Future of Patient Data Patient of Future Insights from Discussions Multiple Around the Expert World
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Future of Patient Data Insights from Multiple Expert Discussions Around the World World Expert the Around Multiple Discussions from Insights FUTURE OF PATIENT DATA Insights from Multiple Expert Discussions Around the World 1 Future of Patient Data Insights from Multiple Expert Discussions Around the World World Expert the Around Multiple Discussions from Insights 2 Future of Patient Data Insights from Multiple Expert Discussions Around the World World Expert the Around Multiple Discussions from Insights FUTURE OF PATIENT DATA Insights from Multiple Expert Discussions Around the World 3 Contents Foreword 6 Acknowledgements 7 Introduction 8 Future of Patient Data Context 16 Shared Challenges 26 Integration 28 Ownership vs. Access 38 Trust 45 Insights from Multiple Expert Discussions Around the World World Expert the Around Multiple Discussions from Insights Security and Privacy 52 Future Opportunities 58 Personalisation 60 Data Marketplaces 68 The Impact of AI 73 New Models 86 Emerging Issues 96 Data Sovereignty 98 Digital Inequality 102 Privatisation of Health Information 111 The Value of Health Data 115 Conclusions 120 Questions 122 Appendix 124 4 Charts Project Summary 10 Healthcare Spend vs Life Expectancy 12 Growth In Healthcare Data 17 Doctors with EHR and Multifunctional Health IT Capacity 30 Consumers Willing To Share Health Data 46 Future of Patient Data Data Breach Cost Per Capita 53 Number of Personalised Medicines (US - 2008 to 2016) 63 Genetic Disorders with Diagnostic Tests Available 65 Number of Artifical-Intelligence Companies 76 Older Adults With Three Or More Chronic Conditions 104 Insights from Multiple Expert Discussions Around the World World Expert the Around Multiple Discussions from Insights Case studies Validic 35 Apple 36 Nebula Genomics 43 Digi.me 44 Flatiron 50 Deepmind 80 iCarbonX 82 Facebook 84 Verily 92 Amazon 94 Cityblock 109 Tricog 110 5 Foreword I am pleased to share this unique and wide-ranging We believe that the growing body of research insight on the Future of Patient Data as part of a on patient data and digital healthcare will help crowdsourced research initiative organized by our stakeholders make better-informed decisions. partner, Future Agenda. Accenture was fortunate Initiatives, like this workshop series with Future to be part of this project — hosting workshops in Agenda, help to advance complex discussions that Future of Patient Data Oslo, Singapore and London—as part of the larger impact society and humanity as a whole. effort that brought together some 300 attendees in eleven countries. We sincerely thank Future Agenda’s program directors, Dr. Tim Jones and Dr. Caroline Dewing, The report provides a synthesis of the main views for their collaboration, my colleagues involved, expressed and explored. As such, whilst not as well as the other partners and experts for representing the views of any single organisation, devoting their precious time and resources to this it is a provocative and highly valuable contribution. worthwhile project. Its geographic scope along with the range of contributors involved make it a unique undertaking Insights from Multiple Expert Discussions Around the World World Expert the Around Multiple Discussions from Insights at a time when health systems around the world are taking steps to guide the advancement of patient data and health records. The findings highlighted two diverging ideals: one focused on the need to “free” data, arguing that better research, intelligent applications and efficiency depends on data accessibility, with the other arguing for the privatization of data, giving ownership to the consumer or health organization. Ensuring data quality while protecting property, sovereignty, trust and security, seems to be the way forward. Kaveh T. Safavi MD JD Senior Managing Director, Global Health Accenture: Insight Driven Health 6 Acknowledgements The insights upon which this report is based were We hope that this report provides an accurate gained via multiple discussions with over 300 reflection of your views. In addition, we would like experts around the world. We would also like to to thank the generosity of the forward-looking thank all those who have spared their time to join in organisations that have supported the varied events. these events and share their perspectives. Future of Patient Data Insights from Multiple Expert Discussions Around the World World Expert the Around Multiple Discussions from Insights 7 Introduction The world’s healthcare systems are experiencing significant change. We are at a point, or more accurately multiple points, of major transition around the ways we can improve access, manage and transform how to control and treat