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 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 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 trends

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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 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 ‑recommended AgeTech Her doctor, Dr Ahmed, advises her how chronic disease and have , 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 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 . 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 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 healthare 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 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 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 dries better produtiity 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 fous hepatitis B, haemophilus influenzae B, tech organisations including Google A national accountale authorit Behaioural 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 pulic health orkforce mart heath communities Digital inclusion 37,38 Appropriate funding Ill ealth preention Pulic health campaigns children enrolling in state‑run schools, by COVID‑19. PR CT EV RWD and IT infrastructure TE EN Productie emploees ealth creening O T and fines were introduced for parents/ R

Local and national leel partnerships P PUBLIC Efficient response to major incidents programmes

guardians refusing vaccination. Partially P

R Reduced pulic health risks

Vaccination

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or unvaccinated children under the age O

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of 6 years were not permitted to attend P Better seual 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 antiiotic usage autonomous provinces.35 ource Deloitte afe enironments

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 and , 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 , 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, involves Tel Aviv University researchers have In June 2019, ZYNTEGLO® gained approval Cliniians are empowered by new diagnosti and non-personalised treatment with multiple ‘printed’ a 3D vascularised engineered from the European 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 Genomis driing 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, predictie, 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 deliering Robotis proiding 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 deices comple 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 delier medications, bioelectric treatment may unique personalised medicines that can be have been genetically modified to contain the way for precision medicine and personalised treatment Blokhain Adaned 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 distriuted AI‑enaled CT and RI dataases improing 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 ’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 connectiit specific disease-causing molecules from Kheiron Medical Technologies and lab-free RT-PCR test that delivers results at the point of supporting actiities 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 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 Adaned tehnologies an improe 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 priac and securit of patient data

ource eloitte P 18

14 15 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

The who, what and where of work rearchitechted Healthcare professionals, augmented by technology and life‑long learning, have transformed their ways of working

The world in 2025 Conquered constraints Imagine the world in 2025 Prediction: In 2025, advances • New ways of working, augmented by • Skills and talent: Recruitment strategies in AI‑enabled robotics, automation and robotics, have helped have encouraged a wide range of more cognitive automation and providers with task-shifting and role diverse individuals from more varied A community pharmacist supporting A smart hospital enabling healthcare Expediting a patient’s safe diagnosis digitalisation are helping HCPs enrichment to create a sustainable and backgrounds to become HCPs. All HCPs patients virtually in 2025 professionals to work differently and treatment Olivia is a community pharmacist who Dr Patel is the Chief Clinical Information Tony, 80, is experiencing a chesty cough to work more productively, flexible workforce. receive core training, using blended oversees the care of Ayesha, a 60 year‑old Officer of a brand new ‘hospital’ which with sputum and has been feeling including rearchitecting the learning methods, including classroom • Employers refine the working culture and and on‑line digital training and VR to patient with Parkinson’s disease alongside opened its doors in 2022, following increasingly unwell. Tony uses his general who, what, where and how working conditions including enabling increase expertise. There is an emphasis other comorbidities. Because of Ayesha’s a $2.4 billion investment and a decade of practice’s AI‑enabled clinical assessment work is done. There is more HCPs to practice at the top of their license on continuous development of core complex medication regime, Olivia provides planning and construction. The hospital tool which suggests a possible diagnosis focus on cognitive, emotional as part of a blended workforce, augmented human traits such as problem solving, her with a monthly supply of medication has 400 patient rooms and a robot‑enabled of pneumonia and recommends that he and analytical skills and less by AI-enabled clinical decision aids, robotics communication and engagement. to be taken via a smart medication infrastructure with consumables and should speak with his doctor immediately. dispenser. Olivia loads the dispenser at the medical equipment delivered to each room Dr Jones receives an urgent electronic on repetitive, administrative and other digitally enabled insights. Professional competencies in genomics, using an automated robot and via a fleet of 23 self‑driving robots, each the alert to call Tony. Dr Jones reviews Tony’s tasks. These changes enable digital health, data analytics and ethics • Training is focused on developing cognitive, have become part of the curricula. programmes it to release medication for size of a large office printer. The robots have medical notes and can see that Tony is all HCPs to practice at the top digital, emotional and analytical skills to All HCPs are also expected to have an Ayesha at set times, and to sound an alert their own infrastructure and a dedicated generally fit and healthy, but wellness data of their professional license, enable HCPs to communicate effectively understanding of how the health system when medication is released. The device elevator, and they move through corridors fed through in real time from wearable enriching career development with each other and with patients, works, with an increased focus on agile, is registered to Ayesha’s smartphone app, at two miles per hour, transporting heavy devices show that he has a low temperature 0 opportunities, improving the whether face‑to‑face or remotely. adaptable and collaborative working and if the medication is not taken at the items such as rubbish, bedding and food. of 35.5 C, an increased heart rate of correct time Olivia is alerted since Ayesha’s There is also a machine for dispensing pills 91 beats per minute and a breathing rate attractiveness of the profession across the health ecosystem. medications are time‑critical. One day, in sealed-box packs (which is connected to of 22 breaths per minute. These results, and creating new specialisms. • HCPs are confident in discussing the results of AI-enabled diagnostics and • Funding: National and local governments Olivia is alerted via a SMS to the community a medication distribution and electronic coupled with Tony’s symptoms, suggest Task shifting is commonplace genomics testing with staff and patients. help determine and allocate training pharmacy’s smartphone that Ayesha has health registration system). Each room he may be at risk of developing sepsis leading to a diverse, multi- budgets and align incentives and not taken two scheduled doses of her is equipped with a smart TV (which related to pneumonia and so requires professional, blended, workforce • HCPs proactively respond to intelligent funding models to create a flexible and Parkinson’s disease medication. She calls also enables daily menu selection and immediate medical attention. Dr Jones that is employed across alerts from continuous vital signs sustainable workforce. Employers provide Ayesha via an online consultation platform translation facilities), IoMT‑connected arranges to speak with Tony in an online and carries out a structured medication medical devices, and a bed and chair consultation and arranges a zero emissions permeable boundaries providing monitoring or from digital telehealth opportunities for staff to develop their review to check if Ayesha is okay, and asks with in‑built sensors to detect when the e‑ambulance that has a video and voice care wherever needed. All HCPs coordinators, providing effective advice skills, underpinned by consistently applied and real‑time interventions. remuneration packages. whether she requires any counselling patient gets in or out. Patients download collaboration platform. Dr Jones is able to participate in multi-professional or advice relating to her medication or a smartphone app to enable them to communicate virtually with the paramedics training to enable more adaptive, • The provider infrastructure is configured • Regulations: Regulators and professional condition. Ayesha explains that she had navigate the hospital. Dr Patel’s philosophy and send through Tony’s results via an agile ways of working. This to assist HCPs with data sharing across bodies collaborate to ensure compliance taken her smart dispenser to dinner with is that it’s not about the technology but API integrated platform. This ensures training uses simulation and organisational boundaries. with safe staffing models. They also partner a friend the previous evening and had is about a hospital change management that the e‑ambulance is equipped with misplaced it. Olivia arranges for a new programme with AI‑enabled technology an appropriate sepsis biomarker test kit virtual reality to equip HCPs to with academia to design education smart dispenser to be delivered to Ayesha supporting staff to work differently. and the specific antibiotic medication to use technological innovation. • Pharmacists’ have a greater role as curricula, to align learning needs with the caregivers and provide online and video evolving roles and responsibilities of the on the same day, to ensure that she does He believes they will see a positive return treat the infection at the point-of-care This enables staff to adapt their consultations and monitor and track technology‑enabled healthcare workforce. not miss any further doses. on the investment and improved patient without delay. skills to work where and when medication adherence remotely through outcomes. needed. Staff are also trained in smart pill dispensing devices. • Data and interoperability: Staff understanding the application understand data provenance, curation, and ethics of genomics, digital • Some health tasks are conducted integration and governance, and the ethical, health and AI in determining by physical robots delivering and data privacy and security considerations administering medication, taking and associated with technology. They obtain treatments and are able to documenting vital signs and conducting the benefits of data sharing while convey this to patients. minor procedures. Remote and complying with robust information robot‑assisted surgeries for several major governance and data security standards. procedures are commonplace.

Note: All elements on this page are from a perspective of 2025 and are fictional 16 17 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

Area9 has developed a blended CMR Surgical Ltd, widening adoption Virtual reality is reshaping training of The COVID‑19 impact education platform to customise of robotic surgery healthcare professionals healthcare learning experience Robot‑assisted minimal access surgery Virtual reality is being used for medical Area9 have partnered with the New (MAS) reduces blood loss, recovery education. Embodied Labs has created Deloitte view on the impact of COVID‑19 AI‑enabled platform REiLI, supporting radiologists in England Journal of Medicine (NEJM) Group time, intraoperative and postoperative a programme called We Are Alfred COVID‑19 has had an unprecedented impact on healthcare assessing the impact of COVID‑19 on patients’ lungs to create the first-of-its-kind medical complications and pain when compared that simulates elderly patients’ real‑life services across the world. Health systems had little time to During the COVID‑19 pandemic, hospitals in the Italian education platform, NEJM Knowledge+, to open surgery, yet uptake remains experiences and trains healthcare workers prepare and in the shortest of time frames had to reorganise Lombardy region faced unparalleled pressures, and had to which uses smart technology that adapts low. To increase adoption and improve to understand a patient’s fears.58,59 services, train staff to work in new ways in unfamiliar teams, reorganise services swiftly to tackle the influx of patients with to clinicians’ learning goals, pace of learning outcomes, CMR Surgical Ltd, by working and develop effective ways of supporting the wellbeing of the serious breathing difficulties. and knowledge gaps to deliver customised collaboratively with surgical teams, Wireless StethoMe rolls out AI medical workforce and deliver safe care to patients. All in the absence information and training. Research from developed the Versius® Surgical Robotic device following major deals with of suitable treatments and a real risk of staff acquiring an Vimercate Hospital, a HIMSS 6 hospital leading in digital 2020 shows physicians who used NEJM System, for use in MAS. The system aims European telemedicine providers infection themselves. The response was an unprecedented transformation, collaborated with Fujifilm to implement an AI Knowledge+ performed better on their to empower surgeons to transform how Polish telemedicine innovations company transformation programme implemented in weeks that platform, REiLI, to help reduce the impact caused by the rapid board exams by a statistically significant surgery is performed across the world. StethoMe has announced that it will be might otherwise have taken years. One notable outcome spread of COVID‑19 and to deliver a timely response to the margin than a well-matched control group. The system has a novel, mobile design rolling out an AI wireless stethoscope is an accelerated adoption of digital technologies including evolving pandemic. REiLI’s processing of CT scans and chest Area9, has collaborated with the American with independent arm carts and surgical following recent collaborations adopting new robotic processes to help support service X‑rays (CXR) provides important support for radiologists, Heart Association and Laerdal Medical console, with wristed instrument tips with major telemedicine providers delivery. Hospitals are using data analytics and automated giving them a rapid, objective assessment of zones of to deliver a more adaptive streamlined, providing seven degrees of freedom and MaQuestionMedicale and HomeDoctor. dashboards to ensure staff are working in the most optimal and the lungs for evaluating the presence of the pulmonary personal and tailored resuscitation learning a ‘game controller’ handgrip design. It is The company is also in talks with other efficient manner. A crucial enabler has been the growing use of parenchymal consolidation caused by the virus. The AI experience for healthcare professionals. approved for use across Europe with CMR providers across Europe and hopes to connected care solutions, such as telehealth and remote patient data supports reporting on daily examinations aimed at Area9’s Rhapsode™ learning and publishing Surgical partnering with surgeons and expand operations.60 monitoring, technology‑enabled ways of diagnosing, monitoring monitoring the development of the disease, and also supports platform uses AI to deliver a personalised hospitals. In bio‑mimicking the human and treating patients, eTriage systems and simulation models clinical analysis and decision making. REiLI was installed at and efficient approach that measures arm, Versius® has the ability to improve Liverpool University chooses ‘Better’ for emergency departments and outpatient and primary the hospital in just two weeks. During the first few months of time-to-completion, confidence and team communication, the surgeons’ work way to teach e‑prescribing care consultations pivoting to become telehealth services. the pandemic more than 900 cases of COVID‑19 lung disease self-awareness to more accurately assess environment and career longevity.55,56 Liverpool John Moores University has New approaches to delivering care have also emerged, from were identified using this more precise and timely approach and respond to each learner’s individual teamed up with Better to teach nursing drive-through testing centres to pop‑up walk-in centres and to diagnosis.62 competence and performance.52,53 Patient first: how Karolinska and pharmacy students’ about digital vaccination clinics. University Hospital is transforming to prescribing practices. The university will RITA: Referral and Intelligent meet future demands of healthcare use Better’s OPENeP electronic prescribing Triage Analytics At Karolinska University Hospital in and medicines administration (EPMA) The who, what and where of work rearhitehted RITA uses the latest AI and robotics Stockholm, Solna, new operating models solution as part of student’s learning. technology to automatically triage incoming are designed around patient care flows, It’s aimed at enabling students to learn urrent or otion uture or otion cancer referrals and assign patients to instead of traditional clinical departments. about the prescribing, dispensing and TALENT “WORKFORCE” appropriate pathways. Deloitte initially For example, patients with heart and administering medicines electronically.61 2 Who does the work? completed a proof-of-concept with vascular conditions are treated in an Technological advancements are enabling new models of interaction between the employer, workforce, patients and informal carers. Task shifting and task reorganisation a department in a Scottish integrated manner, with specialists from have led to a more diverse, multi-professional, blended, workforce that is employed hospital, with promising results. In the proof- functions such as , across permeable boundaries of-concept, RITA developed an algorithm imaging and working together based on analysing over 24,000 incoming – often in the same building or corridor. referrals, using natural language processing This new operating model is strengthening to identify patterns in the referral letters cooperation between different functions, “WORKPLACE” “WORK” and assign them to a specific pathway. improving patient care, and delivering Where is the work done? What is the work being done (including work patterns)? 57 Proximity - Rethinking combinations of talent, technology and RITA displayed a high level of accuracy in better outcomes. Increasing automation, cognitive and AI technologies have changed workplace. Where do the workforce need to be located to deliver triaging patients with suspected cancer. the perceptions of what needs to be done by humans and what work services and support to patients including remotely, reshaping where can be done by and with smart machines and when work gets done The project has now been extended to two other cancer referral processes and 3 is following the necessary regulatory 1 PHYSICAL PROXIMITY processes.54 AUTOMATION ource Deloitte

