Stanford Medicine 2017 Health Trends Report Harnessing the Power of Data in Health June 2017 Stanford Medicine Foreword from Dean Minor Today across the world, enormous to better understand the most important transformations are taking place in health care trends and gain insight into the health care. future. We interviewed industry experts to better understand those trends and Demographic, economic and technolog- how they envision the future of medicine. ical changes are forcing us to reconsider And we spoke to our own faculty to better everything about health care, from its understand their work and how it fits into delivery to its funding models, from the wider picture. patient’s various personalized education to scientific innovation and monitoring devices, whether they be from the role of the physician to the What has become very clear from wearables or home devices, can now role of pharmaceutical companies, the findings in this paper is that be interpreted to identify trends and payors and patients. the greatest force behind these markers of future disease. trends is data. Like the rest of the world, health care is But that is just the start. Among many becoming increasingly connected but Whether it is health wearables or things, data will change how doctors, also increasingly complex. This poses on-demand testing, better hospital health care teams and institutions like both an opportunity and a challenge to software or algorithms capable of catching Stanford partner together, how cost is institutions like our own whose job it is to disease more effectively, rapid change is rationalized to increase accessibility heal, innovate and educate. taking place because of increased access and, most importantly, how we protect to big data and advanced data analytics. patient privacy and maintain patient That’s why, given all of these forces If this continues – and we firmly believe it trust. We do not expect to provide all shaping health care, I am very pleased to will – doctors will need to learn new skill the answers here. But we do hope it’s introduce Stanford Medicine’s inaugural sets that, in turn, will require changes to the start of a lively debate and, if you Health Trends Report. education and learning. As Kleiner Perkins’ have any feedback or thoughts, I’d be Mary Meeker stated in her recent Internet delighted to hear them. Our aim in producing this Report is to draw Trends Report, “health care is at a digital together the key trends facing the health inflection point.” We couldn’t agree more. I hope you find the inaugural care sector and by doing so inform and But what role will big data play? Health Trends Report valuable. educate patients, doctors, governments and other members of the medical We at Stanford Medicine believe in a vision community about the opportunities and of health care – Precision Health – that is challenges that lie ahead. If there is one more preventive, predictive, personalized thing we can confidently predict about and precise. By leveraging big data and Lloyd B. Minor, MD the future, it’s that the trends we have scientific advancements while maintaining Dean identified in this paper will upend our the important doctor-patient bond, we Stanford University School of Medicine thinking and revolutionize patient care. believe we can create a health system that will go beyond curing disease after To produce the Report, we undertook a the fact to preventing disease before it comprehensive review and analysis of a strikes by focusing on health and wellness. wide range of existing open-source data For instance, the data gathered from a Stanford Medicine Executive Summary The future of health care is being Data is permeating every component of When it comes to the road ahead, it will shaped dramatically by a number of the health care ecosystem: be absolutely vital that all players in the significant trends. • Medical research: Access to new, di- health care community, in both private verse data and open datasets are fueling and public sectors, come together to With the cost of care on the rise, the drug discovery and making clinical trials overcome several challenges: industry is experiencing a shift toward and research more efficient. • Rising costs: Spiraling costs across the preventive and value-based care. At the • Daily life: Wearable devices, online U.S. health care system could nullify the same time, technology like wearable diagnostic tools and genetic sequencing additive role data plays. devices, at-home testing services and services hold the promise of better • Data sharing and security: Silos and telemedicine are empowering patients informed and engaged patients. roadblocks prevent effective data shar- to be more engaged with and proactive • The patient experience: Health ing but, at the same time, privacy and about their own health. Meanwhile, the systems are investing heavily in security of patient data is paramount. industry is grappling with the tension technology, including machine learning, • Policy and legislation: Data privacy between encouraging data sharing which is proving as effective as or more and interoperability must be addressed to maximize the benefits of data and effective than human diagnosticians. at a legislative level to create a maintaining patient privacy and trust. • Ongoing care: Telemedicine and health regulatory environment that encourages All of these developments are altering apps make it possible for physicians innovation and research while putting the role of physicians and their relation- to see patients virtually, outside of patients first. ships with patients. traditional facilities for increased access • Electronic medical records (EMRs): and tailored care. Frustrations with the design of elec- Behind these trends is one fundamental • Prediction and prevention: Health tronic medical records undermine the force driving health care transformation: data is allowing doctors to build better physician-patient relationship. the power of data. patient profiles and predictive models • Skills and training: Without proper to more effectively anticipate, diagnose infrastructure and a data-literate clinical and treat disease. workforce, health data can only be collected and stored, not leveraged fully. • Encouraging preventive health care: Reliance on reactive health care will hamper physicians’ ability to anticipate, diagnose and treat disease. A focus on data in the coming years has the potential to make health care more preventive, predictive and personalized, meaningfully reduce health care costs and lead to better patient outcomes. Stanford Medicine Table of Contents Introduction 1 Data’s Impact on Health Care 2 Medical Research 3 Daily Life 5 The Patient Experience 7 Ongoing Care 9 Prediction and Prevention 11 The Road Ahead 12 Rising Costs 12 Data Sharing and Security 12 Policy and Legislation 14 Electronic Medical Records (EMRs) 14 Skills and Training 15 Encouraging Preventive Health Care 17 Appendix 18 Stanford Medicine Introduction quality of care and cost of care. At both A number of important trends are On the front lines of this change, the individual and population level, shaping the future of health care. As human capital needs are shifting as data is helping us reach new frontiers the cost of health care continues to technological advancements and in how to treat patients, improve climb, in the U.S. alone health care artificial intelligence transform how outcomes and achieve new solutions. spending has outstripped inflation by care is delivered. Cybersecurity is top a 5:1 ratio over the past 10 years.1 As a of mind in an era of sophisticated In the Report that follows, we’ll share result, we are seeing a shift toward targeted cyberattacks, while industry the key trends in health care and the encouraging preventive care through experts are pushing for more open way in which data is revolutionizing the an increased focus on nutrition, data sharing infrastructure to gain industry and our view on how to best exercise and wellness, and a pivot faster, broader insights into public foster and embrace this change. toward value-based payment models. health. Meanwhile, the rapid increase in corporate partnerships and VC Along with the widespread use of funding in the sector are accelerating online resources such as WebMD change at a powerful pace. that sees 212 million unique monthly visitors,2 the increased use of wearable Behind these key themes lies an devices and at-home genetic testing important common thread: the services are leading to a generation of power of data and its potential to empowered patients who are taking fundamentally transform the future increasing ownership of their health of health care. far beyond the walls of their doctor’s office. And on the horizon, the use of Information is becoming easier to telemedicine is widely expanding collect, analyze and understand, access to, and convenience of care opening the door for major advances across the globe. when it comes to preventive care, 1 Stanford Medicine Data’s Impact on Health Care The last decade has seen major advances in the production and collection of data, as well our ability to effectively analyze and understand this new information. Big data Daily Life is helping every industry become more efficient and productive – and health care is no exception. Today, data is a powerful force driving health care forward. The year 2016 reinforced the impact data is having on all The Patient aspects of the health cycle. Notably, the Ongoing Care Medical Chan Zuckerberg Initiative announced a $3 Research Experience billion investment over the next decade to find solutions to cure, manage and prevent diseases. Rather than spending only on scientific research, significant funding is going towards bringing together scientists and engineers. The research and output produced will be open data for physicians Prevention & and researchers. In addition, the initiative Prediction will seek to improve communication chan- nels between key sector stakeholders. The government has also been involved in data changes in health care.