders across the 3. Clinicians are empowered by diagnostic and treatment paradigms 12 health ecosystem have seen a dramatic acceleration in the pace and scale of technology‑enabled transformation. A legacy of the pandemic is likely to be new relationships based on partnerships, ‘good will’ and heightened levels of trust. Attitudes to 4. The who, what and where of work rearchitected 16 both public and population health have changed, with a shift in emphasis to prevention, and an acknowledgement of the importance of the social determinants of health and the need to reduce health inequalities and improve healthy ageing for all. Traditional boundaries are 5. Care is designed around people not place 20 becoming more porous, creating an opportunity for new healthcare behaviours, new business and funding models, and more effective collaborations among stakeholders, leading to new services from both incumbents and new entrants. 6. MedTech and the IoMT are crucial drivers of value-based care 24 Crucial enablers include our improved knowledge of genomics AI and digital health; the emergence of new skills and talent; access to 7. Companies have reversed the decline in the returns from 28 robust, interoperable data, analytics and insights; new approaches to regulation; and a value‑based outcome approach to funding. These enablers can help deliver a future for healthcare that is more predictive, preventive, personalised and participatory. pharma R&D Making predictions is never easy, especially given the disruption in the past year; nevertheless our vision of the world in 2025 is mostly 8. Next generation supply chains are integrated into healthcare 32 optimistic and deliberately provocative. Each prediction is brought to life through a series of portraits of how patients, healthcare and life science organisations and their staff might behave and operate in this new world. We describe the major trends and the key constraints to and the patient experience be overcome; and identify the evidence today to predict what the future might look like tomorrow. As always we welcome your views ideas and questions as we continue to explore the future of health. 9. Healthcare and life sciences companies have prioritised 36 decarbonisation Karen Taylor Sara Siegel John Haughey Hanno Ronte Director Lead Partner Global Consulting LSHC Partner 10. Clusters of trusted partnerships have accelerated innovation 40 UK Centre for Health Solutions Public Sector Health Industry Leader and Life Sciences and Healthcare +44 (0) 7825 793729 +44 (0) 20 7007 7098 UK LSHC Industry Leader +44 (0) 20 7007 2540 Conclusion 44 [email protected] [email protected] +44 (0) 20 7303 7472 [email protected] [email protected] Endnotes 46 Abbreviations 49 Contacts 50
1 The future unmasked | Predicting the future of healthcare and life sciences in 2025 The future unmasked | Predicting the future of healthcare and life sciences in 2025
Trends in life sciences and healthcare
Demographic trends conomic trends Disease trends
2021 2 022 2 the over 6 ill % 2 lo al healthcare ending 5.5% 02 The lo all oor mental health 11 1% 5% 3 global irtual diagnosti s num er ome 8 M 11 of ill fall 1 1 in ut 5% mar et i ro ected to gro affects at least 10% of the the global population 21 of ill recover and ri e annuall a out 1 orld o ulation ith the European population . 5.5 in 2021 and during 1 3 from of children and 5 annually till 2023 6M in 18 adolescents suffering some geing o ulation in oth t e of mental di order 13 emerging and develo ed nation P i e ected to contract in 3 annual ending in are increa ing the demand mo t mar et ut the glo al geriatric care mar et uring the 1 andemic for healthcare The orld healthcare ending a a hare home health remote atient re earch acro countrie o ulation i e ected to of P ill ri e har l 6 monitoring etc ill e ceed RE nternational found increa e one illion eo le 1 T 1 2 of women and 10 of 3 M of hom ill men re orted an increa e in e aged 6 or older mental health ro lem 1 Pre andemic the global o ulation gro th ea telemedi ine industry a and egin to decline the e ected to gro at 1 a ear financial and carer resources thi foreca t i no needed to care for the frail 1 3 and 17 Elderl o ulation ill e World ide a ro imatel 3 a huge challenge n the irtual are isits 00,000 deaths per year are ill oar to more than 1 thi attri uted to antimi robial The num er of child death ear including M vi it resistan e AMR The num er ounger than ear from 7 related to 1 i e ected to ri e to 1 M condition for hich vaccine at a co t of ome are availa le fell from Pharmaceutical ale are 1 T 1 5.5M in 1990 to 1.8M in 201 foreca t to reach US 1,366B in 2020 and ending to ri e a ination a ti ities ha e at a R of 3 in dollar been delayed or suspended term from u from The num er of eo le ith in at lea t 7 countrie to 3 in 1 1 11 dia ete glo all i e ected revent the read of 1 to ri e from 463M to 5 8M Modelling ugge t that for by 2030 and 00M by 2045 5.5M 1.8M ever 1 death revented The e timated co t of treating u en ion of routine The glo al healthcare dia ete i 76 a ear vaccination in order to reduce information technologie T and i ro ected to reach tran mi ion more than 1 mar et i e i ro ected to reach US 825B by 2030 and The effects of children could die a a re ult lo all 1,249M health and US 2 0.3B by 2021 from US 845B by 2045 16 fitness apps ere do nloaded US 22 .5B in 2020 driven C ID‑19 are more evere in eo le in 1 com ared to rimaril the ri ing incidence ith underl ing health 3 M during ame eriod a ear of 1 government n mo t countrie a condition ranging from earlier a ri e of around 3 8 mandate availa ilit of ig data di ro ortionate death rate i dia ete and a thma high return on inve tment and een among the over 7 a ell to cardiac di ea e the need to curtail e calating a in lac ian and Minorit and cancer healthcare co t 1 Ethnic ME communitie 17 1990 2019 2020 2021
2 3 The future unmasked | Predicting the future of healthcare and life sciences in 2025 The future unmasked | Predicting the future of healthcare and life sciences in 2025
From health(care) to healthy ageing Individuals are incentivised to take responsibility for their own health and lifestyle choices