18 19 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

Care is designed around people not place Fully integrated care models are delivering more accessible, efficient and cost-effective patient-centred care

The world in 2025 Conquered constraints Imagine the world in 2025 Prediction: In 2025, the • Healthcare services and clinical pathways • Skills and talent: Multidisciplinary integrated healthcare have been redesigned with and around teams facilitate collaboration amongst delivery model is adaptive the needs of specific patient groups to the different professional groups and Virtual wards and digital command Streamlining the patient’s experience Remote monitoring and delivery of based on digital-first triaging deliver seamless integrated care. functions working successfully across centres optimise hospitals’ clinical and of care, from home to hospital personalised antimicrobial therapy operational services discharge Sally is experiencing symptoms of a urinary and signposting patients to organisational boundaries to deliver • HCPs in primary care act as care care in the most appropriate settings. As part of a new partnership, some Kate’s heart disease has worsened, and tract infection (UTI). She has a history of the most appropriate care navigators and co-create patient New models of education and training 50‑plus hospitals have aggregated care in two weeks she will be undergoing recurrent UTIs and her electronic health setting. Networks of primary care plans. have equipped staff to use digital delivery monitoring into a single digital a coronary angioplasty at her local record includes a history of the antibiotics care providers manage technologies, AI and genomics to design command centre. Mohammad is the centre hospital to improve blood flow through she has received and found to be effective population health needs in • Widespread use of AI-enabled services around the patient. director, managing a team of 200 medical her coronary arteries. To learn about her in the past. She uses her smartphone a patient‑centric healthcare technologies have enhanced care professionals on-site and 400 team condition and what to expect from the app to book a virtual appointment with members off-site who monitor and manage surgery, she is using an app prescribed a medical professional. Her doctor, Dr model. Advanced technologies delivery including pharmacy dispensing, • Funding: Budgeting in silos has been smart ambulance services and radiology replaced with integrated care budgets to patients remotely using cloud‑based, by her physician during her pre‑operative Richards, asks her to use a home testing and data interoperability and pathology services. Virtual command support population health management. interoperable electronic health records. assessment. The app includes directions kit to confirm her diagnosis. The kit is provide continuous connected centres manage customer relationships, Funding extends to telehealth services On their health record, patients have to the catheterisation laboratory where delivered to Sally via her local pharmacy on care. Digital tools support including RPM. and social prescribing to support a dashboard showing information on the surgery will take place, parking the same day. The results are immediate: HCPs in co‑developing equality of access to digital solutions. their Health ID, hospital location and vital information, and where her partner can the test is positive, showing that Sally has personalised care plans with • Telehealth services involving continuous Data‑driven funding models have signs trend line. The patient’s risk status wait during her surgery. Ahead of the a UTI caused by Escherichia coli (E. coli), is symbolised as a simple green dot for appointment, the app prompts Kate to a type of bacteria commonly found in their patients. AI‑enabled RPM RPM at home and in hospitals, attracted new stakeholders, driving transmitted via the cloud and displayed innovation across the health ecosystem. low risk and red for high risk – that beeps complete pre‑operative forms about the gastrointestinal (GI) tract. The result and point‑of‑care diagnostics through real-time dashboards alert HCPs intermittently. The team monitors red dots her health, and when she arrives at the is uploaded instantly to her electronic collect and interpret real‑time to deterioration in a patient’s condition. • Regulation: Regulators help support closely and alerts the hospital’s own staff or hospital, she is given a smartwatch that health record, and Dr Richards is notified. data on vital signs, whether innovation while promoting public and the field force about possible interventions monitors her vital signs. This information Through an AI‑enabled clinical support in hospital or at home, so • Digital hospitals cater to patients provider safety. They work with provider if a patient’s risk escalates. Digital real‑time is fed directly into her electronic health tool that looks at Sally’s history and HCPs can intervene early. requiring urgent or more complex organisations to develop products and monitors track a patient’s health in the records. Kate’s surgeon can access her pharmacogenetic profile, Dr Richards sees hospital and at home, and the command vital signs data, consent forms and history which antibiotics are most suitable for her, Enhanced HCP‑to‑HCP interventions, including robotic critical solutions based on a security-by-design care and complex surgical procedures. mind-set and a trustworthy framework centre uses AI and predictive analytics to via her electronic record which he reviews to provide the correct therapy at the correct communication provides for data exchange. Compliance with help with diagnosis and treatment plans. in advance. Before and after the surgery, dosage. Through the smartphone app, more coordinated, efficient • Community health hubs in partnership robust cyber security standards has Patient‑facing virtual assistants also make Kate is provided with real-time information Dr Richards arranges for Sally’s antibiotics and cost‑effective care. with voluntary, private, health and social reduced risks, despite the increased use direct requests to the command centre on the progress of her health via an iPad to be delivered to her home via her local Advanced network connectivity care sectors provide a hybrid (virtual and of connected medical devices. (using natural language processing) which that connects to her wearable. A monitor pharmacy. She requests that Sally uses provides an array of face-to-face) one-stop shop. They deliver the team reviews, allocating support above her bed also displays the information a wearable device to assess remotely any accordingly. Mohammad obtains real‑time in real‑time for her care team to view. signs of intolerance to the antibiotics. opportunities around real high quality preventative clinical services • Data and interoperability: Data science (such as and ), and cloud technologies have improved data on operational efficiency, and his She has access to a health‑bot hologram Through continuous remote monitoring, time monitoring, combining rehabilitation, phlebotomy, diagnostics the security, completeness and quality statisticians use predictive analytics on which answers her queries. Once Kates Dr Richards can see that she does not have data from biosensors, health and minor urgent care. of health and behavioural data. hospital (clinical and operational) and electronic discharge plan is activated, any signs of an inadvertent reaction and applications and personal Agreed interoperability standards community health data to forecast needs the pharmacy is automatically notified Sally reported that her symptoms have health records. This includes • Automation and AI algorithms have have accelerated data sharing between for clinician and nursing staffing, supply to dispense her prescription, and her cleared. the use of digital twins to enhanced pharmacists’ responsibilities, all stakeholders, enabling insights chain operations and logistics to ensure smartphone app notifies her partner she efficient use of resources. is ready to be picked up. The app provides predict and monitor responses including diagnosing and prescribing from these data to inform shared approved medications and managing decision‑making, and enable real‑time information about her medication, what to disease and treatments. chronic diseases. diagnosis. The emergence of 5G, cloud to expect throughout recovery, diet and and edge computing together with AI lifestyle advice, wound management advice • Retail enhance the consumer algorithms has provided the analytical and tracks her progress to support Kate’s experience using 3D printing, self-check scale and speed to drive the new virtual speedy recovery. kiosks, telehealth, 5G-enabled telehealth, healthcare ecosystem, including data and same-day delivery. simulation and visualisation, with strict protection of patients’ data. Note: All elements on this page are from a perspective of 2025 and are fictional 20 21 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

Freenome: Artificial Intelligence Israel‑based Sheba Medical Center A digital biomarker for diabetes The COVID‑19 impact Cancer Diagnostic launched the ARC innovation center Given the multifactorial vascular effects of The Longevity Vision Fund has invested in 2019 diabetes, researchers hypothesised that in Freenome, which has developed early To promote open innovation in the smartphone-based photoplethysmography, Deloitte view on the impact of COVID‑19 Rapid deployment of emergency and outpatient detection blood-based diagnostic tests medical arena, the Israel‑based Sheba ((PPG) a simple optical technique used Since the start of the COVID-19 pandemic, healthcare providers ophthalmology video consultation services at Moorfields for cancer. In a recent study, Freenome’s Medical Center launched the ARC to detect volumetric changes in blood in have implemented a major transformation, reorganising Eye Hospital NHS Foundation Trust diagnostic test demonstrated a 94% innovation center in 2019. ARC (accelerate, peripheral circulation) could provide a widely services and training staff to work in new ways in unfamiliar Moorfields Eye Hospital NHS Foundation Trust is one of specificity (patients who do not have the redesign, collaborate) is as an incubation accessible digital biomarker for diabetes. teams. Moreover, the rate of the adoption of virtual healthcare the largest providers of ophthalmology services in Europe. disease) and a 94% sensitivity (patients hub for start‑ups to work with hospital Researchers developed a deep neural technology has accelerated across the world. Healthcare teams Between 2018 and 2019, the Trust handled nearly 800,000 who do have the condition) for early-stage executives in identifying unmet clinical network (DNN) to detect prevalent diabetes have developed and implemented new ways of working while patient encounters, and about 100,000 patients attended colorectal adenocarcinoma. The standard needs through breakthrough solutions. using smartphone-based PPG from an initial keeping patients in a safe, remote environment. This includes the main accident and emergency (A&E) department or genetic diagnostic rate is in a range of 33% It currently focuses on innovation in six cohort of 53,870 individuals (the ‘primary the use of virtual consultations, RPM, and the use of apps and an emergency satellite clinic. The COVID‑19 pandemic to 98% sensitivity and a range of 72% to areas – precision medicine, telemedicine, cohort’). Their findings demonstrate that wearable devices for disease surveillance and interventions. and subsequent UK lockdown in March 2020 created two 99% specificity.63,64 virtual reality (VR), big data and AI, surgical smartphone-based PPG provides a readily New business models have been developed at speed with immediate challenges for the Trust: how to identify and innovation, rehabilitation, each headed by attainable, non-invasive digital biomarker of medical leaders, including hospital boards collaborating with manage the most critical emergencies while minimising Bradford Teaching Hospitals NHS Sheba’s senior physicians, along with the prevalent diabetes.68 private providers to create the right infrastructure including hospital visits, and how to provide care to those patients for Foundation Trust (BTH) opens a digital start‑ups. A major feature of the ARC is the tools and training to enable a digital-first health ecosystem. whom prolonged care disruption could lead to significant command center the fully digital reality‑based departments HBKiCare, home monitoring solution As healthcare providers attempt to recover and restore normal harm or loss of vision. The national roll out of video In November 2019 the Bradford Teaching in the medical centres. Sheba is working jointly marketed by the UAE and Israel activity levels, infection control measures and social distancing consultations in Trusts across England, led by NHS England Hospitals NHS Foundation Trust (BTH) with extended reality start‑up XRHealth to The first product to be jointly marketed rules are being used where possible to help minimise and NHS Improvement, enabled rapid roll out of multiple opened a digital command centre to help use a digital reality platform for cognitive from the United Arab Emirates (UAE) and unnecessary interactions between patients and HCPs to help services across the Moorfields network, covering both drop‑in a centralised ‘control’ team see the full therapy, , pain relief and Israel is HBKiCare a “universal remote mitigate the spread of COVID-19. Digital working is becoming and scheduled appointments.70 picture of hospital activity in real time. other applications throughout the hospital. healthcare IoT platform” and home-care the ‘new normal’. The team monitors a ‘wall of analytics’– XRHealth’s platforms are particularly useful kit, soon to be released by Dubai’s multiple digital screens on the wall–that in helping medical professionals analyse Hamad Bin Khalifa Department of pulls streams of data from various sources patient data in real time to track their Projects HBK DOP and the Ramat Care is designed around people not plae such as BTH’s EHR system, patients’ vitals recovery both physically and remotely.66 Gan‑headquarted healthcare IoT software sensors, and other scheduling systems to developer, Sure Universal. The solution make a real‑time impact on all operational, Ohio State University’s (OSU) Wexner enables “continuous patient monitoring clinical and financial decisions. Medical Center uses bedside tablets with maximum flexibility and affordability,” With over 96% utilisation and a 40% that act as virtual care assistants for recording electrocardiogram (ECG), increase in ER visits in the past ten years, patients and relatives temperature, pulse, blood oxygen and the command centre will help optimise the The tablet, with the OSUMyChart pressure measurements.69 resources and improve how patients move application, allows patients to see their in and out of the hospital. The ‘wall’ enables EHRs, ask questions, view test results, faster ambulance transfer times, faster and schedule appointments. Patients can intra‑hospital patient movements, getting set medication alarms, schedule visits by home quicker, and even fewer surgery physicians and relatives, view test results, cancellations due to winter pressures.65 or read educational material about their diagnosis. Patients can also make minor requests for water, snacks, and even for help going to the toilet, without using a nurse call button.67

