“The healthcare system of the future will look very different, with a crucial change being the move to ‘consumer-centric’ healthcare, allowing citizens to have much more responsibility for managing their healthcare and that of their families”. (World Economic Forum)
Healthcare 4.0 represents major shifts in the sector worldwide: Big Data, personalized medicine, precision medicine, nanotechnologies, biotechnologies, digital innovation, the Internet of Things, Artificial Intelligence. Where is the future of medicine headed and at what economic and ethical costs? Discussion at the seminar in Venice revolved around these questions.
The power of science, the “omics” (in particular genomics and proteomics), synthetic biology and more are transforming healthcare and the institutions charged with providing it. The speed of disrupting changes in the field are leading to a “precision medicine” capable of converting the entire system: unnecessary treatments with poor outcomes will be abandoned, for example. If any one thing is sure, it is that prevention must be the starting point for future healthcare policies.
The excellence of the Italian universal access system is recognized worldwide. 6.5% of the Italian GDP is invested in healthcare, with impressive results, as compared to almost 17% in the US, despite the fact that only a small part of the population is covered there. In order to reduce costs, improve efficiency and ensure better outcomes, the American system is shifting towards a results-based model.
The role of governments everywhere is key: policies and regulations need to adapt quickly to the healthcare evolution. A skilled and receptive staff needs to stand ready to operate with new tools and practices. We need to break down old systems and modernize them in such a way as to guarantee long-term savings.
The availability and spread of information is crucial for patients and civil society, as it allows everyone to understand and manage ongoing changes. Unfortunately, fake news has its consequences in this sector, like elsewhere. For example, whereas many studies have clarified that there is no connection between vaccines and autism, many people continue to believe the opposite. Also, while diseases like rabies cause up to fifty thousand deaths every year, they no longer grab headlines and are mostly forgotten (and thus neglected).
Ethics plays a big role in digital innovation in medicine, including as regards the debate on AI. One delicate point is the question of the programming influence of AI creators, who inevitably operate with their own prejudices and beliefs.
What is the true cost of all this transformation? The issues are manifold: the cost of developing drugs, how different models are used, the economics of care, how to use money efficiently. Access and equity must be taken into account in developing new treatments and medicines.
The use of Big Data will be revolutionary, though privacy issues are numerous and remain delicate. Silos must be broken down, homecare favored over hospitalization, and patients empowered. Our resources must be focused on creating such changes. At the same time, patients must become more conscious of their own responsibilities.
The seminar concluded with a discussion on the global public good and on the importance of improving our understanding of epidemics. There is optimism for the future, despite an ageing population and widespread demographic changes. Maintaining some semblance of control over the many changes is key.
The overriding conclusion of all the discussions can be summed up in the words: “At the end of the day, if you don’t have your health you have nothing”.