The world in 2025 Conquered constraints Imagine the world in 2025 Prediction: In 2025, many • Consumers understand that they are • Skills and talent: A coordinated set of more people are fully informed largely responsible for their own health health improvement initiatives have about their health risks and and how ageing, nutrition and exercise helped develop people’s digital skills Next generation diabetic health Biomarkers and AgeTech reversing the How the microbiome can improve the take a proactive rather than affect their immune health, resulting for and health literacy, giving them a better management through a digital risk of age‑related chronic conditions immune health of a new mother and programme Mary, 45, is concerned about her her baby reactive approach to prevention many in healthier lifestyle choices. understanding of their health risks and how digital technologies and therapies Tom has obesity with insulin‑dependent risk of developing heart disease as Freyja is booked to have a caesarean and treatment. They are • The biological science sector of the can improve their immune health type 2 diabetes, and has been struggling she has a strong family history of section (C‑section) due to complications well informed about their longevity industry, comprising geriatric and mitigate the risks of poor health. to control his condition. He experiences the condition. Mary already uses she has experienced during pregnancy. personal risks of developing science, regenerative and precision Numerous online health coaches, frequent hyperglcaemia and difficulty a physician‑recommended AgeTech Her doctor, Dr Ahmed, advises her how chronic disease and have medicine, provides new insights to help gamification and chat‑bots are available in doing everyday tasks. Tom’s doctor device and has noticed a gradual rise in babies are born has a significant impact on embraced prevention, based on our understanding of ageing. to support, encourage and motivate suggests switching his therapy to a new her heart rate and blood pressure over their gut microbes, which influence many 800 calories‑a‑day diet and exercise the past year. The device connects to areas of the baby’s development (including hyper‑personalised insights. people to maintain healthy lifestyles. • Individuals understand their genetic programme, and that they should both her smartphone and feeds data into her neurodevelopment, immune health Many individuals are focused profile (and associated risks), and how • Funding: As the cost of sensors monitor Tom’s progress via a digital electronic health record. She decides and future health risks). Freyja consults on ageing well by maintaining this can be modified to improve their and genetic testing has decreased programme. Since the FDA provides to have a genetic profile and longevity a recommended chatbot which explains their physical and mental immune health. significantly, individuals are prepared a 20 per cent leeway for accuracy on food test, recommended by the patient that babies born by C‑section tend to health, including tailored levels to invest their own money in calorie labels, Tom’s doctor also provides support group that she joined six lack strains of gut bacteria found in those of exercise and nutrition. • Individuals use supplements, therapies that will help them age well. him with a food scanner so that he knows months ago. The longevity test assesses born via the birth canal. Instead, their the exact amount of calories and sugar in four metabolic biomarkers, including guts are more likely to harbour harmful There has been a shift in focus prophylactic treatments and Insurance companies and other payers vaccinations to prevent disease and give financial discounts and incentives his food, and the specific macronutrients he cholesterol, that are associated with microbes that are common in hospitals. to preventative measures, ensure healthy ageing. in response to evidence of healthy is eating. His scanned meals are logged in cardiovascular disease. Her results To ensure her baby can develop a healthy including vaccines, genetic lifestyles. Governments and the healthy his app, and after meals Tom takes a breath indicate that she is at high risk of gut microbiome, Freyja consults Dr Ahmed testing and therapies that • AgeTech provides customised digital ageing and longevity industry have test via a breath analyser connected to developing heart disease within the who takes a cervical and vaginal swab boost vitality, wellness and solutions to support older people to become a major investor in the AgeTech his app. Analysis of the volatile organic next five years. Mary therefore requests and sends it to the hospital’s lab. At the immune health, encouraged live independently for longer. industry. compounds in his exhaled breath helps him a virtual consultation with her doctor lab, scientists uses an AI‑enabled in‑vitro to understand exactly which foods spike his to discuss preventative measures. diagnostic test to identify the helpful strains by payer incentives, role • Individuals no longer request • Regulation: Regulators have developed blood glucose, and which foods he can eat Her doctor prescribes a personalised of bacteria from Freyja’s swab that her baby models and many consumers intermittent healthcare checks when specialist teams focused on preventative regularly and which to avoid. Changes to smart pill that targets each of the may lack to create a personalised formula sense for a longer, healthier feeling unwell: instead they deploy health and fast‑tracking regulatory Tom’s blood glucose are monitored through biomarkers, and a diet and exercise for Freyja to give to her baby when she is life. Consumers also monitor continuous health monitoring. approvals for health technology a continuous glucose monitor which regime. Mary continues to share her born. Dr Ahmed also mentions to Freyja their healthcare data through and medical devices that enable Tom had fitted by his digital co‑ordinator. health data with her doctor through that women who undergo C‑sections are validated apps, wearables and • Mental health needs are identified consumers to take more control of Through the app, Tom joins a virtual patient her AgeTech device linked to her thought to be at increased risk of postnatal group where he learns about the risk of electronic record. At six months, Mary depression. Freyja arranges to speak to other connected monitoring through a number of channels such their own wellbeing. Regulators have as facial recognition technology and modernised the oversight of consumer diabetic foot disease (DFD). He has not has a scheduled bi‑annual biomarker the clinic’s dietician, Andi, who explains devices. For some individuals, via apps on sleep patterns, mood and health products by developing an noticed