disease. The expectation is that over the next few years we will see a sizeable shift in the Future of Patient Data effectiveness of healthcare. As the impact of rising public expectation around • Increasing automation across healthcare – from better wellness and health, the effect of increasingly chat-bots to surgery, sedentary lifestyles and progressively aging • The expansion of wearables, providing access to populations all converge, some fear that, in many new aspects of personal health data and Insights from Multiple Expert Discussions Around the World World Expert the Around Multiple Discussions from Insights nations, we will be unable to find the necessary funds for high quality healthcare. Others are more • A steady decrease in the cost of, and an increase hopeful that with the adoption of new technologies, in, the access to genetic profiling. particularly associated with a more patient-centric approach to both health and sick care, we are on the cusp of a significant step forward in the efficiency, Within this context, there are however many efficacy and effectiveness of how we diagnose, treat, differences of opinion and perspectives on how these manage and, ideally, prevent chronic and acute and other shifts will actually play out over the next disease. Indeed, a commonly shared ambition is decade. What will drive them? Who will pay? Who that a more information-rich, digital approach to will benefit the most? How quickly will transformation healthcare over the next decade will inherently be occur? What will be the catalysts for change? Where more effective and patient focussed. specifically will be the greatest impact and why? These are all key questions that many organisations around the world and across multiple sectors are Some key advances that are seen to have already asking. As many governments, companies and had substantial effect include: communities all seek to make the right moves and investments, a good number are keen to see the • Wider adoption of smartphones which are able to global, cross-functional context within which the sense as well as diagnose, possible change is occurring. In a sector where • More empowered patients equipped with a fragmentation is sometimes extreme, where funding burgeoning volume of information about their is often challenging and where local or regional condition, regulations can frequently influence the market, many are keen to gain the broader perspective and then • Tangible advances in machine learning, cognitive see how, where and why their individual areas of computing and wider AI, focus can have the greatest impact. 8 Approach In order to provide a global view of the patient data arena, over a six-month period the Future Agenda team undertook a major multi-country project to explore the key changes on the horizon. A series of 12 events took place around the world from September 2017 to the end of January 2018 providing the opportunity to Future of Patient Data discuss the major shifts with multiple experts from across a wide range of industries, providers, researchers, governments and start-ups. As with all Future Agenda programmes, each event identified the key issues that matter, added in brought together a rich mix of informed people who additional views and highlighted the pivotal areas for could challenge existing assumptions, share new future innovation and the most significant shifts - both perspectives and build insightful pragmatic views of globally and locally. Each event was supported and World Expert the Around Multiple Discussions from Insights how change will most likely occur. Starting with an hosted by different organisations from across the initial perspective drawn from existing research and healthcare arena keen to collaborate and build the previous discussions about the future of health, the informed global view. This report is a synthesis of the future of ageing, the future of data and the future insights gained from these discussions. of privacy, this series of workshops progressively 9 Project Summary London 14 DEC 2017 Oslo 30 OCT 2017 Mumbai 23 NOV 2017 C Combining Data Sets C Combining Data Sets C Data Quality Trust Getting Closer to the Patient Ulterior Motives Linkability of Open Data Expanding Set of Data Data Ownership O Embedded AI O Predictive Analysis O Data Marketplaces Getting Closer to the Patient Personalisation India Setting Standards Predictive Analysis Artificial Intelligence Artificial Intelligence Future of Patient Data E New Business Models E Standardised Measures E Informed Consent Standardised Measures Inequality New Models Inequality Global Data Sharing Inequality San Francisco 19 JAN 2018 Brussels 9 NOV 2017 Dubai 27 SEPT 2017 C Integration of Data C Ulterior Motives C Data Gaps Data Quality Resistance from HCPs Infrastructure Unstructured Data Trust Digital Skills O Individualized