In the future, the biggest opportunities are likely to lie in the smallest markets. This is the fascinating premise of Heman Taneja's book Unscaled.
Growing datasets, computing power and connectivity are powering a rise in artificial intelligence that is leading businesses to shift from mass production to mass customisation. No aspect of our lives is likely to benefit more from this shift than our health. And no part of our healthcare system is likely to be left unchanged as it transforms to revolve around us.
This transformation is reinforced by the powerful convergence of many fields and technologies. Gene sequencing, machine learning, powerful imaging, sensors, new types of therapy – these technologies and many others were confined to academic labs just five to ten years ago.
Scientists are increasingly able to study diseases at an individual level thanks to the falling costs of gene sequencing and associated tools.
By analysing detailed genetic and protein data, they can pinpoint the exact strain of a virus or bacteria and/or the exact biological pathways causing a disease. This has triggered a wave of reclassifying diseases based on genetics - including cancer, heart disease and even mental health.
It is also enabling faster and more precise diagnosis. In the past, patients often underwent a seven-year odyssey to get diagnosed with a genetic disease. For many, this is now condensed to a few weeks, most of which is spent waiting for an appointment rather than test results.
As tools for scientific investigation continue to get cheaper and more accurate, “common” diseases are likely to cease to exist. The differences between individuals’ biology may matter infinitely more for their health than similarities with others in how their disease manifests itself.
Drugs and treatments
To date, treatments have been prescribed based on what has historically helped most people with similar symptoms. Consequently, drugs were designed and developed to gather such evidence in long and expensive clinical trials.
Successful drugs help to alleviate symptoms, but cures have remained elusive for most diseases. That’s not surprising given that drugs were never designed to cure. We didn’t know to do so.
Increasingly, we do. The direction for the future is clear: the better we can design treatments to target disease biology - which may prove to be unique for each patient - the higher the chances of stopping a disease in its tracks.
If we can design drug development to match an individual’s disease biology, we could afford to create personalised drugs by reducing the cost of failure and lengthy clinical trials. The development of tools for such precision is well underway.
Delivery of care
Healthcare services are currently centralised around hospitals and clinics that have amassed sophisticated equipment and expertise. As monitoring and diagnostic equipment continues to get smaller and smarter, our connected devices are facilitating the delivery of hospital-standard services at home.
This is reducing barriers to accessing care, which in itself could lead to earlier diagnosis and more preventive care as people seek treatment earlier.
But perhaps the most important implication of healthcare decentralising is that the nature of healthcare services is beginning to change.
A big hospital can treat more patients in a standardised setting, but chronic diseases are highly individual and require constant care and attention that doctors cannot squeeze into brief office visits. As a result, the costs and health burden of chronic conditions have ballooned in recent decades. In the US, every second adult has a chronic disease and costs of care make up 75% of total healthcare costs.
New business models are beginning to emerge using sensors, connectivity and artificial intelligence to introduce healthcare that is proactive and continuous.
The data captured by connected devices is making it possible to tailor personalised treatment regimens for individuals based on what is likely to work for them. Treatments can be adjusted based on continuous feedback from an individual’s blood sugar, blood pressure, weight, activity levels or other data - without spending weeks or months waiting for an appointment.
The future of healthcare
So, what does this all mean for the future of healthcare? Ample data and artificial intelligence are increasingly making it possible to tailor drugs and treatments to individuals - and to do so at scale. Personalising care in such a way is likely to prove a critical component in making healthcare more effective.
Data allows us to anticipate and prevent problems. Armed with such tools, the biggest opportunities in healthcare are likely to lie in reducing the need for healthcare as we know it; shifting the healthcare experience from cure to prevention, and from generic to personalised. We sit at the beginning of a health revolution, enabled by the data and technology that surrounds us.
If you’d like to learn more about Baillie Gifford’s insights into the future of healthcare, you can read more on our website. You can also discover more about our Health Innovation fund in this case study.