any of the symptoms of DFD but test which shows an improvement in her how the gut‑brain axis impacts mental data alone may not be enough environmental factors. internationally agreed framework which sees that he can book an annual check‑in. condition, which enables the doctor to health, and how a person’s microbiota to influence behaviour change segments products by their risk profiles At his check‑in, he sends in a picture of his readjust her medication. This encourages can help the synthesis of serotonin and and they may require further • When healthcare is needed, AI chat- to ensure they are safe and effective. foot and learns how to reduce the risk of Mary to continue with her healthy other mood influencing neurotransmitters. motivation for example, via bots provide digital-first access to help developing DFD. lifestyle regime. Andi formulates a personalised daily solution of pre – and pro‑biotics to help a virtual health coach or navigate the health system, matching • Data: Enhanced data security and individuals with virtual or face-to-face privacy settings have improved keep Freyja’s gut microbiota in balance, a digital twin. services. consumer confidence in using medical protect her mental health and improve her technologies. Connectivity in peoples’ overall immune system. • Individuals have easy access to their homes has been strengthened with the own, portable and secure personal roll out of 5G technologies. health information on their smartphone and decide who to share it with.
Note: All elements on this page are from a perspective of 2025 and are fictional 4 5 The future unmasked | Predicting the future of healthcare and life sciences in 2025 The future unmasked | Predicting the future of healthcare and life sciences in 2025
Evidence in 2020
Apple Watch® Series 6: Amazon Halo – newest wearable DnaNudge: DNA analysis + wearable + The COVID‑19 impact How the smartwatch has become tracking fitness and stress levels phone app to encourage healthier food a health watch Halo tracks fitness through steps, walking, choices guided by the user’s genetics Initially providing a fitness tracker running and climbing, as well as the quality DnaNudge provides on the spot DNA Deloitte view on the impact of COVID‑19 ChatBots and featuring a health monitor that and quantity of sleep, providing improvement testing in under an hour. The user’s DNA is The COVID‑19 pandemic has raised public awareness of the There has been a significant increase in the number of AI chat- provides alerts, Series 4 introduced the advice where needed. Using the app, extracted from saliva taken from a cheek risks to their health of having a poor immune system and bots that answer patient’s questions about symptoms and electrocardiogram (ECG) and Series 5 body scans are taken using a smartphone swab and analysed for nutrition-related some of the actions they can take to improve their immune other related factors to determine the individual probability added the always-on display. The new camera to give a better idea of BMI than health conditions using a portable ‘lab in health and health outcomes. Evidence is also emerging of a coronavirus infection, and provide the patient with a Series 6 health app measures blood just weight alone, and a personalised 3D a box’ PCR machine. The user’s results are on the increase in mental health risks. On a positive note clear risk assessment and advice based on the latest policies, oxygen levels, a key indicator of an model allows consumers to track progress uploaded to their DnaNudge app and a COVID‑19 has increased significantly the use of technology including recommendations on telemedicine options, advice individual’s overall wellness. It uses a over time. Halo also analyses the tone of wearable which monitors inactivity. The by individuals to monitor their own health and improve their on isolation and nearby test centres. SpO2 sensor to measure oxygen levels the consumer’s voice throughout the day to user receives personalised ‘nudges’ based activity levels and awareness of healthy lifestyles. It has also for fitness and wellness purposes via red monitor stress levels.22 on their DNA to increase their activity, demonstrated the importance of improving digital literacy For example, German start‑up, DOCYET, has created an and infrared light. Apple Inc. is partnering choose foods that are more suited to them, and establishing more local, meaningful public engagement intelligent chat‑application helping patients navigate the with academics to study how this new Digital therapeutics for sleep and make healthier lifestyle choices.29 that focuses on building trust and compassion with local healthcare system, delivering decision support based on metric can be used to help treat medical Sleepio is a digital, sleep improvement communities. Importantly, COVID‑19 has shone a spotlight individual symptoms, and matching them with medical conditions.18 programme that uses cognitive behavioural Deep Longevity’s ‘Biohorology’ is on the role of vaccinations in protecting people’s health. services both on – and off‑line.31,32 therapy (CBT) techniques to overcome poor helping address our understanding of While many see a vaccine as a crucial step in return to a ‘new Invitae direct‑to‑consumer sleep and improve mental health. The Sleepio age‑related diseases and longevity normal’, it will be 2021 before we know how quickly COVID‑19 DNA testing programme (also available with a companion Some new tools are based on ‘biohorology’, vaccines will be available for the general population or the Invitae provides at‑home DNA testing app) collects information about the user the science of measuring the passage extent to which people are willing to be vaccinated. to help people understand their risk through a series of clinical questionnaires of time in living systems. These ‘ageing of developing certain conditions such and daily sleep diary to personalise the clocks’ use the biomarkers of ageing as specific cancers, heart disease and programme to them. In March 2020, Sleepio such as DNAm, gene expression and From health are to healthy ageing neurological conditions. It provides was rolled out to 2.2 million workers in the metabolomics. Today, DNAm clocks are actionable, personalised advice to help US and UK in just one month in response to the most popular, using deep learning people manage their health. Invitae also the COVID‑19 crisis, including all 1.2 million to analyse data. Deep learning can also partners