Dialing Up Digitalized Healthcare

“This isn’t a magic wand—it is going to take a long time,” he said.

Given Lord Prior’s long career in business, finance, politics and public service, he has a unique perspective on the challenges facing modern medicine. And he remains at the forefront of thinking about the future of healthcare in his current portfolio of roles.

After standing down from a four-year stint as NHS chairman earlier this year, he is now Deputy Chair of Lazard UK Financial Advisory, where he advises a range of innovative healthcare companies, helping them achieve their growth aspirations. He also chairs Protas, a not-for-profit clinical trials group in Oxford, and the Cambridge Life Sciences Council. Previously he chaired University College London Hospital and the UK Care Quality Commission, as well as serving as a non-executive director for Genomics England.

The conclusion he draws from this deep experience is that healthcare systems in all high-income countries are currently on an unsustainable financial path. Different countries may adopt different systems—funded by private insurance, social insurance, direct taxation, employer contribution or a mix of all these—but they all face similar problems as healthcare costs chew through an ever-increasing share of GDP.

“There is always this conundrum in healthcare, which is that as medicine advances you also create more demand. That makes it very hard to get ahead of the curve,” he said.

The net result of the mounting financial pressures is that healthcare provision is increasingly skewed to costly late-stage care of the sick rather than offering smarter—and cheaper—services targeting prevention and early intervention to keep people healthier longer.

The problems of the current “sick care” system are all too apparent. In England, for example, the National Health Service waiting list for hospital treatment now stands at a record high of more than 7 million patients, as medics struggle with a post-pandemic backlog of work. Life expectancy is also falling for the first time in over a century, driven by the burden of chronic disease and rising health inequalities.

Similar pressures are evident around the world as providers focus on tackling short-term problems rather than trying to stop populations falling sick in the first place.

“If I look around the world, I don’t see a best system. I see lots of broken systems—and just chucking more money at the problem isn’t going to help in the long run,” Lord Prior said. 

The task, as he sees it, is moving to a system that is proactive, preventative and personalized—and the good news is that modern science and technology means this is no longer a pipe dream.

“It is the convergence of deep understanding of biology with computing power that is creating this incredibly powerful predictive machine that is going to transform healthcare,” he said.

Progress in genomics is a case in point. Thanks to the power of modern computers and advances in life science technology, the cost of sequencing a genome has fallen to as low as $100, with industry continuing to work toward even lower costs. For comparison, the original project to complete the first human genome two decades ago cost $3 billion.

Diagnostics based on genomics provide a precise way to identify high-risk individuals and even capture conditions at a pre-disease stage. Coupled with progress in taking samples—such as using blood tests rather than tissue biopsies to profile patients—this promises to revolutionize the treatment of cancer and other conditions.

At the same time, screening systems are increasingly using artificial intelligence to streamline and improve professional decision making, while digital tools that allow people to monitor their own health and wellness can be harnessed to help determine future care needs. 

“If we can put this resource to work in the silent pandemic of chronic diseases like cancer, diabetes and obesity, it could have a massive impact,” Lord Prior said.

So where are we on the journey toward broad application of these technologies? The COVID-19 pandemic has fast-tracked some aspects of healthcare digitalization by accelerating the uptake of key digital tools, such as platforms for remote consultations or at-home patient monitoring. It has also shown the power of population level data, both for tracking disease and coordinating vaccine delivery.

Digital health technologies are certainly gaining traction, with the global digital health market expected to reach $430 billion by 2028, a compound annual growth rate of 17% over the next six years, according to a recent forecast from Vantage Market Research. 

Meanwhile, an annual survey of 1,300 physicians conducted by the American Medical Association between 2016 and 2022 shows accelerating rates of digital health tool use among US doctors, with 93% of them now believing such mechanisms offer advantages over traditional ways of working.

Yet, overall, the adoption of technology and the embedding of digital solutions within healthcare workflows remains piecemeal. The goal of healthcare systems that are ready to leverage the full benefits of digital technology is still a way off, with more than a quarter of clinicians in Europe in a 2020 survey saying that their organizations were ill-equipped for the transition.

Another key consideration is the need to bring the public along with the technology—especially when it comes to guaranteeing the privacy and security of medical records.

“You have to persuade the public that their data is going to be safe. Governments and healthcare providers need to take that very, very seriously because you can have all the technical solutions but if you can’t actually take the public with you then it won’t happen,” Lord Prior said.

The pandemic introduced the public to the value of health monitoring and population-wide data collection. However, according to Lord Prior, people have very short memories. COVID-19 demonstrated that there are new ways of doing things, but the job remains to convince people that the benefits outweigh the risks when it comes to handing over their data.

Used wisely, modern data science tools can be transformational, he believes. They can help close the gap between scarce healthcare resources and ever-increasing demand by shifting the focus of care from late-stage treatment to prevention and early diagnosis. But navigating this path will not be easy.

“The challenge is that healthcare systems have to deal with the current crisis situation, while simultaneously committing to a different and better way of operating in future.” 

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Ben Hirschler is a Senior Advisor based in Brunswick’s London office and a former global pharmaceuticals correspondent for Reuters. Ayesha Bharmal is a Partner in London, where she is part of the firm’s global Healthcare and Life Sciences team.

Illustration: David Plunkert