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MedTech and the IoMT are crucial drivers of value‑based care Data from connected medical devices is enabling population health management

The world in 2025 Conquered constraints Imagine the world in 2025 Prediction: In 2025, MedTech • Government and other funding models • Skills and talent: MedTech companies companies are actively driving the have expanded to provide wide-scale recruit talent with advanced digital, cognitive future of health, focusing on the telehealth coverage including telemedicine and analytical skills and have established The use of RWE to smooth regulatory Recent technology developments Digital therapeutics successfully use of transformative technology to and other breakthrough technologies to partnerships with academia, tech companies medical device submission and streamlining stroke care and treating chronic back pain expedite approval SBTech has a reputation for its strong enhance products and services and deliver efficiencies and proactive care. and innovative start-ups, to obtain access dramatically improving outcomes Amen is the market access lead for a new Mike is at high risk of having a stroke, innovation and product development enable 4P medicine. Companies to data scientists and bioengineers. • Most MedTech companies have robust Six new MedTech roles have emerged medical device aimed at transforming the having had two mini strokes. Knowing that (I&PD) strategy which has helped it to have access to sophisticated data strategies and transparent policies for (see figure) with leaders acquiring new management of diabetes. In gathering stroke was the third main cause of death develop and deliver the right products analytics capabilities through generating and publishing peer-reviewed skills and capabilities. the information needed for regulatory and disability, he and his wife Mary had to market at the right time using agile in‑house skills development and evidence on efficacy of outcomes including approval, he first piloted its use in a small recently attended an online support development methodologies and advanced partnering, working closely with HTA cost-effectiveness analyses. • Funding: Companies’ new payment patient pool to refine the technology and group training session on recognising the IT tools that support engineering and collect efficacy data. He then partnered signs of a stroke. Mike was in the kitchen clinical development. SBTech has recently end‑users and leveraging new models use innovative contracting and with the university hospital and research making a cup of tea when his wife noticed launched a new digital therapeutic solution cognitive and robotic technologies • Providers, clinicians and patients use value-based arrangements such as risk connected medical devices at scale to sharing. Payment pathways encourage institute to run a . In this second he was slurring his speech and one side of to treat back pain which includes an to improve outcomes. MedTech monitor health, improve efficiency and adoption of VBHC payments at scale, as phase, Amen collected efficacy and safety his face had sagged. She knew that if this AI‑enabled triaging and monitoring tool, companies have also partnered patient outcomes. Business models use data quality has improved. Payer funding data from early adopters to qualify the was a stroke, ‘time lost was brain lost’, so an education and training app about back with consumer‑focused technology RWE from connected medical devices, has been extended to remunerate RPM, solution for certification as a medical she called immediately for an ambulance. pain, mindfulness practices, and a range companies to benefit from their to enable companies to transition from digital therapeutics etc. using flexible product. He also worked with the university The ambulance call centre reviewed Mike’s of physiotherapy developed physical to develop a health economic model to EHR and despatched their specialised exercises. SBTech’s solution was initially experience of brand development, a provider of products to an insightful models such as ‘per-patient per use’. A new support reimbursement discussions with stroke ambulance fitted with 5G‑enabled developed through a partnership between customer engagement and partner, delivering evidence-based evaluation framework has been agreed for value for stakeholders across the the reimbursement of in vitro diagnostics payers. The platform collected a large video communication, monitoring and the company and a neighbouring Technical advanced analytics. Where once clinical pathway. (IVD) aimed at improving health outcomes amount of RWE, increasing confidence in consultation technology. Mike was moved University to demonstrate how such MedTech companies were in a sustainable way. the validity of the results, which Amen used quickly into the ambulance and using a new a digital therapy can provide effective, traditionally focused on developing • Companies developing services use the to start early dialogue with the regulator smart camera ML‑algorithm, the paramedic cost‑effective standard care for back hardware (surgical equipment, generation and transmission of patient • Regulations: Regulatory teams use a and payers about a reimbursement model. Alex confirmed the likelihood of a stroke. pain. An independent review of SBTech’s He decided to follow the centralised Using the video Alex shared the results and digital tool provided compelling evidence joint replacements, diagnostic data and FAIR data sharing principles to ‘Regulation by Design’ approach from approval process which has stricter a mobile CT scan (taken in transit to the of improved outcomes and this led to equipment, etc.) many more now help increase the trust of patients and design to manufacturing to after care, confidence in using devices. including validated software updates. technical and efficiency criteria than local hospital) with the stroke consultant, who a number of partnerships with payers to use software and sensors and Companies have robust systems for agreements; and once the the device is confirmed an ischaemic stroke (a blocked trial a way of paying for the therapy in the deploy advanced analytics, to • MedTech companies have entered compliance with the raft of regulatory approved for use on a countrywide basis, it blood vessel). Under supervision, Alex, same way as for conventional treatments. become Software as a Service into long-term VBHC arrangements changes introduced over the past five is likely to be recommended as a standard administered a clot‑busting intravenous This resulted in inclusion of the technology (SaaS) providers, targeting that differentiate products which offer years, including MDR, IVDR and GDPR. part of the diabetes care pathway with an thrombolytic drug as Mike was well within in the standard patient pathway. A recent agreed nationwide reimbursement model. the 3‑4 hour window from the onset of the randomised control trial demonstrated that preventative care at specific protection from price erosion, create They also collect and publish RWE on This ensures patients will be able to get stroke. A cerebral angiogram at the hospital SBTech’s technology was more efficacious patient populations. Companion stickier relationships with customers, and outcomes to satisfy safety and efficacy increase market share and revenue by requirements and expedite approval of access to the device across the country confirmed that there was no evidence of than physiotherapy and online education, diagnostics have become being a preferred product. innovative medical devices. more quickly. This is a win‑win for the further clots stroke. Mike was discharged the current standard of care. a crucial tool for personalising company, for patients and for Amen’s own from hospital two days later with only patient therapy with MedTech • Established collaborations between • Data and interoperability: MedTech has performance evaluation. minor after‑effects and a set of RPM tools playing a major role in driving stakeholders have enabled the adopted FAIR data principles and protocols to support his rehabilitation. VBHC, helping reduce medical transmission, aggregation, analysis and for the exchange and use of data, a costs, optimise surgical management of data, improving their governance framework and eConsent understanding of patient needs. systems. Manufacturers have adopted a performance, and improve patient ‘security by design’ approach (adopting outcomes. Connected medical • MedTech companies have developed a key data encryption and authentication devices have helped close the loop better understanding of the clinical context mechanisms), working with providers between patients and HCPs by in which their devices are used, creating to manage AI-ethics, data privacy and augmenting HCP skills. VBHC solutions to deliver preventative cyber security, enabled by cloud, edge wellness solutions. computing and blockchain technologies. Note: All elements on this page are from a perspective of 2025 and are fictional 24 25 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

NICE Evidence framework for Launch of a Digital Health Centre of Evidence of new payment models The COVID‑19 impact MedTech products Excellence by the FDA to advance digital in MedTech The UK’s National Institute of Health and health technology Medtronic‑Tyrx antibacterial sleeve has Care Excellence (NICE) Evidence launched In September 2020, the FDA announced 1,000 contracts that require the company Deloitte view on the impact of COVID‑19 Philips’ IoMT solution for critical care patient monitoring a standards framework in 2019, HealthTech the launch of the Digital Health Centre of to reimburse hospitals for certain costs if its The COVID-19 pandemic has accelerated the use of MedTech Philips has a comprehensive portfolio of solutions to help Connect to make it easier for innovators and Excellence within the Centre for Devices antibacterial sleeve fails to prevent infection devices enabling individuals to record their behaviour, get an support the care of COVID-19 patients. Solutions include secure, commissioners to identify the evidence that and Radiological Health (CDHR). Its aim is to in patients receiving cardiac implants. online diagnosis and manage their health more efficiently, connected and intelligent approaches to diagnosis, treatment should be available, or developed, for digital boost the advancement of mobile devices, without having to leave their homes. Virtual consultation and predictive monitoring in hospitals, plus screening, RPM health technologies in order to demonstrate software‑as‑medical‑device (SaMD), wearables J&Js has developed a ‘Thermocool’ catheter technologies have been scaled dramatically to help HCPs diagnose, and care at home. Philips’ telehealth and AI-enabled data their value. This includes evidence of when used as a medical device, and other ablation procedure whereby if a repeat monitor and care for patients remotely while reducing the risk analytics help support HCP’s workflows, facilitate remote effectiveness relevant to the intended technologies. The Centre is responsible procedure is needed within a year of of infection. Wearable technology has magnified the added collaboration and help optimise the use of resources, being use(s) of the technology and evidence of for providing advice and coordinating and treatment the company guarantees value provided by IoMT technology, giving patients, carers and designed for rapid deployment and scalability. In June 2020, economic impact relative to the financial risk. supporting the work being done across a discount on the cost of its device for HCPs with numerous real-time data points about the patient’s Philips received Emergency Use Authorisation (EUA) from the This initiative aims to help companies develop the FDA in advancing best practices and the second procedure. activity and vital signs. The IoMT has also played a crucial role in FDA for it’s IntelliVue Patient Monitors and Active Displays, for health technologies to identify routes to reimagining digital health device oversight. ‘test, track and trace’ to curb the spread of COVID-19 by creating use during the COVID-19 health emergency. These solutions national evaluation programmes, as they seek Through the Center, the FDA intends Bruin Biometrics has developed a hand-held a virtual perimeter using GPS, RFID, Wi-Fi, Bluetooth signal, support infection-control protocols and provide critical patient to move from inception to adoption in the to modernise digital health policies and wireless scanner that detects pressure ulcers and cellular network. AI-enabled MRI and CT scanners and IVD information remotely when caring for hospitalised COVID-19 health and care system.71,72 regulatory approaches to ensure access to (bed sores) and helps caregivers or providers tests have also increased the accuracy and speed of diagnoses. patients. Updated features, include enhancements to monitor ‘the most cutting edge, digital technologies are prevent the formation of pressure ulcers. The pandemic has highlighted the importance of large-scale and assess clinical and network device performance, and Digital therapeutics for the treatment of rapidly developed and reviewed’.75 The company has been developing a variety partnerships to mobilise and coordinate public and private additional functionalities to strengthen cybersecurity.78 Substance Abuse in the US of risk sharing agreements with providers in efforts to tackle global public health threats. Pear Therapeutics is a leading prescription Deloitte crowdsourcing simulation with the UK which may involve payment tied to digital therapeutics (PDTs) company with MedTech stakeholders early detection and prevention of ulcers. the first three FDA-authorised PDTs. Deloitte conducted a crowdsourcing MedTeh and the IoMT are ruial driers of alue‑based are six new MedTeh roles hae emerged Pear’s products are clinically validated simulation, to understand what the MedTech Philips and the Jackson Health System have software-based therapeutics that directly company of the future might look like. entered into an 11‑year enterprise‑monitoring‑ treat diseases. Its lead product, reSET®, It found that companies that traditionally as‑a‑service (EMaaS) partnership. Under the Strengthen core capabilities to differentiate Expand offerings to optimise value Enter into brand new spaes treats Substance Use Disorder (SUD), focused on developing hardware (e.g. surgical terms of the agreement, Jackson Health will Future Roles: Next-Gen Best-in-Class "Medical Solutions Disease Owner Ecosystem Data Consumer Health the first PDT to receive FDA marketing equipment, joint replacements, diagnostic use remote patient monitoring systems, such Commodities Innovator as a Service" and Informatics Enablers authorisation to treat SUD. It’s second, equipment, infusion pumps, pacemakers, as wearable biosensors, for a per‑patient fee Supplier Provider Providers reSET-O®, for the treatment of Opioid etc.) are shifting their focus to software, data and adopt standardised patient monitoring Use Disorder, was the first PDT to receive collection, and advanced data analytics. for each care setting across its network. Breakthrough Designation. Pear’s third MedTech companies that focus on Philips own the hardware, software, and Differentiating Best-in-class R&D Delivering holistic Providing end-to-end Integrating data and Enabling consumers product, Somryst™, for the treatment developing acquiring or partnering to access networking solutions to patient monitoring through meaningful capabilities to deliver solutions, including solutions across generating insights to self-manage and of chronic insomnia, was the first PDT sophisticated data analytics capabilities can technologies, Jackson pays only for hours of and sustainable most advanced, hardware, software, patient journey and ecosystem-wide improve health via submitted through FDA’s traditional 510(k) better address changing patient and clinician monitoring usage.77 cost advantage personalised and services to enable to diagnose, analytics across connected sensors, treatment devices optimised care treat, and monitor entities, devices, virtual doctors, etc. pathway while simultaneously reviewed needs. The top technologies cited were AI specific diseases and diseases through FDA’s Software Precertification Pilot (80%), robotics (53%) and nanotechnology Program. Its products collect RWE, have (47%). The research noted that the MedTech been tested in RCTs with results published company of the future will face intense in peer-reviewed journals. The products, are competition from consumer technology Holistic medical Smart health devices/ adjuncts to outpatient counselling, providing companies. Beyond product offerings, Commodity devices Clinically End-to-end solutions Data/analytics/ Value Drivers: solutions to platforms for at lowest costs differentiated devices for specific diseases algorithms patients with algorithm-driven CBT, fluency MedTech companies are also positioned to optimise care consumers training, and contingency management, help hospitals and health systems make the while clinicians receive access to clinical transition to the future of health through Providers, other Providers, other Providers, Payers, Providers, Payers, Providers, Payers, Customers: Providers dashboards to inform in-office and tele services.76 MedTech Roles MedTech Roles Consumers Other MedTech Roles Consumers visits.73,74