with biopharma companies NHS workers.23,24,25,26 extend the functionality of ageing clocks to offer sponsored genetic testing beyond age prediction. Deep Longevity programmes which are provided free Mobile health digital behaviour change is developing user‑friendly AI systems to of charge to individuals with specific programme to facilitate weight loss track the rate of ageing at the molecular, conditions who have been referred by their Noom is an evidence‑based app, digital cellular, tissue, organ, system, physiological healthcare providers. In return the pharma behaviour change programme and health and psychological levels, and developing companies receive de‑identified patient coaching platform for obesity and diabetes. systems for the emerging field of longevity data for research purposes.19 The app enables users to adopt strategies medicine, enabling physicians to make for healthier lifestyles including daily food better decisions on interventions that may Zio by iRhythm – ambulatory cardiac logging and access to a virtual support slow down or reverse the ageing processes. monitoring service group. Noom has over 47 million users Deep Longevity has integrated multiple Heart data are captured through a heart worldwide that typically lose 7.5 per cent deep biomarkers of ageing which provide monitor with an uninterrupted signal that body weight over four months. In October a universal multifactorial measure of has minimal disruption to patients’ lifestyle. 2019, Noom partnered with the US human biological age. During the past few The Zio service offers the potential to National Diabetes Prevention Programme years a number of Longevity therapies have change the diagnostic pathway for patients and NovoNordisk to enable patients entered human trials.30 with suspected arrhythmia in primary participating in weight loss drug trials with care. It offers a streamlined solution for free app access for 12 months.27 Noom has capturing paroxysmal arrhythmias and can shown reduced chances of pre‑diabetic avoid significant downstream costs as well individuals developing type 2 diabetes as significantly reduce the time to diagnosis by 58 per cent, and saved payers around 20, 21 28 or reassurance. $2,650 per patient over 15 months. ource Deloitte
6 7 The future unmasked | Predicting the future of healthcare and life sciences in 2025 The future unmasked | Predicting the future of healthcare and life sciences in 2025
Better public health drives better productivity A resilient public health system protects the public, prevents disease and prolongs healthy life expectancy
The world in 2025 Conquered constraints Imagine the world in 2025 Prediction: In 2025, public • Government investment has led to • Skills and talent: Public health health is an established priority strong national public health systems professionals have been upskilled to for governments everywhere, using population data, behavioural identify and tackle population health Gamification supports the mental Smoking health literacy programmes Introduction of a digital immunisation with a higher percentage of science and digital technologies to and social care needs, and prepare health of children and young people are delivered through smartphone and passport as a record Funded as a government initiative, the Mari’s twin girls are about to start school healthcare funding devoted to protect the public, prevent disease, for and respond to emergency health wearable devices ‘Balance App’ has digitalised the use of Will has been smoking on and off for and she is alerted to a new government‑led public health. National statutory promote and prolong good health. threats, utilising data analytics and targeted evidence‑based interventions. CBT to assist young people with mild to around 20 years. He has tried quitting initiative to provide people with a digital public health organisations are • A robust strategy for handling disease Digital inclusion initiatives have moderate depression. The app is available seven times but generally relapses after immunisation passport (DI‑passport). accountable for building and outbreaks is underpinned by real‑time improved equity of access to digital on prescription to all 13‑19 year‑olds a couple of months, usually due to work Mari applies for a DI‑passport for her maintaining a robust responsive access to high quality data and technologies and resources targeted and has dramatically improved access stress. His local healthcare authority is children and is assured that all the relevant public health infrastructure, strengthened health protection systems. at reducing inequalities. and reduced waiting times. The app working alongside a social enterprise data from their electronic health records was co‑created alongside young people to reduce smoking rates across its will be uploaded safely and securely, based including regionally coordinated experiencing depression and anxiety, communities, regardless of income, on robust rules, information governance public health agencies; a diverse • AI and predictive modelling is applied • Funding: A greater proportion of to multiple data points including travel healthcare funding is devoted to public and applies gamification techniques to location, age, gender or ethnicity. He has processes and FIHR interoperability and well‑qualified public health patterns, food habits, environmental health as policymakers acknowledge a series of proven CBT activities. Liam has received a SMS notification promoting standards. Her children’s DI‑passport is workforce; and modern data parameters and global prevalence data, the shift in focus from sickness and cure struggled with depression and behavioural an online smoking cessation initiative uploaded via the DI‑passport app on to and information systems. to detect signals to identify health risks. to wellness and disease prevention. problems since the death of a close family which includes impressive feedback from Mari’s smartphone. Mari also opts to use an Non‑traditional players, Stakeholders have implemented payment member, and his therapist has prescribed other users about the results achieved. antibody test that has been made available the smartphone app. Balance uses avatars Will downloads the app and the first step is to confirm her children’s immunity status, including public, non‑profit and • Public health authorities deploy a range reforms, including value‑based payment to explore a 3D world to complete quests, to complete a form describing his