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The Future of Public Health: Personalized, Participatory, Predictive, Precise Deloitte | A Middle East Point of View - Spring 2021 | Healthcare 34 Deloitte | A Middle East Point of View - Spring 2021 | Healthcare The future of public health: Personalized, participatory, predictive, precise The Covid-19 pandemic has changed the entire concept of public health. As we progress through it and the subsequent global mental health pandemic we are likely to face, a future of public health that is personalized, participatory, predictive, and precise will help us navigate changed public health principles and how we deal with ourselves. 35 Deloitte | A Middle East Point of View - Spring 2021 | Healthcare ublic health has developed from analysis of their health all the way down focusing only on health to their genes and granular behavioral P promotion and lifestyle insights (to be combined with data for paradigms—to avoid many preventable Population Health Management), leading diseases—to a more holistic view beyond to decision-making and tailored traditional/clinical personal health and treatments based on data. Finally, the reactive care to include social, political, digitally-enhanced user experience and economic, environmental, and public health and healthcare journeys for geographic determinants, all while individuals, payers and care providers will improving outcomes and ideally reducing be seamless and interoperable, allowing costs. for greater satisfaction, empowered self- management of care, increased With the advent of globalization, efficiency, and reduced costs. increased interconnectedness, social media, and more readily available Public health becomes personalized education, individuals are steadily and predictive becoming the stewards of their own As populations continue their health. We are living in a culture of health demographic and epidemiological and well-being, in which a well-informed, transitions, and people start suffering more health literate person is the from consequent diseases related to ultimate decision-maker and is at the aging, longevity and increased life center of their own health. expectancies, it is possible that future clinical medicine may see increased costs A strong foundation for the future of without significantly improved health public health will be dependent on outcomes. Medicine will therefore seek enabling governments (providing whole- to become more data-driven and less of-government approaches to care individualistic in order to efficiently provision) and collaborative ecosystems, manage and improve the health of based on intersectoral collaboration and populations (versus solely individuals) cross-industry collective research. while keeping costs from becoming too Digitally-enabled healthcare and public high. Conversely, yet in a complementary health sectors will emphasize a 360- fashion, and in order to keep pace, public degree view of the person leading a health will start benefiting from healthier lifestyle or seeking care, taking personalization and individualization of into account their health journey from initiatives and practices for the well-being pre-birth to grave, as well as the detailed of communities and populations. One of the forerunners of this future era We are living in a culture of health and of precision public health is the science of genomics 1. By taking our knowledge well-being, in which a well-informed, of health beyond the traditional disease correlates, genomics helps public health more health literate person is the better improve the health of the population and of sub-groups within the ultimate decision-maker and is at the population who are more pre-disposed to certain ailments and conditions that center of their own health. can now be more easily stratified into the more detailed layer of genetic risk and 36 Deloitte | A Middle East Point of View - Spring 2021 | Healthcare predisposition for common or rare will be most useful to improving health Using Big Data to more diseases. Because some countries in the and well-being. GCC are comprised of quite homogenous accurately and more populations, this more precise method of Participatory public health precisely predict trends public health can tailor population-level The Covid-19 pandemic has been a clear interventions to targeted groups whose exemplar of the role each member of and analyze individuals’ conditions may have otherwise been society plays as a part of the public health choices, lifestyle missed in less bespoke and traditional health workforce, and the role all factors and their public health interventions. The individuals must play in supporting increased ubiquity and integration of effective public health outcomes. The environment can help genomic knowledge in clinical practice most successful country responses have authorities, regulators (partially due to the decreased cost been those with robust public health and associated with genome sequencing over healthcare systems under governments and providers apply the last few years) is lending itself to the who have employed a whole-of- tailored interventions delivery of targeted interventions for government approach to their response. patients, better known as precision and promotion and medicine. We should therefore expect In order to obtain effective public health prevention campaigns at the same for precision public health. interventions, there is a continued need the community level, for an intersectoral approach to care that Another aspect of the future of public goes beyond core health stakeholders— especially for at-risk and health that can offer contributions similar one in which academic institutions, vulnerable groups. to those that the field of genomics does, workplaces, religious leaders, social but which focuses more on the sharing of institutions, civil society, law enforcement, interoperable, accurate and secure data, have a place in providing the right culture is Population Health Management. Using and support for sustaining change. By Big Data to more accurately and more continuing to educate, and raise precisely predict trends and analyze awareness in, individuals regarding their individuals’ health choices, lifestyle important participation and key role in factors and their environment can help the improvement of the population’s authorities, regulators and providers health, coupled with digital enablement apply tailored interventions and leading to interconnectivity and promotion and prevention campaigns at empowerment of individuals to own and the community level, especially for at-risk understand their health data, public and vulnerable groups—thus improving health will succeed. the health of the overall population. Predictive public health requires these in- Powerful technology and its ethical depth data analyses to provide a highly use targeted approach that can help prevent The future of public health will render common diseases that are likely to larger amounts of data—personal and spread or become endemic in a system-level—more available than ever community, encourage certain lifestyle before; thus, the challenge and ethical practices applicable to parts of the dilemma of data storage and analysis will community, improve care outcomes, have to be tackled, especially in the field reduce costs, and reach a larger portion of genomics, whose advances have been of the population. By understanding the dependent on, and facilitated by, drivers of health in a population, it will be progress in data science, informatics, easier to predict issues that may rise and, and the development of novel and more accordingly, decide on the strategies that advanced technology. The immense 37 Deloitte | A Middle East Point of View - Spring 2021 | Healthcare The Covid-19 pandemic volume of data that next-generation surveillance during emergencies like sequencing will generate as countries Covid-19 may therefore pose a threat to has shown us that the and public health systems sequence a person’s privacy and consequent bodily lines of privacy larger portions of their populations will integrity, thereby further increasing the require data storage and protection importance of informed consent and protection become possibly beyond available capabilities. privacy protections, along with the blurred in emergency protection of the greater public good. settings. The Beyond the issue of storage and analysis will be the continuous ethical dilemma Not only will there be differences in International Health of data protection and confidentiality. As health literacy and the intellectual Regulations require we move toward more integrated and capability to truly have informed consent, consolidated sources of individual and but there will be differing ease of, and states to keep individuals’ population health data and information, barriers to, access of necessary digital data “confidential and some of the questions that will need to technology and broadband services. As be addressed include: What will the governments accelerate the digitalization processed anonymously cybersecurity and identity protection of their public health systems and as required by national implications be? Which disease variants services, they will have to take these law”; nevertheless, in a should be reported? How will issues into account. governments safeguard the safety of crisis it can sometimes their populations’ health information Back to basics – The importance of be necessary to collect and, moreover, how will public health traditional public health and medical healthcare systems protect The Covid-19 global pandemic showed us and disclose certain individuals’
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