Similar to existing model More transformative

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Companies have reversed the decline in the returns from pharma R&D Advanced AI-enabled technologies have accelerated drug discovery and clinical trials improving efficiency and reducing costs

The world in 2025 Conquered constraints Imagine the world in 2025 Prediction: In 2025, Pharma • Pharma companies use DL algorithms in • Skills and talent: recruiters target data R&D processes are augmented their drug discovery processes, deploying science, bioinformatics, computational through digital platforms and in-house data analysts and partnering biology and biochemical specialists. R&D Using AI algorithms to match patients The regulatory function of a biopharma Technological advances that herald a large-scale access to FAIR data with AI for drug discovery start-ups and scientists are increasingly a blend of to clinical trials company is fully integrated across renaissance in peptide drug discovery Susan has been diagnosed with a rare clinical development Nina is currently working as a Chief and research partnerships government-supported genomic teams. clinician, natural scientist and computer data scientist. Companies are also cancer for which there is no available Luis is the regulatory affairs director of Business Officer at an AI-enabled, with academia and digital tech • Novel biomarkers and drugs identified using partnering with academia, AI for drug treatment. Her doctor, Dr Nemo, used MJ Biopharma (MJBP) and is accountable peptide-focused drug discovery company companies, driven by leaders AI have increased alongside better knowledge discovery companies and tech giants her clinical data (including EHRs and directly to the Board for ensuring that founded in 2019 by a renowned scientist with digital skills and a fail-fast on disease mechanisms. As a result, a to bring people with proficiency in data genomic data) to find a suitable clinical the use of next generation technologies who has received numerous awards for mind-set. This is improving greater proportion of pipelines comprise science and data ethics into the R&D trial through an AI-enabled search tool. helps drive regulatory compliance. Luis her business leadership and scientific success rates and reducing candidates for more precise . team. Skilled interdisciplinary leaders with By mining numerous datasets, the AI has automated the company’s dossier work in AI. Her team includes some 60 algorithm matched Susan with a Phase II compilation to reduce the time and employees, composed of ‘drug hunters’ the time to market. AI for AI-friendly, tech-savvy boards create new • Increasingly, early-stage research uses businesses and operating models. study and Dr Nemo helped Susan enrol. cost of the marketing authorisation working in partnership with a number of drug discovery companies de novo design and/or in silico clinical trials. The pharma company provided Susan application process. He also uses AI major pharma companies. Last month are using DL to derive crucial Many Phase I trials also use quantum • Funding: biopharma companies have with comprehensive information about to identify any anomalies in dossier Nina was part of the team that identified insights from multiple datasets, computer simulations to accelerate increased investment in data, analytics, the study and addressed her anxieties, so compilation and rectify them before and accelerated clinical development improving the speed and decision making at key milestones. technologies and research collaborations. that she was happy to sign the eConsent submission, with NLP used to translate to launch a novel anti-inflammatory accuracy of drug discovery, Faster drug discovery, use of synthetic form. Susan received a smart watch, digital dossiers for multiple applications. product identified by the AI platform and diagnostic tools and an app, all of which fit Automation has been implemented developed in the record time of 420 days. and delivering more precise • Advanced techniques such as DL are control arms and improved recruitment embedded in clinical trials improving and retention of patients in clinical trials seamlessly into her daily routines providing across the clinical development process The company has since entered into seven therapeutic candidates. the diversity of trial participants and have reduced R&D costs and helped real-world remote two-way communication to improve regulatory compliance with further corporate partnerships and a joint Innovative clinical trials, using the development of precise treatments, reverse the previous decline in ROI, while continually monitoring her health. enriched recruitment and retention venture and are actively deploying the AI digital technologies, AI and RWE such as for rare diseases. attracting high levels of investment. AI algorithms capture and analyse data strategies. The custody and serialisation platform in developing new therapeutics have helped define new patient- Reimbursement discussions with payers to provide insights, including precise of blockchain capabilities are used for that target novel pathways in and centric digital end-points, refine • New platform technologies have changed begin at Phase I, with new funding models, digital biomarkers that monitor Susan’s real-time tracking of the control, transfer cardio-metabolic diseases. Nina and her response to her treatment and whether and distribution of medicines to trial team have published over 20 peer-reviewed indications and improve trial the development of next gen therapies, for example for cell and gene therapies. such as CRISPR and mRNA, leveraging the there is need for dose adjustments or participants. Automation has also made papers, applied for a dozen patents and enrichment strategies. Pharma experience of cell and gene therapies, to • Regulations: rapid changes to regulatory any indications of adverse reactions. it easier to create an audit trail to review received a number of industry awards for companies now employ data- create new treatment paradigms. requirements in response to the growing Susan receives automated reminders compliance and decision-making. Overall, their innovative drug discovery work. rich visualisation tools across use of technologies (including experience throughout the study to ensure that she Luis has transformed pre-authorisation the study lifecycle and deploy • Liquid biopsies, combined with improved during COVID-19) have created new follows the treatment and personalised information management by leveraging hub-and-spoke command use of bio-sample libraries, have accelerated relationship paradigms. Regulators messages that keep her informed about AI and BI capabilities, based on his the progress of the trial. Home monitoring understanding of the regulators own use centres to operate virtual the development of precision medicine. readily accept RWE in support of new drug applications, label expansions and means that Susan visits the trial site much of advanced analytics to detect patterns clinical trials, enabling faster • An AI-enabled digital infrastructure, revisions. New regulatory pathways have less frequently than she would otherwise and trends to ensure products’ safety and recruitment, enrolment and has improved approval rates, lowered increased flexibility, transparency and have done. When she does visit, she uses efficacy. monitoring of more diverse development costs, and is delivering speed of approval. Regulators have also her app to arrange her appointments and groups of patients. Apps, medications to patients faster. collaborated globally to develop new evidence transportations. Susan adheres to the trial wearables, eConsent platforms frameworks and enhance their own skill-sets throughout and responds so well that she is invited to join the next stages and telehealth help reduce the • An enhanced hybrid clinical trial experience to use the vast data stored on cloud platforms. has embedded patient-centricity across of the study providing her with continued time commitment and financial R&D, with patient groups and their unique • Data and interoperability: HIPAA access to the treatment. costs that hindered recruitment 360-degree perspective, inputting to the and GDPR compliant cloud, quantum and retention. All these changes design and management of clinical trials. computing, blockchain and AI-enabled are reversing the previous services and tools facilitate global FAIR upward trend in R&D costs. • Biopharma companies use digital twins to data management and sharing. Blockchain simulate clinical trials including costs, patient technology is also used to verify the origin selection, and the likelihood of success. and veracity of dossier submissions. Note: All elements on this page are from a perspective of 2025 and are fictional 28 29 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

Medidata’s Acorn AI gives researchers Japan’s National Cancer Center Hospital Exscientia and the use of AI for The COVID‑19 impact a 360-degree view of the patient East using circulating tumour DNA drug discovery Medidata, a Dassault Systèmes company, analysis for trial selection Exscientia is a leading global pharmatech is helping drive the digital transformation of Japan’s National Cancer Center Hospital East company and was the originator of the first Deloitte view on the impact of COVID‑19 23andMe: from genetic testing, to discovery, to the life sciences industry through its world compared circulating tumour DNA (ctDNA) AI-designed molecule to enter clinical trials. In response to the COVID-19 pandemic, the pharma drug development leading platform for clinical development, analysis to tissue genotyping for enrolling Exscientia has developed a full-stack AI- industry, academia, biotech, and hospitals, embarked on 23andMe is a direct-to-consumer online genetic-testing company commercial, and real-world data. Medidata gastrointestinal patients into two large driven drug discovery platform from target unprecedented scientific endeavours funded by governments, providing users with insights into their health, genealogy and established Acorn AI in early 2019 to develop trials. One trial, SCRUM-Japan GOZILA, used identification to drug design and optimisation multilateral agencies, not-for-profit institutions, and the ancestry, while furthering research into the genetic basis of new insights across all phases of drug the Guardant360 liquid biopsy to identify of novel drug candidates. Fusing the power private sector. Trade secrets and intellectual property have diseases and leveraging genetic data to help develop new development and make data ‘liquid’ across patients, while the other one, GI-SCREEN, of the original AI-design with the experience been more widely shared than ever before as collaborations treatments. Since 2007, 23andMe customers have submitted the end-to-end lifecycle of a biopharma relied on tissue genotyping. Researchers of seasoned drug hunters, Exscientia’s and partnerships formed to expedite the search for new saliva samples, self-reported information and, for those who company (from research to development more quickly enrolled a higher number of Centaur ChemistTM platform enables treatments and vaccines. Regulators entered into immediate opt-in to the 23andMe research program, separate consent and into post-market surveillance). In building patients into a trial using the ctDNA approach. the discovery of exquisitely optimised dialogue aimed at supporting the most promising innovations, documents for biobanking and research. 23andMe has sold linkages between clinical trials, genomics, They further noted that liquid biopsy-based molecules with breakthrough productivity. discussing cost-plus pricing strategies and improving the more than 12 million kits and over 80% of its customers elect to RWE, translational health and other datasets, profiling uncovered a greater number of In tandem, Exscientia’s Centaur BiologistTM diversity of participants in clinical trials. However, pivoting participate in research. In 2018, GSK took a $300 million stake in it aims to help biopharma make quick ‘go/ actionable mutations demonstrating that platform drives the flexible analysis and R&D activities towards COVID-19, while necessary, has 23andMe signing a four-year collaboration agreement to work no go’ decisions, accelerate clinical trials and genomic profiling by ctDNA analysis using the prioritisation of discovery targets across all impacted the progress of other clinical trials. By the beginning together to discover new drugs. To date around 30 therapeutic demonstrate value. Acorn AI is built on the Guardant360 liquid biopsy has the advantage pharmaceutically relevant disease space. of November, ten vaccine candidates were in Phase III trials targets have been identified with majority of pre-clinical Medidata platform, which comprises more of shorter turnaround times and improved Five assets have been delivered in around and developers of three of these vaccines are hoping to programmes in the target validation phase, and the remainder than 20,000 clinical trials with structured, patient enrolment compared to tissue biopsy 8 to 14 months (compared to the five-year obtain regulatory approval before the end of 2020. This are in early drug discovery programs. In January 2020, 23andMe standardised clinical data repositories from for clinical trials, without compromising industry benchmark), with drug discovery is faster than any other vaccine in history. In response to licensed the rights to a drug targeting multiple inflammatory over 6.3 million patients. Acorn AI is focusing treatment efficacy.81 cost savings of more than 80% (30% achieved concerns about the speed of development, the CEOs of nine diseases (including various dermatological conditions) it on addressing precision medicine with CAR-T for the entire drug development process). leading developers signed a pledge committing to uphold the developed in-house to a Spanish pharma company, Almirall, who therapy, tissue engineering, gene and cell Flatiron Health uses machine learning Over 20 AI-Driven drug discovery projects integrity of the scientific process and provide robust evidence plans to take the drug through clinical trials. During the COVID-19 therapy, while leveraging the advancement of (ML) to identify patients eligible for are currently active with further growth of safety and effectiveness. While initially any approved pandemic, 23andMe has used its research platform to identify a AI and new sources of data to give researchers oncology clinical trials and to generate scheduled throughout 2021. The company vaccines are expected to be targeted at healthcare staff and number of genetic and non-genetic associations for susceptibility a 360-degree view of the patient, including important RWE from the experiences of plans to develop its own portfolio as well as more vulnerable populations, their ultimate impact globally and severity to COVID-19. In under four months, more than clinical, genomic, molecular, as well as socio- the 95% of cancer patients who aren’t continue to partner with pharma and biotech will depend on the disease’s epidemiology and transmission a million 23andMe customers consented to participate in the economic, behavioural and environmental represented in trials companies.84,85 and the duration of immunity from infection. Nevertheless, research, more than 15,000 had tested positive for COVID-19, data. They help sponsors make critical The complexities of identifying and screening vaccines will play a crucial role in most response scenarios with 1,100 of them requiring hospitalisation. Through their decisions on how to create better-integrated patients for trials are consistently cited as Trials.ai uses its proprietary database and will serve as an insurance policy against continued health participation, 23andMe has been able to make new findings, evidence, including clinical as well as RWE to causing study delays, unexpected costs and to derive insights and recommendations societal and economic impacts of the pandemic. replicate others, and contribute to the larger effort by other demonstrate the products’ value to regulators, study failure. EHRs are a valuable source for trial sponsors researchers who are searching for treatments.87, 88, 89,90 patients, payers and providers.79,80 of the real-world data key to a solution. Trials.ai uses AI to analyse large sets of Leveraging data from the EHRs of cancer data including past clinical studies, medical patients, Flatiron has developed an approach journals, regulatory guidance, standards of Biopharma ompanies need to pursue a fundamental shift in their RD model that employs ML to provide real-time care, trial complexity information, amendment notifications of potential patient-trial matches information and other forms of trial-related to site staff and research coordinators at documentation to improve study design. Using Advanced analytics Earlier partnering the point of care, integrated into their daily its proprietary codified clinical trials database, and technologies workflows. The functionality is one feature the system is able to unlock information, derive of Flatiron’s OncoTrials® software, which insights and make recommendations to trial Digital The future continuously runs ML models trained on tens sponsors on how to best design and optimise Biopharma of thousands of structured and unstructured their trial protocols, as well-designed protocol transformation of health real-world data points to infer key trial limits improves recruitment, retention, and eligibility criteria such as metastatic status reduces burden on patients and trial sites by New capabilities, and biomarker results.82,83 bringing in cost and time efficiency. For one of New operating models skill sets and talent its clients Trials.ai shortened study timelines by 33% and reduced data errors by 20%.86