previous which is also recorded in the DI – passport. commercial enterprises, based of targeted preventative interventions in models to optimise outcomes at the response to intelligent insights into the lowest cost. meet new characters, play mini‑games history, motivations and cravings. The app If there are suboptimal levels of antibodies, around smart health communities health of the population. and solve puzzles, all designed to help him uses an AI algorithm to derive a tailored an alert is sent to the individual’s primary work together with a focus on • Regulations: Regulators across self‑manage his depression. Virtual guides education and support plan and deploys care provider for further intervention. intelligent protection, prevention • Health promotion strategies have been public health have aligned on core provide him with instructions on how to push notifications to help Will self‑manage Mari can keep track of her children’s and promotion while prolonging co‑created, based on strong public expectations, strengthening public apply the insights gained to help tackle his and modify his behaviours. Will is also vaccinations: this is particularly useful as problems in real life. The app tracks Liam’s monitored through daily questionnaires her children’s new school requires proof longevity and improving the engagement and nudge interventions. health regulations with public health progress using a validated mental health and data from a connected breath sensor. of their vaccination status before either productivity of the nation. authorities proactively measuring • Deep knowledge of local communities and monitoring compliance using assessment questionnaire as he progresses The app recommends nicotine‑based can start. Mari is also able to use the app Digital inclusion and acceleration has reduced health inequalities such as advanced analytics. through game levels. Early on in Liam’s products or facilitates a virtual consultation to alert their family doctor if there are in the adoption of scientific and infant mortality and childhood obesity use of the app, the self‑assessment results with a community pharmacist or physician any adverse reactions to new vaccines. technological advancements with targeted application of evidence- • Data: The authorities have created a alerted his therapist to the fact that Liam to enable e‑prescribing and therapy Her children’s anonymised ‘real world’ data have reduced health risks and based intervention strategies and robust public health IT infrastructure needed further help and an app prompt adherence tracking. Will can also access is used to help monitor responses to the encouraged him to seek face‑to‑face talking digital CBT and a virtual coach who vaccine and spot trends earlier. improved prevention. The public measurable KPIs. to identify and target reductions in therapy. After two sessions Liam felt able supports him in his goal to quit smoking health system is underpinned health inequalities, with a national body • Preventative public health digital accountable for progress. National to continue with the app, and ongoing ahead of his 40th birthday. Will has also by intelligent national screening interventions have dramatically lowered and local authorities have established assessments provided assurance that the opted to join a peer support group. He is and vaccination programmes smoking rates, improved nutrition and data-sharing agreements for collecting, intervention was working. further incentivised by the app notifying that focus on high – risk reduced loneliness. They have also analysing and sharing multiple him that he has saved nearly £500 in his populations through better use reduced premature mortality among sources of data, to address the social first month of being smoke‑free. of technology, genomics and AI. people with chronic and mental health determinants health. Distributed ledgers Empowered local authorities conditions. (such as blockchain) have improved data integrity and transparency over access enabled by digital technology • There is significant investment in and use. and behavioural science infection control with financial incentives focus on tackling the social and penalties driving improvements. determinants of health. • A focus on appropriate use of antibiotics has improved antimicrobial resistance. Note: All elements on this page are from a perspective of 2025 and are fictional 8 9 The future unmasked | Predicting the future of healthcare and life sciences in 2025 The future unmasked | Predicting the future of healthcare and life sciences in 2025
Evidence in 2020
Portugal: Health literacy Serviço England: The PrescQIPP Antimicrobial Australia’s approach to tackling The COVID‑19 impact Nacional de Saúde 24 (SNS 24) Stewardship Hub initiative supports childhood obesity The Directorate General of Health better antibiotic prescribing in Approximately 17 per cent of Australian (DGS) launched the Serviço Nacional primary care children are overweight, and 7 per cent Deloitte view on the impact of COVID‑19 Digital technologies using disparate data sets to support de Saúde 24 (SNS 24) in 2017, as part of A joint initiative between NHS England are obese. The Australian government and The COVID-19 pandemic has highlighted the critical importance the public health response to COVID‑19 the government’s 2020 strategies and and NHS Improvement, the PrescQIPP Healthy Australia have created feedAustralia, of having a robust public health system underpinned by Digital technology can enhance public health education and healthcare system reforms, with a specific Hub offers online access to ready‑to‑use an early obesity intervention, childhood a comprehensive epidemiologically‑relevant data infrastructure communication messages. In the United States, the COVID‑19 focus on strengthening digital health antibiotic prescribing data sets for all nutrition and health education programme. including demographic and mobility data. A consensus is Task Force partnered with Apple, Inc. to develop an app that literacy across the population. The main Clinical Commissioning Groups and GP Over 6,000 early childhood education emerging on the elements of the wider infrastructure needed to provides CDC recommendations, including guidance on social objective of SNS 24 is to serve as the single practices in England, shares successful and care (ECEC) services currently use protect public health, enable recovery and mitigate subsequent distancing and self‑isolation, how to monitor symptoms, access point for health information. It is practice, and links to other AMR‑related feedAustralia’s tools, which include a menu surges in infection. Specifically: recommendations on testing, and when to contact a medical a free online and telephone service that resources, including those published by planning tool and app, which connects to provider. provides first‑hand health information TARGET, Health Education England and existing child care management systems, • test, track and trace – for new cases and levels of immunity, and responds to enquiries 24/7. SNS 24 the Antibiotic Guardian campaign. Data in and includes a nutritional database of to improve the confidence of decision‑makers in reducing The COVID‑19 Mobility Data Network is a network of infectious provides advice and guidance on a range of the PrescQIPP Hub is offered in multiple more than 200 healthy recipes and snack restrictions without undue risk to health disease epidemiologists from universities around the world, health behaviours as well as enabling users formats to allow comparisons across time suggestions with established energy, working with technology companies to use aggregated • evidence‑based mitigation strategies (social distancing, to book vaccinations. It offers services and organisations.36 macronutrient profiles and food group mobility data to support the COVID‑19 response. face masks, hand and environmental hygiene and good that allow people to solve health‑related breakdowns. The feedAustralia programme Their goal is to provide daily updates to decision‑makers ventilation) together with segmentation based on an issues without having to visit a primary The US: Grapevine Health – community also saves each service an average of at the state and local levels on how well social distancing understanding of how and where transmission occurs care service or hospital. The platform is health literacy project $3,500 in groceries every year.39,40 interventions are working, using anonymized, aggregated accessible across a range of devices and Grapevine Health is a non‑profit • consistent and clear communication strategies to data sets from mobile devices, along with analytical support aims to support users in plain and simple start‑up in the US that designs culturally encourage compliance with mitigations and address for interpretation. The participants in the Network share language.33 appropriate health information complacency and dissent a deep commitment to personal privacy and data protection.41 campaigns targeted at underserved Italy: Vaccines are compulsory for populations. Grapevine Health leverages • sustained investment in an adequate supply of personal children enrolling in state‑run schools storytelling, short educational videos, protective equipment (PPE) and other infection control In 2017 the Italian government’s National community‑based support and digital resource requirements including new supply chain solutions. Plan for Vaccine Prevention (NPVP), communication to improve health followed by the National Law 119/2017, literacy and health care engagement. increased the number of mandatory Grapevine Health has joined the Health Better publi health dri es better produ ti ity vaccinations from four to ten (vaccination Equity and Access Leadership (HEAL) for polio, diphtheria, tetanus, pertussis, Coalition, along with 16 other health What you need Where to fo us hepatitis B, haemophilus influenzae B, tech organisations including Google A national accounta le authorit Beha ioural science measles, mumps, rubella and chickenpox). and Microsoft, to use technology to stem leadership What you get Effective surveillance The vaccines are compulsory for tackle health disparities exacerbated pert pu lic health orkforce mart heath communities Digital inclusion 37,38 Appropriate funding Ill ealth pre ention Pu lic health campaigns children enrolling in state‑run schools, by COVID‑19. PR CT EV RWD and IT infrastructure TE EN Producti e emplo ees ealth creening O T and fines were introduced for parents/ R
Local and national le el partnerships P PUBLIC Efficient response to major incidents programmes
guardians refusing vaccination. Partially P
R Reduced pu lic health risks
Vaccination
HEALTH O G
M
N
O
or unvaccinated children under the age O
L
T Reductions in smoking and o esit E O Programmes R
of 6 years were not permitted to attend P Better se ual health pre‑school.34 Data from 2018 shows an Longer health life ears increase in vaccine uptake at the national Good mental health level and in almost all regional and Appropriate anti iotic usage autonomous provinces.35 ource Deloitte afe en ironments
10 11 The future unmasked | Predicting the future of healthcare and life sciences in 2025 The future unmasked | Predicting the future of healthcare and life sciences in 2025
Clinicians are empowered by new diagnostic and treatment paradigms Genomics and AI are driving more predictive, preventative, personalised and participatory (4P) medicine
The world in 2025 Conquered constraints Imagine the world in 2025 Prediction: In 2025, medicine • Clinicians have access to data from • Skills: The education and training of all has undergone a paradigm multiple sources to help understand clinicians now includes an understanding shift with clinicians basing changes in patients’ health, including of medical research, statistical analysis Nanotechnology used as a drug delivery Developing a 3D printed heart with CAR‑T therapy, a type of their diagnoses and treatment vital signs (blood glucose, heart rate and data science, and the ability to model for cancer remote imaging immunotherapy, providing a unique Oni is clinical director of a research centre Dr Klein identified that his patient Paul, approach to cancer treatments decisions on predictive, and blood pressure); physiological interpret and convey to patients biometrics (sleep and voice patterns) diagnoses derived from genomic, digital transforming the way cancer therapies who has cardiovascular disease, requires accelerating the shift to product as preventative, personalised and and environmental metrics (weather and AI applications. Clinicians are also are delivered. Her research team has a heart transplant. Cardiovascular disease a service participatory (4Ps) medicine. conditions and pollutant levels). trained in using virtual technologies been using AI and nanotechnologies is the leading cause of death globally. Most healthcare authorities have This shift has been