30 31 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

Next generation supply chains are integrated into healthcare and the patient experience The convergence of clinical, commercial and manufacturing processes, networked through data-driven value chains

The world in 2025 Conquered constraints Imagine the world in 2025 Prediction: In 2025, the adoption • Advanced data analytics have transformed • Skills and talent: Collaborations with of advanced digital technologies the operating models of the pharma supply experts in other industries have improved has improved the visibility and chain enabling a fundamental shift from the skill-set of in-house staff and helped Real-time, end-to-end tracking to Deploying digital twins to drive How AI is driving integration of efficiency of the supply chain. linear to dynamic, interconnected DSNs. to establish a more diverse workforce, deliver cell and gene therapies efficiencies and reduce costs for planning and operations across In biopharma’s hyper-connected, globally Many companies have shifted including experts on AI design-thinking. manufacturers the pharma supply chain complex supply chain, companies need to ‘Spear’ is an optimisation and simulation RST Solutions, is a decision management from a linear supply chain to • Control towers provide end-to-end visibility Manufacturing and distribution staff are across the supply chain with AI tools more flexible, digitally-literate and open to respond rapidly to any event that impacts engine that helps manufacturers find software company that uses an AI an interconnected digital supply applied to real-time data to generate continuous learning. outcomes, which is particularly challenging better ways to balance their production and platform to power integrated planning and network (DSN), which utilises actionable insights and improve decision- when distributing therapies derived from inventory. In order to understand the best operations across pharma manufacturing interoperable data to provide making and regulatory compliance. • Funding: The return on investment in living organisms. IPTherapeutics (IPT) is way to meet the demand, Spear analyses companies. RST’s platform provides a foundation for companies DSNs has improved across the supply a leading clinical stage biotech company entire product portfolios and builds digital demand forecasting, commercial and that develops cell and gene therapies. twins of production lines. It also optimises supply chain planning, and integrated to compete more effectively. • Companies have adopted robust Third chain. Earnings before interest, tax, Through a partnership with Olaf Logistics, costs involved in production and storage to business planning. It brings together graph Track and trace is no longer a Party Risk Management (TPRM) solutions depreciation and amortisation (EBITA) to manage global risks. have increased substantially over the past an AI-enabled cold chain logistics company, determine the right production frequency modelling, big data analytics and advanced vision, but a blockchain-enabled five years. This has convinced companies IPT can have end-to-end visibility across and optimal production pattern for each algorithms to provide demand forecasting reality from manufacturing to the • Data analytics are used to interpret data of the benefits to be gained by investing in its supply chain. Olaf Logistics’ advanced product. It also optimises inventory by and scenario planning. It also provides a patient and HCP. AI technologies from multiple sources to detect patterns advanced technologies, including investing cold chain technology integrates a real- defining exactly how much stock should be digital engagement portal and easy-to- have transformed the supply and anomalies, including creating a digital in robotic applications and intelligent time tracking software from packaging held in each warehouse. In the final step use interfaces for customers, suppliers, and storage to transportation and of the simulation, Spear models millions of internal operations, on one cloud-based chain and manufacturing through twin of the supply chain to produce better real-time monitoring systems to track demand forecasts. operational performance. distribution, ensuring the effectiveness possible permutations to validate findings platform. Jamie is a data analysts who is real-time data processing and and safety of IPT’s temperature-sensitive and arrive at a new operational model. leading a project with one of RST Solutions’ decision-making, reducing the • Companies have revaluated their overall • Regulations: Regulators use accelerators cell and gene therapies when they reach LJPharma, a large global pharma company, key clients, PharmaKF, and is leveraging risks of human subjectivity and value chain, manufacturing and transport to and ‘sandboxes’ to test products, individual patients. This advanced logistics wanted to make its complex production the RST platform to integrate PharmaKF’s bias. Commercial, regulatory meet the overall companies’ sustainability services and business models. RPA risk system links patients and clinicians and processes more efficient, and contracted business and operational planning and and operational data have goals. Smart transport vehicles provide management tools ensure regulatory the manufacturing site with complete Spear to develop a digital twin across its model the effect of demand and supply visibility to produce therapies for individual five main production lines. In under a year, challenges across its complex supply been unlocked by AI tools to real-time insights about delivery and requirements are met. International patients. Through continuous collection LJPharma realised a reduction in its working chain. The supply modelling identified identify non-linear and complex product status. agreements have reduced the risk of individual governments resorting to trade and aggregation of data on temperature, capital and additional operational savings. a number of potential disruptions in the relationships and provide • Responsible supply chains enabled by protectionism. Compliance with the EU’s conditions and packaging across all supply Spear has also shown the potential to cut transport infrastructure and ran a number strategic insights for improving the advanced automation and open data Falsified Medicines Directive and FDA’s chain functions, IPT and Olaf Logistics are manufacturers’ changeover times by up to of simulations to identify workarounds. supply chain. Advanced analytics management have improved transparency Drug Supply Chain Security Act (DSCSA) has able to use AI-based predictive analytics 22% and reduce inventories by up to 25%. PharmaKF was able to intervene early have helped deliver significant while supporting biopharma companies improved product traceability and visibility. to generate actionable data and take and address the transportation problem proactive and timely interventions when ensuring that its products were delivered improvements in productivity to collaborate more effectively with TPRM across the life sciences industry any issue arises. in a safe and timely manner. and costs. This has enabled more regulators, improving compliance. helps clients make a positive ethical impact, reduce regulatory risk and manage efficient demand forecasting, • Companies improve operational supply chains faster and more efficiently. inventory management, logistics effectiveness by adopting a resilience- optimisation, procurement, and by-design mind-set (such as financial • Data and interoperability: Data integrity workforce planning. Biopharma and reputational resilience) and deploy has improved by establishing a robust companies have streamlined predictive maintenance, including IT infrastructure and adopting FAIR their regulatory compliance optimising machine uptime. standards, reliable connectivity and robust cloud-enabled data security across the functions across the supply chain • Sensors and actuators within facilities, DSN. Blockchain technologies provide to overcome functional siloes connected securely to the cloud or data transparency in tracking systems (through and improve efficiency across centre, provide companies with BI across visibility of the chain of custody and chain the product lifecycle. the supply chain. of identified risks), especially in multi- nodal hand-offs.

Note: All elements on this page are from a perspective of 2025 and are fictional 32 33 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

GSK is accelerating technology Gartner forecasts that the supply BlueDot Insights – infectious The COVID‑19 impact adoption in manufacturing chain and manufacturing solutions disease tracking GSK is building a ‘pharmaceutical factory market will exceed $19 billion by BlueDot Insights sends tailored, near of the future’. In 2016, the company used the end of 2021 real-time smart-alerts about infectious Deloitte view on the impact of COVID‑19 Moderna Therapeutics has digitalisation as a core element knowledge gained by other industries This is driven largely by software as diseases with global visibility. The alerts The COVID-19 pandemic has highlighted the critical importance of their business strategy using Industry 4.0 technologies, to develop a service (SaaS), which will enable new can be used by biopharma companies to of an operational global biopharma supply chain, but has also Moderna is a clinical stage biotechnology company pioneering its own project in Stevenage, UK: the IIM revenue opportunities (estimated value adjust their operations accordingly, and is exposed its vulnerability to global shocks. Companies affected most the development of messenger RNA (mRNA) therapeutics Digitisation Lab. GSK built this unit to $6 billion).94 vital for biopharma companies to optimise are those that rely largely on a single geography or a single supplier and vaccines that have a therapeutic or preventive effect on be used as a proof-of-concept facility to the manufacturing and distribution of for key products. From the outset, countries across the world have a broad spectrum of diseases. Moderna is also a front-runner demonstrate what a ‘data-based strategy’ RxAll and FarmaTrust are using specific drugs to affected areas.97 used export bans, price caps and supply chain diversions to shore in the development of a COVID-19 vaccine. Its digitalisation for manufacturing within the company AI-enabled digital solutions to fight up supplies for COVID-19 patients within their own populations. strategy has six key building blocks: AI – analytics and predictive might look like. To build the IIM Digitisation fake medicines across the world Maintaining temperature stability Consequently, many biopharma companies are considering the modelling; Cloud – to provide computational power, agility, Lab, GSK reached out to different partners, RxAll, a US start-up, has developed an of biologics is a key supply chain location of their manufacturing facilities. Experience with COVID-19 cost-effectiveness and processing of data; Integration – to including Siemens, which has experience on AI-based technology to provide patients requirement highlights the need for companies to accelerate the digitalisation of bring data and processes together; IoMT – based on smart, transformative technological innovations with access to authentic, high-quality Biologics are difficult to keep stable their manufacturing and supply chain operations. Companies and interconnected devices to improve compliance and traceability in its own industry. Siemens’ role in the drugs. Its platform combines a proprietary with temperature fluctuations and governments are actively reevaluating the resilience and integrity in the supply chain, control inventory, and optimise energy partnership was key to integrating data molecular sensor (a spectrometer) and contamination affecting batch quality and of their sourcing strategies and considering diversifying through consumption; Automation and robotics – to increase acquisition and use, as well as workflow a cloud-based DL algorithm, and uses a yield, especially during transportation. ‘Near Sourcing’, ‘Localisation’, and ‘Moving closer to the customer’. operational accuracy, repeatability and throughput, while execution, including the elimination of database of spectral signatures of drugs, Given that regulations require end-to-end, A major challenge now is the development, manufacturing and reducing human errors and improving quality and compliance; paper records.91,92 to perform non-destructive verification of rigorous temperature control, cold-chain equitable distribution of safe and effective vaccines; requiring the Analytics – to generate insights for informed decision-making. drugs authenticity. Its newest device, the transportation technology needs to world’s largest ever supply chain infrastructure. Manufacturers The Moderna Technology Center (MTC) manufacturing Merck KGaA uses ML to optimise RxScanner II, can identify the authenticity be integrated with tracking software to have taken a risk by standing up facilities and preparing a resilient facility, designed to Current Good Manufacturing Practices demand forecasting and quality of prescription drugs – in tablet, ensure the effectiveness and safety of and scalable supply chain in anticipation of regulatory approval. specifications, has three core functions: Pre-clinical production – Merck, headquartered in Darmstadt, powder or liquid forms – in 20 seconds and therapeutics when they reach patients. By Functionalities such as identification of recipients (vaccine to develop materials for pre-toxicology studies using integrated Germany, has embarked on a multi-year with an accuracy of 99.9%. This technology 2022, an estimated 30 of the 50 top global passports) and cold-chain transportation technology integrated robotics; Clinical production – to run Phase I and II clinical project to create a data-driven supply is used by hospitals, pharmacies, biopharma products will require cold chain with real-time, end-to-end tracking software, will be important in development programmes driven by real-time data and a fully chain operation to optimise demand biopharma and regulatory bodies around handling and specialised, temperature- ensuring safe, equitable and efficient distribution. Governments, integrated manufacturing execution system; and a Personalised forecasting. It is using a combination of the world. Their ML system continuously controlled logistics. Advanced, intelligent regulators and pharma companies will have to work together to cancer vaccine (PCV) unit – to ensure fast manufacturing and tools (SAP Integrated Business Planning, learns from the spectral reads to inform technologies that allow for real-time end- establish trust in the vaccines. supply of individualised batches.99,100 ML Statistical Forecast and home-made ML pharmaceutical manufacturers about to-end visibility can enable biopharma and 95 engines) to provide an Automated Demand counterfeiting. logistics companies to track the state of The eolution towards the Digital Supply Network from linear to network thinking Forecast, helping to increase efficiency the drugs and take proactive and timely across its supply chain. This Automated FarmaTrust is a company that offers digital interventions when any issue arises. For TRADITIONAL SUPPLY CHAIN DIGITAL SUPPLY NETWORKS Demand Forecast is proving to be better solutions that combine blockchain and AI example, companies like Vineti Inc and Synchronised than the standard judgmental forecast for tools to create a system that is immutable, Cryoport Inc integrate IT systems, track planning 75% of the products for which a statistical secure and transparent, supporting shipments and maintain chain of custody forecast can be generated. A better data-driven decisions. The company’s and temperature logs in gene therapy Cognitive planning Dynamic Connected 98 fulfilment customer forecast is helping to optimise the Service solution provides end-to-end traceability patient cycles. Quality sensing level production plan, and reduce costs by of biopharma products to safeguard integrate data and optimising inventory levels. The Automated the supply chain against counterfeit or information from different Demand Forecast is also reducing the time substandard medicines. In addition, ource leveraging spent on forecasting, allowing this time to clients can use FarmaTrust’s Consumer Digital advanced digital technologie Develop Plan Source Make Deliver Support ore and enale greater roduct be allocated to more value-added tasks.93 Confidence App for authentication of viiilit traceailit and 96 medicinal products. 3D printing inventor control Sensor-driven replenishment Digital Smart development factory