driven by and conducting virtual consultations. for drug development and precision Heart transplants are the only way to treat established funding and treatment sites technological and scientific • Molecular biology, computational analysis New clinical specialisms have evolved. therapy; and have discovered several end‑stage heart failure. There are over for Chimeric antigen receptor (CAR‑T) advancements including: digital and mathematical modelling identify new targets for cancer therapies and 100,000 people on the organ transplant T-cell therapy, a type of individualised a new drug delivery model consisting waiting list. Dr Klein is concerned that immunotherapy that involves therapeutics, epigenetics, what properties, at cellular, tissue or • Funding: Providers have invested in organism levels, are responsible for data and analytics capabilities, and use of nanoparticles. The nanoparticles are a long wait would have potentially fatal reprogramming the patient’s own immune and AI; massive amounts of health conditions. of real world evidence (RWE) to inform loaded with cancer drugs, and can target effects on his patient’s health. Knowing that cells which are then used to target their health data and information; disease stratification, tailor dosing, specific areas of cancer cells, delivering the hospital has a partnership with cancer. Hans, who has been diagnosed and increased expectations of • Clinicians have access to fast, reliable and provide tailored drug regimens. high doses of treatment without damaging the academic science and engineering with relapsed/refractory lymphoma, the quality of care provided. AI-enabled diagnostic technologies, Organisations collaborate in designing other body cells (as in typical cancer department at his local university who has been referred by his clinician to be Technological breakthroughs in including radiology and pathology, as new payment models that reward treatments). The nanoparticles are also have been pioneering the development assessed as a potential candidate for the infused with a non‑toxic dye so that they of 3D printed organs, he contacts them treatment. As access to CAR‑T is controlled AI, nanotechnology, quantum well as new point-of-care diagnostics, providers for health outcomes and better including liquid biopsies, to help detect management of health and wellness. can be visualised and scanned to make to discuss Paul’s situation. They agree to via an enrolment process, Hans is referred computing and fifth‑generation and analyse molecular biomarkers. Value‑based care models are used to sure the drugs have been delivered to develop a 3D printed heart using Paul’s to the nearest CAR‑T cell therapy centre. wireless technologies, have re‑allocate resources to where they can the correct cells. This highly targeted, tissues including blood vessels, collagen The specialist at the centre establishes that enabled the development of • Treatments are based on be most effective. hyper‑personalised therapy minimises the and other biological components. Paul is Hans meets the clinical eligibility criteria faster, customised diagnostic hyper‑personalised, data-driven insights patient’s risk of adverse reaction. Oni’s new scheduled for his heart transplant, and says that the centre can begin his pathways. Clinicians are also and interventions through multiple • Regulations: Organisations have technology opens the way to many exciting bypassing the waiting list for organ donors. treatment within a week. Hans is informed therapeutic approaches for targeted high Following Paul’s operation, he is fitted of the risks of the treatment but because supported by AI‑enabled clinical real‑time data insights. A new value chain adopted rigorous nationally‑agreed is emerging, driven by the explosion standards of ethics and safety for concentration drug delivery to cancer cells with a FHIR‑compliant remote monitoring evidence suggests that response rates decision tools that incorporate in health data to generate highly the use of AI and genomics medicine with reduced injury to normal cells. system that holds his biometric data in are as high as 80‑90 per cent, he elects data on biomarkers and genetic personalised therapies in the form of in healthcare, within a technical a secure, self‑tracking cloud‑based platform to go ahead. At the clinic, his immune information, as well as clinical tailored nanoparticles, 3D bioengineering infrastructure that supports SNOMED‑CT via a smart patch. The patch monitors cells (T‑cells) are isolated from his blood, and behavioural health data, of transplantable organs and skin grafts, medication terminology and HL7 FHIR Paul’s vital signs including heart rate, blood engineered and genetically modified, grown to deliver hyper‑personalised gene editing, and implantable microchips application programming interfaces. pressure and oxygen saturation levels and then expanded in vitro, producing which links to his electronic record. Dr Klein millions of cells which are infused back evidence‑based prevention to control pain. • Data and interoperability: then monitors Paul’s data remotely, and is into the patient. Because the cells go on to and treatment interventions. • Clinicians are supported by clinical Healthcare providers have built a new able to offer timely interventions. multiply in the body and continue fighting Clinicians also use point-of-care decision aids and medication and open multi‑omics data ecosystem, the cancer, Hans needs just one CAR‑T cell diagnostics and knowledge management technology to co‑create underpinned by blockchain open infusion. His prognosis is very positive and about the genetic markers proactive prevention strategies involving source technology, and use distributed he is supported in his recovery through of a disease and Health patient’s as active participants in care databases for secure transcription a virtual rehabilitation coach who can answer any concerns. At the last follow‑up Technology Assessment (HTA) decisions. to address most privacy and security concerns. Data is of low latency and high visit he celebrated his one‑year remission. guidelines to determine the • Clinicians share the complete records bandwidth, with unlimited continuous treatment that it most likely to of a patients previous interventions, internet connectivity. benefit the patient with minimal medication prescriptions, physical side effects; ultimately lowering therapy recommendations, and care costs. outcomes, to co‑create 4P care plans.