Intelligent ource eloitte supply 34 35 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

Healthcare and life sciences companies have prioritised decarbonisation Organisations are focused on being sustainable and responsible businesses

The world in 2025 Conquered constraints Imagine the world in 2025 Prediction: In 2025, healthcare • Healthcare and life sciences organisations • Skills and talent: Life sciences and and life science organisations are phasing out their use of fossil fuels and healthcare staff are upskilled to drive and have adopted mitigation have reduced their carbon footprints by implement sustainable actions across Smart hospital infrastructures creating How pharma companies have developed Collaboration between a healthcare strategies to reduce their switching to renewable ‘green’ energy. the health ecosystem. Companies whose ‘greener’ sustainable environments new strategies to minimise waste organisation and pharmaceutical In 2021, in response to a government Anna works as the Digital Strategy Lead for company to reduce carbon emissions carbon footprint and improve Natural gas needs are replaced by bio-gas. leaders champion sustainability goals have had the most success in reducing mandate, Jupiter Hospital Trust, a new a forward-thinking pharma company. She from transportation sustainability by improving waste • Pharma companies have adopted the their carbon footprint. Training on climate four-hospital building project, appointed has been tasked with developing a strategy Verde Pharma and Seacole Hospital Trust management and water usage, principles of circularity (reduce, reuse, change, health and sustainability has Nick Weber to the board as Head of to digitise workflows and audit trails to have collaborated to reduce emissions from adopting renewable energy, recycle) by developing closed-loop been introduced across all staff training Sustainability. Nick has been working with provide transparency over the sustainability transportation. This remodelling of logistics greener procurement policies and product life cycles and reducing the use of courses. the executive team for four years to embed of the supply chain. The company aims to arrangements aims to reduce emissions adapting low-carbon transport raw materials and associated emissions. climate-smart features in the design of achieve carbon neutrality. Anna’s strategy is by reducing distances travelled by vehicles. hospital operations and real estate. Energy to implement AI-powered supply chain and They use zero-emission lorries to transport delivery systems. Resilient pharma • Funding: Most countries have established • Most pharma companies have amended a ‘Green Bank’ prioritising industry for the hospital buildings is obtained from manufacturing functions, with performance pharmaceutical products and medical companies have implemented their packaging, using 100% recyclable, investment in infrastructure projects that an energy efficiency and conservation monitored through interconnected equipment devices from the hospital’s local distribution these and other carbon neutral reusable or compostable clear plastic deliver net zero goals, including carbon scheme, using clean renewable energy. The units that continually provide data and centre. By centralising operations they solutions across their clinical packaging and certified recycled paper capture and storage, waste management, hospitals use various forms of renewable analytics. There is also greater oversight have introduced multiple-stop deliveries; development and supply chain and pulp-based packaging. ‘building decarbonisation’ digitalisation energy: solar, wind, geothermal, biomass, through real-time inventory management, or and via a digital command platform, Verde functions. Digital transformation and green transportation systems. landfill gas and anaerobic digestion. The monitoring of processes to prevent, reduce Pharma and Seacole Hospital Trust track buildings contain water recycling plants or recycle waste, or ensure safe disposal. the multi-stop deliveries and monitor is improving carbon efficiency • Healthcare organisations have increased Private investors prioritise companies ‘out-of-hospital’ care and focus on that openly report their progress towards and have extensive garden areas and bio- A closed-loop manufacturing system is polluting emissions. Data analytics show such as RPA and virtual clinical prevention and population health. environmental sustainability goals. diverse external spaces. Nick introduced implemented to convert waste into energy how operating facilities might be relocated trials. Organisations prioritise Digital-first primary and outpatient procurement policies to ensure that the and to avoid wastage of materials that can to reduce distances travelled. Pathways suppliers that have zero-carbon care are reducing travel and protecting • Regulations: Regulatory standards hospital reduces its use of single-use be reused or sold. Anna reports waste data are remodelled through the use of a digital landfill policies, recycle waste local communities from emissions and have been introduced on measuring plastic, and instead uses bioplastic and on a quarterly basis, and contractors are twin for the supply chain, which uses and water, and use sustainable pollutants. and reporting carbon emissions across biodegradable packaging. The hospital routinely audited to ensure compliance machine learning to enhance in real time the has also reduced its reliance on single-use with waste management standards. accuracy, speed and efficiency of responses materials in packaging and parts. the health ecosystem with regulators • Switching from disposable to reusable evaluating progress on a regular basis. equipment, and where possible buys only Gainsford Pharma chooses to commit to to the procurement needs of the hospitals. Healthcare providers have also instruments wherever possible has Organisations track their emissions mercury-free and sustainable medical longer term relationships with a selection of switched from disposable to improved hospital handling and and disclose their results annually. ‘Eco- devices. A key initiative by Nick in 2021 critical suppliers, who in turn invest in new reusable instruments wherever transportation costs, reduced use of labelling’ of products and supplies with was to work with clinicians to shift all technology to deliver exceptionally recyclable possible, reducing use of landfill landfill sites, saving costs and improving details of their carbon footprints has also non-essential physical services to virtual products. The company has established sites and transportation costs sustainability. Healthcare procurement been introduced to inform consumer healthcare models, reducing resource waste. metrics and targets for waste: for example, Patients, physical products and services 85% of all non-hazardous waste and 70% (for example, ‘near-shoring’), teams consider sustainable goals when choice and drive industry practices. purchasing medicines and medical are now connected via cloud-based digital of all hazardous waste should be reused or ultimately saving costs whilst equipment and prioritise companies • Data and interoperability: Stakeholders offerings. The hospital’s food supply comes recycled. It has also committed to longer improving sustainability. Payers with shared values. across the health ecosystem have from local distributors that have zero landfill term relationships with a selection of critical are seeking evidence that developed a set of new decarbonisation policies and the hospital’s ambulance fleet suppliers, that have invested in technology suppliers are becoming carbon • Life sciences and healthcare organisations targets based on agreed data-reporting consists of electric vehicles powered by to deliver exceptionally recyclable products. neutral, choosing medical have developed a system level set standards and metrics. A new global rechargeable lithium batteries. Jupiter was the company also use sustainable design certified as carbon neutral in April 2025. principles and to eliminate the use of supplies and equipment with of common metrics and disclosures, predictive simulation model is used to including independent audits to engender forecast the impact of different carbon polyvinyl chloride (PVC) in packaging. Digital low carbon footprints. Providers confidence and trust in their progress reduction strategies on each company’s twins are used to predict which products can have reduced patient journeys towards sustainable environmental goals. carbon footprint and the extent to which be reused and which should be disposed of, through the shift to virtual their environmental sustainability goals and how. Hospital procurement teams support models and widespread use • New reimbursement schemes for zero are being met. Sustainability indicators recycling schemes by returning products of remote monitoring and emission inhalers, anaesthetic gases and are audited and reported nationally or packaging to the pharma company that supplied them, for reuse in the supply chain. electronic prescriptions. 3D printed products, broaden access to against aligned industry goals of a net affordable, quality products. zero impact on climate. Note: All elements on this page are from a perspective of 2025 and are fictional 36 37 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

Johnson & Johnson Consumer Health Automedi device aims to make Novo Nordisk is the first global The COVID‑19 impact (J&JCH) Healthy Lives Mission NHS supply chain more sustainable company to have assessed its J&JCH is investing $800 million over the Automedi has created an intelligent, on- performance against the Future-Fit next ten years to improve the health of site machine that makes and assembles Business Benchmark, and have the Deloitte view on the impact of COVID‑19 Reducing the environmental impact of PPE in the UK people and the planet. It expects to provide healthcare equipment at the point-of-care. results independently assured The COVID-19 pandemic has demonstrated quite clearly the During the first wave of COVID-19, the global demand for transparency for all the ingredients used Automedi’s on-site ‘FabLab’ combines Novo Nordisk used the Future-Fit Progress interrelationship between health and the environment. During PPE rose to unprecedented levels, putting a huge strain in its brands, inform consumer choice, 3D printing, a live catalogue, and a user Indicators to define real progress, the pandemic many healthcare and life sciences organisations on supply chains. The NHS procured exceptionally large and to use 100% recyclable, reusable or interface with fleet support, all consumables identifying its strengths and weaknesses have had to transform their operating models almost overnight volumes of PPE to maintain service delivery and sustain high compostable plastic packaging and certified/ and software and hardware upgrades into and thus the areas where improvement and seen an acceleration in digitalisation across their supply quality care. However, there were growing concerns about post-consumer recycled paper- and pulp- a simple managed service. The ‘FabLab’ was needed e.g. before the assessment chains. They have also had to adopt new ways of engaging the environmental impact due to increases in the demand based packaging by 2025. Other initiatives device enables healthcare organisations the company didn’t know that 7% its with clinicians and patients, including virtual consultations for single-use items, which are made predominately from include removing pumps from products, to reduce delivery emissions, produce water use is occurring in water-stressed and virtual clinical trials which, in reducing the need to travel, plastics. Work is already underway in the NHS to reduce the and making disposable wipes made from equipment faster and minimise equipment area; now it can work with local experts have the potential to deliver long-term reductions in carbon environmental impact of PPE. A part of the UK Make initiative plant-based, home-compostable fibres and shortages.103 Fleet support is available to reduce the footprint.108 Novo Nordisk emissions. Conversely, other responses to the pandemic such is for the UK to establish domestic PPE manufacturing, and to bottles made with at least 30% recycled through the Automedi service, where users has also announced targets to ensure all as an increased need for cold-chain transportation and demand develop a resilient supply chain with high quality, innovative material and recycled plastic in its packaging. can access a cloud-based fleet management its direct suppliers supply the company for single-use technology and personal protective equipment and environmentally-friendly products for end users. It also aims to source and process platform, supported by a management team based on 100% renewable power by 2030. (PPE) could undermine decarbonisation goals. Nevertheless, Examples of this are measures to procure made-for-reuse PPE natural ingredients in an environmentally that responds to calls from devices, delivers Novo Nordisk will work with all existing health stakeholders continue to acknowledge their responsibility items, including masks and gowns.112 responsible manner.101 consumables and hardware upgrades, and and new suppliers to meet the target. to take action in response to the threat to health from climate recycles surplus material.104 The Axelisys The commitment is the next step in Novo change. Moreover, although the pandemic has not changed the US hospitals and health systems sign team plans to extend the Automedi device Nordisk’s ‘Circular for Zero’ environmental fundamentals of the climate crisis it has helped galvanise global up to Practice Greenhealth and Global fleet to the entire Greater Manchester strategy.109 action, at government and organisational level, with some Green and Healthy Hospitals, a global Health and Social Care network. A UK-wide healthcare systems and large global life sciences companies network committed to sustainable alternative supply chain will be launched Kaiser Permanente reaches a carbon adopting more ambitious sustainable, decarbonisation goals. operations early in 2021.105 neutral health system Across the US healthcare sector, more than In September, Kaiser Permanente 43,000 hospitals and health systems are part Pharma companies develop next- became the first health system in the US Healthare and life sienes ompanies are foused on being sustainable and responsible businesses of a global network, Practice Greenhealth generation inhalers to reduce to achieve carbon neutrality by making and Global Green and Healthy Hospitals carbon emissions its buildings more energy- efficient, vironment and the health o ® he en f the that is committed to sustainable operations. Respimat , Boehringer Ingelheim’s investing in sustainable business practices ing t popu rov lati Practice Greenhealth is a healthcare propellant-free soft mist inhaler has and purchasing carbon offsets. The Imp Improved air quality on membership organisation that provides carbon emissions approximately 20 milestone was certified in accordance sustainability solutions to benefit patients, times lower than that of an ipratropium with The Carbon Neutral Protocol. The health and care workers, communities and pressured metered dose inhaler (pMDI). company improved energy efficiency in t Re rin du otp ce the environment. Member hospitals aim to A recently-developed reusable model its buildings, installing on-site solar power fo d e O 2 m C is minimise their own environmental impact has the potential to reduce emissions and making long-term purchases of new er si w on and encourage suppliers to do the same by an additional 71%, when used with renewable energy. In 2018, it reached a Lo s through sustainable procurement policies. six cartridges.106 power purchase agreement to acquire Practice Greenhealth operates an annual enough clean energy to power 27 of Top 25 Environmental Excellence Awards AstraZeneca expects the propellant its 39 hospitals. The agreement helped system, and all award winners are seen as used in the next generation pressurised establish new solar and wind farms and leaders in the US in addressing the links metered-dose inhalers (pMDI) to have one of the largest battery energy storage between the environment and human health. a GWP that is 90-99% lower than facilities in the US. The health system also Life sciences product development and supply chain Hospitals/care settings All transport (from supplier to patient care) From serving less meat to reducing toxic propellants used in older pMDIs.107 targeted reductions in waste and water • Renewable energy sources • Recyclable and biodegradable • Low-carbon health facilities • Centralised production • Fewer single-use plastics • Sustainable food • Virtual visits chemicals to installing life-saving renewable use, and 100% sustainable or local food • Automation • Reduced waste • Waste reduction • Drone technology energy sources, these hospitals demonstrate consumption. Kaiser Permanente said it • Clean technology is used to develop clean tech/ • Virtual trials • Remote patient monitoring • Electric vehicles and other leadership and performance that set an plans to address its supply chain in future products e.g. greener asthma inhalers and consultations clean transport initiatives example for others in the health sector projects aimed at reducing emissions.110,111 to follow.102 ource Deloitte analsis

38 39 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

Clusters of trusted partnerships have accelerated innovation Collaborative working has redefined traditional operating models for a more cost‑effective health ecosystem

The world in 2025 Conquered constraints Imagine the world in 2025 Prediction: In 2025, multiple • Government support and incentives • Skills and talent: Sustainable trusted types of trusted partnerships have helped concentrate innovation in partnerships are based on shared between industry, academia and clusters across health ecosystems based mind‑sets and ability to listen, learn and Medscan and IVDiagnostics driving Building trust by putting patient An innovative alliance between two providers, with shared views on on a shared commitment to improve the act on feedback from all stakeholders. clinical insights in oncology centricity at the heart of everything life sciences and healthcare clusters Medscan and IVDiagnostics entered into value exchange, are a central health and wealth of local communities. Partner organisations have clear strategies we do building a secure cloud research a strategic ten-year partnership in January In 2020, NWPharma appointed Jordan platform to advance R&D into rare feature of the successful health to manage conflicts of interest between • Enhanced and new standards have partners and leaders have the digital and 2020 to develop and co‑market digital James as its Chief Patient Officer to diseases clusters that have emerged over encouraged life science companies of all technical skills needed to enable them to clinical decision support solutions, with champion patient centricity and engage In the search for treatments for rare the past five years. These clusters sizes congregate in clusters of excellence, understand business needs and ‘speak an initial focus on products that improve with more diverse representative groups. diseases, a leading healthcare cluster in are backed by a creative and supporting faster, easier and more enduring data science’ to experts. Patient groups personalised treatment options for His first action was to implement an Western Europe formed an ‘Alliance’ with reputable financial services sector, ways of working between stakeholders. have a pivotal educational role across cancer and critical care patients. By 2025 engagement strategy with global patient another cluster in the Nordic countries, their dashboards are bringing together advocacy groups across the company’s to combine their research and innovation supported by governments and a the health ecosystem. data generated by IVDiagnostics tissue therapy area to help improve patient capabilities and drive progress in the new regulatory paradigm, creating • All stakeholders recognise the importance of investing in and nurturing a high degree • Funding: National and local governments pathology biomarkers and next generation involvement, trust and adherence to search for treatments for rare diseases. optimal conditions for the of trust within and between clusters and have established favourable economic AI‑enabled endoscopes and genomics existing therapies and recruit more diverse Each cluster comprises a leading university, development of new VBHC across different types of partnerships, environments to drive investment in life data to aid decision‑making by oncology clinical trial candidates. In 2021 Jordan several teaching hospitals, a Research business models, with savings including with patients and the public. sciences R&D such as ‘enterprise zones’ or and critical care teams. Oncology team launched a new patient-centric online Biobank, and National Disease Registries. delivered to the broader health direct investment. This includes IP, trade specialists have a comprehensive data platform for all patient‑related information The Nordic cluster received funding dashboard for reviewing and collaborating and activities across the company. He also from a non‑departmental government system. By working collaboratively • Stakeholders are focused on forming and tax credits, grants and other incentives on precision treatment decisions for commissioned a regular online survey of innovation agency, and the Western clusters have also accelerated values‑based, high-performance/ that support the commercialisation of high-trust partnerships and have signed innovation. There is a systematic approach individual cancer patients at each stage of each advocacy group to collect regular Europe cluster received government the pace of innovation and driven up to a code of ethical business practices. to funding based on public-private the disease. Technology‑enabled support feedback on the perceived culture of funding and additional investment from the adoption of revolutionary partnerships, cross‑industry collaborations systems have increased the productivity of the company and trust in its products. a private research consortium. The IT new medicines and technology, • These trust-based, VBHC partnerships and venture funding, encouraging the multi‑disciplinary teams. Additionally, Every quarter patients attend a virtual and digital infrastructure for the project, faster than ever before. Digital deliver clinical and economic value innovation at scale. New innovative within critical care, the integration of ‘Town Hall’ meeting to discuss how the based on open interoperability standards, data from a patient’s hospital monitoring company is responding to feedback and is provided by a large tech company and transformation, enabled by new through product and service innovation, contracts allow reimbursement over including subscription services. longer timeframes, not just budget cycles. equipment with biomarker, tissue hear about the latest innovations including a leading AI for drug discovery company. standards and radically pathology, genomic and sequencing data launches and progress in trials. In 2022, The alliance has been transparent about interoperable data, advanced • Healthcare providers work with industry • Regulations: The use of RWD and aligned enables clinicians to identify complications, an innovative partnership between the its use of patient data and the role of each technology and analytics, and to take well thought through risks and objectives have helped industry comply and even predict them before they arise. advocacy groups and NWPharma with partner organisation, helping to build and secure, open platforms, have willingly accept revolutionary change. with regulatory legislation and respond AGBT24 technologies to roll out clinical maintain public trust in it. Using a secure driven much of this change. in a coordinated and timely manner. trials in patients’ homes. Patients also cloud‑based research platform to helped design and implement new combine datasets, within 12 months the New standards for data sharing, • Academic institutions, comprising both Greater alignment of regulators at a national value‑based contracting and pricing Alliance had achieved its first objective of analysis and transparency have research academics and specialisms in and international level has provided key areas of science, have established a framework to optimise commercial models, aligning payments to differentiated moving drug candidates for two potential emerged improving trust, driving enduring industry collaborations. objectives and patient outcomes. improvements in patient outcomes. treatments into a Phase I trial. efficiencies, expanding access An AI‑enabled adherence tracking tool was and reducing costs. Clusters are • Product developers have formed strong • Data and interoperability: Data provides also introduced to provide differentiated also uniquely placed to draw on R&D partnerships with leading universities the currency on which VBHC partnerships support and motivate patient adherence to medication regimens. technological advances and play and tap into patient and HCP groups to are designed and executed with patients a major role in the move towards inform research, evaluate outcomes and willingly sharing health data as part of a provide continuous customer feedback on value exchange. There is a consensus among sustainable models of care. the effectiveness of products and services. partners on the use of HL7 interoperability standards and a framework to enable shared • Healthcare providers have partnered access to high‑quality RWE. Open data with MedTech and telecom companies to sharing is the common ‘truth’ on which apply low latency of 5G, edge computing partnerships have been formed, and and IoMT in areas such as critical care healthcare transactions are undertaken. on‑demand and remote robotic surgery. Note: All elements on this page are from a perspective of 2025 and are fictional 40 41 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

Medtronic and Lehigh Valley Health During the COVID‑19 pandemic, Genomics Vodafone is investing in new The COVID‑19 impact Network (LVHN) building an England has partnered with the GenOMICC technologies and partnering with infrastructure for new VBHC programmes consortium (Illumina, the University of health systems Medtronic and LVHN are transforming Edinburgh and several NHS hospitals) to Technologies like 5G, Mobile Private Network Deloitte view on the impact of COVID‑19 How COVAX is building and upscaling vaccine healthcare using a VBHC model, with shared derive insights into the role of genomics (MPN) and Multi‑access Edge Computing The level of national and international collaboration triggered manufacturing and supply capabilities to provide financial accountability for outcomes. Since in the spread of the disease and severity (MEC) are part of Vodafone’s strategy to by COVID‑19 has surpassed all expectations and historical equitable access 2018 they have pursued value-focused of symptoms. Illumina’s technology is revolutionise healthcare. It has established precedents. A raft of public‑private partnerships between At the start of November 2020, ten candidates had reached business models to achieve outcomes that being used to sequence the genomes of a novel 5G clinic, providing the foundation regulators governments, healthcare providers, the life the last phase of clinical development prior to seeking matter to patients and lower the overall 35,000 people with either mild or severe to test new, more efficient approaches science industry and tech and consumer health businesses regulatory approval. These candidates have been developed cost of care. They built a new VBHC model symptoms to develop an understanding to healthcare services such as surgery have brought stakeholders together to tackle the pandemic, by international collaborations, some of which involve existing requiring everyone to shift their mind-set of the different responses and identify rehearsal, remote access to expertise and improve population health, and help economies to survive and life science clusters such as Cambridge and Oxford in the UK. and an ‘Advantaged Ecosystem™’ designed treatments that have the best chance of enabling rural clinics to provide access ultimately thrive. During this extraordinary time, cross‑industry One of the most challenging tasks now facing the industry to enable both organisations to: establish success, and people at extreme risk if they to expert treatment without patients or collaborations quickly refocused efforts and resources to support is how to get the life‑saving COVID‑19 vaccines to people trust in the technology; apply well-defined develop COVID‑19.115,116,117 clinicians needing to travel. The University clinical trials, test new equipment and develop new test, track and around the world, in record time, to halt the spread of this rules and governance; design and deploy Hospital Düsseldorf is the first German trace systems. They also developed innovative digital and virtual virus. In anticipation of this challenge, in the summer of 2020, the programme to scale adoption and Big tech partnerships hospital to create a 5G campus to enable care solutions to enable HCPs to work differently in providing the WHO, together with Gavi, and the Coalition for Epidemic avoid staff burnout; and build a data-rich Google’s Verily teamed up with Novartis, new medical procedures that have proved patient access to virtual healthcare services. These collaborations Preparedness Innovations (CEPI), launched the COVAX IT infrastructure to measure value and Otsuka, Pfizer and Sanofi to improve patient extremely challenging previously. Examples are also tackling challenges in the medical equipment supply initiative to help build and upscale vaccine manufacturing inform objective decision making. LVHN recruitment and retention, and speed‑up include 3D visualisation of brain tumours so chain, including the manufacture, transportation and distribution and supply capabilities and provide countries worldwide and Medtronic agreed initially to focus on clinical trials. Using Verily’s AI‑powered experts from other parts of the country can of testing kits, PPE and ventilators. There has been a previously with equitable access to two billion doses by the end of reducing respiratory compromise in patients research tools, including wearable work together on surgery in real time.122,123,124 unseen level of partnering that has led to a wave of innovations 2021. COVAX is one of three pillars of the Access to COVID‑19 receiving opioids for pain management devices and sensors, EHRs, biometrics and the sharing of knowledge and IP across value chains. Tools (ACT) Accelerator, bringing together governments, using a new, data-driven Enhanced and patient‑reported data, they plan to The Corona Accelerated R&D in Europe The unparalleled speed of development of the leading vaccine global health organisations, manufacturers, scientists, Respiratory Monitoring programme. The launch studies across multiple therapeutic (CARE) public-private partnership candidates and potential treatments is due largely to the level private sector, civil society and philanthropy, with the aim aim is to create efficiencies and reduce areas, including cardiovascular disease, CARE, supported by Europe’s Innovative of collaboration between stakeholders, including regulators. of providing innovative and equitable access to COVID‑19 healthcare costs to patients, payers, and the , diabetes, mental health Medicines Initiative (IMI), is dedicated to Funding and support from government and NGOs have also diagnostics, treatments and vaccines. Importantly, the power health system.113 and oncology.118 discovering and developing treatment been a key to this success. Importantly, established life sciences of procurement now lies with countries that make vaccines options for COVID-19 and future coronavirus clusters were well positioned to face up to the challenge and and drugs, not just those that can afford them.128 Innovative partnerships involving Comprehend Medical is an AWS Cloud NLP threats. The CARE consortium brings drive global excellence. Genomics England service that decodes and mines structured together leading expertise and projects As part of the UK’s Genomics Healthcare and unstructured data to extract information from 37 academic and non-profit research Strategy, Genome UK was launched in about medical conditions and medication institutions and pharma companies in a How health eosystems responded to the CID‑19 pandemi highlights the power of ollaboration in healthare September 2020, setting out plans to use regimens from clinical trial reports, doctors’ comprehensive drug discovery engine. genomics to drive improvements in diagnosis notes and EHRs. It is being used by Roche With a grant totalling €77.7 million, CARE and personalised medicine; disease Diagnostics to enable its NAVIFY Clinical Trial is funded by cash contributions from the R& Provided staff to backfill programmes D m pen soured IP to increae ng an prevention; and research. Genome UK Match platform to extract and structure EU, 11 EFPIA companies and three IMI- ffi uf where health staff have been moved ta ac roduction including reource diverting S tu builds on existing major institutions, funding information from medical documents to Associated Partners. The consortium builds r in to mae euiment and conumale g streams and infrastructure such as: the NHS match patients to independent clinical on: drug repositioning, small-molecule e artnerhi eteen pharma Genomics Medicine Service, the Accelerating trials.119,120 drug discovery and virus neutralising and aademia including ocial Pioted their RD apabilities to enterrie to hel vaccine and accelerate the develoment of vaccine Detection of Diseases challenge and research antibody discovery. Exscientia, an AI for Examples treatment develoment of ways and treatment for resource provided by the UKBiobank Microsoft has entered a five‑year drug discovery company, is leading the LS businesses hae been

g

and NIHR BioResource. Its aim is to offer collaboration with Novartis to explore how to small molecule drug design activities and eled the supply hain to manage d Leeraged their marketing and n n

i

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a predictive, preventative and personalised combine Microsoft’s advanced AI technology Boehringer Ingelheim the work on virus i Health systems c i