Note: All elements on this page are from a perspective of 2025 and are fictional 12 13 The future unmasked | Predicting the future of healthcare and life sciences in 2025 The future unmasked | Predicting the future of healthcare and life sciences in 2025
Evidence in 2020
Bioelectric technologies – implant to Tel Aviv University scientists print Gene therapies breakthrough: The COVID‑19 impact mitigate chronic pain a 3D heart using the patient’s own cells ZYNTEGLO treats rare genetic disease Traditionally, pain management involves Tel Aviv University researchers have In June 2019, ZYNTEGLO® gained approval Clini ians are empowered by new diagnosti and non-personalised treatment with multiple ‘printed’ a 3D vascularised engineered from the European Medicines Agency (EMA) Deloitte view on the impact of COVID‑19 treatment paradigms medications (including opioids) that may heart using a patient’s own cells and for the treatment of patients (aged 12 years Researchers across the world have openly shared their be ineffective. A novel development that patient-specific biological materials. They and older) with transfusion-dependent findings, including the genetic sequencing of the virus to Genomi s dri ing Smart sensors involves imbedded devices like a spinal used 3D-printed thick, vascularized and β-thalassemia (TDT). Patients with this establish its phylogenetic tree. Many have explored the personalised, predicti e, and materials more accurate diagnosis Automaticall collecting cord-stimulating unit with a battery- perfusable cardiac tissues that completely rare genetic disease, which is caused by potential for repurposing existing drugs as an efficient and treatment and transmitting ital powered magnetic transmitter on a matched the immunological, cellular, mutations in the β-globin gene, have reduced and cost-effective approach to developing prevention and signs data wearable belt. More generally, bioelectric biochemical and anatomical properties of or absent levels of haemoglobin, and require treatment strategies. Potential treatments are emerging as therapy is effective in providing temporary the patient.45 lifelong regular blood transfusions to lessen clinicians and scientists share their increased understanding 3D printing deli ering Roboti s pro iding personalised medicines more accurate tools for pain control, but it should only be a part of the chronic anaemia and, ultimately, survive. of diagnosing and treating the disease and use predictive or medical de ices comple surgeries and a total pain management program. When FabRx: 3D printing of medicines ZYNTEGLO’s therapeutic approach makes analytics to evaluate how specific groups of people might streamlining edside used along with conventional pain-relieving 3D printing technologies aim to deliver use of autologous CD34+ stem cells that respond. This increased understanding is expected to pave care deli er medications, bioelectric treatment may unique personalised medicines that can be have been genetically modified to contain the way for precision medicine and personalised treatment Blo k hain Ad an ed digital reduce the dose of some pain medications tailored to individual patient requirements. the working β-globin gene. This authorisation strategies for COVID-19 and improve the evidence base open source technolog imaging from by up to 50%.42.43 In an academic study, FabRx 3D printed six for European marketing was the fastest and approach to the management and control of other using distri uted AI‑ena led CT and RI data ases impro ing machines to point of care different drugs into a multi-layered polypill, assessment of an advanced therapy infectious diseases. data integrit and the handheld ultrasounds Nanomedicine’s potential in demonstrating the potential to improve medicinal product (ATMP) to date, having also transparenc treating disease personalisation for patients. These polypills benefited from the EMA’s Priority Medicines NaNotics, a nanomedicine company, builds aim to help patients adhere to their regimen (PRIME) programme.48,49 CovidNudge: rapid, lab-free COVID-19 test Telehealth technologies enhanced 46 DnaNudge’s, CovidNudge test is a rapid, accurate, portable subtractive nanoparticles that remove and better manage their medications. G connecti it specific disease-causing molecules from Kheiron Medical Technologies and lab-free RT-PCR test that delivers results at the point of supporting acti ities the human body. NaNots do not target PatientsLikeMe (PLM) DigitalMe A UK-based deep learning company need and in just over an hour. The test is authorised by the from RP to telemedicine diseased cells or stimulate immune PLM, a US based company has created an which has developed Mia (mammography MHRA for clinical use and has subsequently obtained its CE cells: they modulate cellular behavior by open online community that is designed intelligent assessment), an AI solution for mark. An average sensitivity, compared against numerous depleting specific signal molecules or their to give a voice to a patient’s story, and breast cancer screening. The AI algorithm NHS lab-based tests, is around 95% and specificity around inhibitors from blood – without disturbing turn that story into data. The company is has been developed on over three million 100%. These results satisfied the MHRA’s performance normal cell signaling. Different NaNots developing DigitalMe, a virtual avatar of the real-world screening mammography criteria. The test is now being rolled-out UK wide in urgent can be biochemically programmed to patient, based on a standardised profile, images and the initial retrospective NHS patient care and elective surgery settings, plus out-of- deplete specific targets driving different qualitative and clinical data. The data evaluation of the system indicated that hospital locations.51 diseases. NaNots are injected into the combine to create a comprehensive digital it compares favourably with established body like a drug, and can potentially treat picture of an individual patient, designed to performance benchmarks for modern any disease enabled by soluble molecules, predict the outcomes of various therapies. screening digital mammography. Kheiron including cancer, autoimmune disease – DigitalMe allows patients in partnership has recently completed a second clinical even infectious diseases like COVID-19. In with their HCPs to ‘try’ alternative study which tested the solution on over a mouse model of triple negative breast interventions, such as a new drug, on the 250,000 cases - making it one of the most cancer, NaNots depleted more than 90% digital avatar first before identifying the ambitious studies in radiology AI to date. of their targets in less than five minutes, one likeliest to succeed.47 This study showed a level of performance blocking metastasis and significantly that strongly indicates practical utility and outperforming checkpoint inhibitors.44 a level of generalisability that strongly Ad an ed te hnologies an impro e indicates safety. The results of this second patient outcomes health care related costs 50 study will be published shortly. access to health care accurac of diagnosis and treatment customisation of products pri ac and securit of patient data