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health and care service for the whole with Novartis’ deep life sciences expertise. neutralizing antibodies. CARE also aims to e

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a o population and ‘make the UK the global maximise synergies and complementarities everaged telehone line or uort P C uorted seroprealene studies leader in genomic healthcare’.114 with other initiatives such as the Gates rogramme to uort atient and rovided antiod creening Foundation.125, 126, 127 or clinician Di s agn rter ostic and suppo

42 43 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

Conclusion A future accelerated by COVID-19

The methodology for this report included We consider that in 2025 people will By 2025, the public’s digital skills and health In 2025, innovative contracting and value- Solutions for data, interoperability, What next a range of discussions and debate with have a better understanding of how literacy have been improved and so has based funding models are deployed at scale. privacy and security concerns In 2025, building on their experience during colleagues across our healthcare and life their immune system and behaviours their confidence in using digital technologies Healthcare and life sciences companies Current data challenges include a the pandemic, healthcare and life sciences sciences practices, extensive literature affect their health risks and chances to monitor and manage their health. Digital have invested in advanced data analytics, fragmented data landscape, a lack of organisations are actively sharing data, review and insights from clients. The of ageing well. Importantly, we identify inclusion initiatives have improved equity of research collaborations and AI companies to interoperability, and problems with data creating stronger linkages between the report also draws on recent primary innovative examples today that allow us access to digital-first healthcare and have inform these models. These developments quality, data privacy, protection, and public and private sectors and a resilient and secondary research undertaken by to predict tomorrow and the prospect of reduced health inequalities. Public health have helped deliver efficiencies and financial cybersecurity. Data being the ‘new oil’ and health ecosystem. Data has fuelled a wave both our UK and US Centres for Health a more predictive, precise proactive and professionals have been upskilled enabling benefits across the whole value chain. a source of revenue for owners is replaced of new AI-enabled, intelligent automation Solutions, as well as insights derived from participatory health system. them to understand how best to tackle by data being the ‘currency of exchange’ in opportunities, with data scientists, our Future of Health 2040 campaign. population health needs, and prepare them A new regulatory paradigm the digital future. In 2025, we expect that business analysts and knowledge workers Each of our ten predictions feature to respond to health threats, utilising data Traditionally, life sciences and healthcare data, in the words of IDC, will be “treated optimising the use of data and insights at Our research was also undertaken at a four sets of constraints that have been analytics and targeted evidence-based companies have adopted a risk-averse more like water - an essential element speed and scale. Technologies like RPA, pivotal time for the healthcare and life overcome, to accelerate in the pace of interventions. Employers recruit staff approach to regulation which has that is fluid across boundaries, readily AI and advanced analytics and 5G, cloud sciences industry. At the beginning of 2020, change and enable us to predict the world from more diverse educational and social impeded the adoption of innovation at accessible and cleaned for use”. Moreover and edge computing provide the scale healthcare and life sciences companies in 2025. These are: backgrounds. These staff have more scale. The evidence today and predictions patients will own their own health data and and speed to drive the new virtual health were on a steady, albeit relatively slow, enriched career paths based on new ways for tomorrow illustrate that while decide who to share it with and for what ecosystem. Enterprises have re-architected path towards digital transformation. Since • new skills and talent of continuous learning, with task shifting and changes aimed at supporting innovation purposes, democratising health data as the way they work, creating solutions March 2020, however, with the declaration • new funding and business models task reorganisation being commonplace, were happening across the regulatory part of a value exchange. that break down barriers, transform of the COVID-19 pandemic, we have seen • a new regulatory paradigm leading to a blended workforce that environment, these changes have productivity and performance and the future of digital healthcare accelerate, • solutions to data interoperability, privacy provides care where and when needed. HCP accelerated, shaped by the experience By 2025, data science and cloud insights, becoming truly intelligence-led achieving advances in nine months that and security concerns. education includes an understanding of during the pandemic. In 2025, regulators technologies will have improved the organisations. would have previously taken many years. medical research and data science, as well are focused on balancing the need to foster security, completeness and quality Importantly, the pandemic has changed New skills and talent as how to understand and communicate innovation, protect patients and address the of health and behavioural data with Data is the unifying force driving our the mind-sets of clinicians, patients, Across all ten predictions, efficient more effectively with patients and explain consequences of innovation. Governments internationally agreed interoperability predictions for 2025; enabling more governments and industry on the ‘who’, and effective service delivery requires diagnoses derived from genomic, digital and have worked with regulators to increase standards, supporting data sharing across proactive, preventative, personalised and ‘what’ and ‘where’ of care delivery. We organisations to have access to specialist AI applications. their internal efficiency, enabling them to all stakeholders. Companies have adopted participatory care, changing care delivery have also seen the establishment of new and generalist skills and talent, including keep pace with scientific and technological HIPAA and GDPR compliant cloud, quantum models, and revolutionising the discovery innovative, cross-industry collaborations digital, analytical and behavioural science New funding and business models advancements and accept RWE to improve computing and AI-enabled services and of new medical interventions, whether and partnerships based on shared values skills. Deloitte’s 2020 report, ‘Global A greater proportion of healthcare funding is the effectiveness of the regulatory process. tools alongside FAIR data principles and drugs or devices or services. Most people and purpose. The disruption wrought by Human Capital Trends’, has identified devoted to public health as policymakers shift protocols for the exchange and use of data. are digitally and health literate and more the pandemic has transformed the world paradigm-shifting forces such as cognitive the focus from sickness and cure to wellness By 2025, regulators have adopted more Open data sharing is the common ‘truth’ on informed about their health risks and as we know it, and neither life sciences technologies and the open talent economy and disease prevention. By 2025, the cost of common and interconnected regulatory which partnerships have been formed, and take a proactive approach to prevention nor healthcare organisations are likely to that will reshape the future workforce. The sensors and genetic testing has decreased frameworks, and established alliances among healthcare transactions are undertaken. and treatment. Clinicians are supported want to or be able to revert back to their extent to which the healthcare and life significantly, with individuals being prepared regulators. Regulatory convergence and by AI-enabled clinical decision tools and previous ways of working. sciences industry responds and acquires to invest their own money in therapies that a more collaborative approach to driving Providers have built an open multi- are confident in using genomics and the right skills and talent will determine how will help them age well. Governments and quality and transparency has improved omics data ecosystem (underpinned by digital technologies to help them deliver Our 2025 predictions report focuses on well the predictions are realised. While the the emerging longevity financial industry are public trust. Regulators now work with blockchain open source technology) and hyper-personalised evidence-based the major changes we have seen in technology is available today to automate major investors in ‘AgeTech’. Moreover, aligned provider organisations to develop products use distributed databases and secure prevention and treatment interventions. the past few years and especially the many of the more repetitive tasks and incentives and data-driven funding models and solutions based on a security-by-design transcription to address privacy and Public health is a priority for governments acceleration of change seen during 2020. enable new ways of working, adoption at are driving innovation across the health mind-set and a trusted framework for data security concerns. Staff understand everywhere, with a higher priority given to Our ten predictions identify a world in five scale requires leaders with a digital-first ecosystem, including flexible funding models exchange is underpinned by robust cyber data provenance, curation, integration maintaining a robust and responsive public years’ time when countries have benefited mind-set and robust change management such as ‘per patient use’ remunerating RPM security standards. New regulatory pathways and governance, and the ethical, data health infrastructure. Our predictions are from insights derived from multiple open- skills. Furthermore, the ‘essentially and digital therapeutics, also social prescribing have increased flexibility, transparency and privacy and security considerations with unashamedly positive as we believe that data sources, and use advanced imaging human’ parts of work such as empathy, to support equality of access to digital speed of approval, RPA has improved risk technology. Manufacturers work with the future for the health ecosystem is and other diagnostic and telehealth communication, persuasion, problem solutions. Integrated care budgets help ensure management, making it easier for companies providers to manage AI-ethics, data privacy bright, very bright. technologies to deliver more precise solving, judgement and strategic decision value-based healthcare is delivered at the right to optimise their commercial objectives and and cyber security challenges. targeted treatments. making are more valuable than ever. time, in the right place, by the right HCPs. deliver improved patient outcomes.

44 45 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

Endnotes

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46 47 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

Abbreviations

93. P.J. Jakovljevic, Striving toward self-driving supply chains, Technology Evaluation 112. NHS, Delivering a ‘Net Zero’ National Health Service, accessed October 28, 2020. 3D printing Three dimensional printing, also known as additive manufacturing HEAL Health Equity and Access Leadership Centers Inc., March 2018. 113. Medtronic, Patient Focused: Building a New Kind of Value-Based Healthcare 5G Fifth generation cellular network HIMSS Healthcare Information and Management Systems Society 94. Gartner, “Gartner Says Supply Chain Management Market Will Exceed Model, accessed November 04, 2020. 4Ps Predictive, preventative, personalised and participatory (healthcare) HIPAA Health Insurance Portability and Accountability Act $13 Billion in 2017, Up 11 Percent from 2016”, press release, June 22, 2017. A&E Accident and emergency HL7 Health Level Seven International (healthcare standards organisation) 114. GOV UK, “Genome UK: the future of healthcare”, September 26, 2020. 95. 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48 49 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

Contacts

Authors Acknowledgements

Karen Taylor Samrina Bhatti Krissie Ferris Pratik Avhad Maria João Cruz Aakash Deep Nishant Sinha Director Manager Research Analyst Deloitte UK Centre for Deloitte UK Centre for Supply Chain and Swiss Consulting UK Centre for Health Solutions UK Centre for Health Solutions UK Centre for Health Solutions Health Solutions Health Solutions Network Operations +44 (0) 7825 793729 +44 (0) 7789 158334 +44 (0) 7990 673809 [email protected] [email protected] [email protected] Laveshni Reddy Cornelia Calugar-Pop Li Xiaofeng Giles Dean Swiss Consulting Clients & Industries Consulting Risk Advisory

Kirsty Davis Jessica Oneal Will Saddington Sarah Thomas Industry Leadership Clients & Industries Deloitte Ventures Consulting US Centre for Health Solutions

John Haughey Hanno Ronte Sara Siegel Colin Terry Sonal Shah Partner Partner Partner Partner Deloitte US Centre for Global LSHC Consulting Lead and Life Sciences and Healthcare Public Sector Health Lead Life Sciences and Healthcare Health Solutions UK LHSC Industry Lead +44 (0) 20 7007 2540 +44 (0) 20 7007 7908 +44 (0) 20 7007 0658 +44 (0) 20 7303 7472 [email protected] [email protected] [email protected] [email protected] Contact information Gus Miah Shivani Maitra Bill Hall Fran Cousins Partner Partner Partner Partner To see more publications from the Deloitte UK Centre for Health Solutions, please visit: Risk Advisory UK Leader – Future of Work Human Public Sector Health Risk Advisory www.deloitte.co.uk/centreforhealthsolutions +44 (0) 121 695 5349 Capital Leader, Life Sciences and +44 (0) 121 695 5147 +44 (0) 20 7303 8316 [email protected] Healthcare [email protected] [email protected] +44 (0) 20 7303 7381 Deloitte UK Centre for Health Solutions, 1 New Street Square, London EC4A 3HQ [email protected]

Michael Dohrmann Gregory Reh Nico Kleyn Mathieu Van Bergen Partner Principal Partner Managing Partner EMEA MedTech Practice Lead Global Life Sciences & Health Care North South Europe Life Sciences & North South Europe Healthcare +49 89 29036 7638 Leader and Global Lead Client Service Healthcare Lead Government and Public Services [email protected] Principal +41 58 279 8166 +3 1882 885179 +1 215 977 7559 [email protected] [email protected] [email protected]

Neal Batra James Gregson Andrew Flockhart Angela Bowden Principal Deloitte Consulting LLP Partner Director UK Supply Chain Lead and Global Future of Health Leader UK Life Sciences and Healthcare Life Sciences and Healthcare +44 20 7303 5100 +1 212 618 4891 Consulting Lead +44 20 3741 2821 [email protected] [email protected] +44 20 7007 8866 [email protected] [email protected]

Bruno Pfeiffer Vicky Levy Neil Lesser Michael Barber Partner Partner Principal, US Life Sciences Partner Supply Chain Lead Global Sector Leader for Life Sciences R&D Practice Leader Risk Advisory in North West Europe – +41 58 279 9002 +41 58 279 7877 +1 (215) 4464364 Sustainability [email protected] [email protected] [email protected] +44 20 7007 3031 [email protected]

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