It’s Day One - The future of health starts now
There is no doubt that the current healthcare system is not sustainable. Given the growing aging population and society’s changing lifestyles, the burden of disease and hence healthcare costs are projected to rise dramatically. Efficiency gains will not suffice to cope with this development, so there will be growing pressure to scrutinize the price of medication and healthcare delivery. This will challenge an industry which is already facing the near breakdown of its business model.
Today, developing a new drug costs an average of 2.3 billion dollars and takes around 12 years from conceptualization of the target to product launch. These costs are rising as it becomes increasingly challenging to find safe treatments or even a cure for common diseases and regulatory approval gets ever tougher. As a result, profit margins are eroding to a point where the return on investment will inevitably approach zero. It is therefore only a matter of time before the development of new drugs hardly pays off and the innovation pipeline dries up – leaving numerous patients without new treatment options.
Given these scenarios, the healthcare industry must reinvent itself. Digitization is seen as the great white hope. The thinking is that, through better analysis and utilization of exploding health data, it should be possible to accelerate research and development, gain a better understanding of diseases, make diagnosis timelier and deliver treatments tailored to individual patient needs. Being able to accurately measure the efficacy of treatment will also allow for new business models linking reimbursement to concrete outcomes of the intervention, thus shifting the risk from the payer and patient to the provider.
This brave new world of healthcare towards precision medicine is still largely a vision and remains to be explored. The main reason for this is that, until now, industry has mostly succeeded in incremental progress. In other words, innovation took place primarily within separate silos, where pharmaceutical companies developed better therapeutics and healthcare providers improved treatment and care processes, while governments focused on increasing their investments in basic research. To tackle healthcare innovation in a much more fundamental, if not disruptive, way will require the ecosystem as a whole to be able or be enabled to adapt to innovation and thus reinvent itself, which means that the entire value chain will have to be redefined.
This clear need for ecosystem innovation has brought together a growing community of professionals and experts from various disciplines and companies in the Basel region, creating a leading healthcare innovation hub under the brand DayOne. The initiative is being run by BaselArea.swiss, the economic promotion office of the Basel Region, with financial support from the Canton of Basel-Stadt. After three years of intense activity organizing discussion forums, expert workshops and open innovation sessions and serving as a catalyst for projects and start-ups, DayOne has identified the following three main fields of action as a starting point to shaping the future of health and reinventing the current healthcare system:
1) Make health data accessible
Thanks to digitization, there has been an explosive growth in health data. But estimates suggest that more than 90 percent of this data is not accessible for research. This means that enormous amounts of potential knowledge lie fallow. Open platforms that allow controlled access to health data and at the same time protect the privacy of individuals are still in their infancy. So far, there has been a lack of economic, social and political incentives for these initiatives to establish themselves against proprietary data aggregators such as Google, Amazon or Facebook. A common effort by all stakeholders is needed to find ways and means to break down data silos and create open, non-discriminatory infrastructures that allow health data to comply to standards and be used as a public good - while safeguarding the privacy of the individual.
2) Turn sick-care into healthcare
Today's healthcare system is an intervention system. As such, it is designed to save lives and combat disease. The business model of all actors is shaped with this goal in mind, and all processes, incentives and competencies are orchestrated accordingly. Even though the current system is able to deliver excellence in acute situations, it reveals its deficiency in treating and caring for the growing aging population and also patients with chronic conditions. Furthermore, the current system is not built to facilitate early detection and prevention of disease. It is precisely in these areas that digitization will reveal its greatest effectiveness. Therefore, healthcare needs to adapt to a new mindset focusing more on staying healthy than on simply fighting disease. “Real healthcare” requires a more holistic view of the individual, putting him/her at the center of a 360-degree health service that has yet to be established
3) Operate at the health/disease continuum
As the new healthcare system will not only deal with sickness but also increasingly shift to early detection of diseases and smart preventive interventions it has to become human-centric instead of solely patient-focused. Therefore, a much better understanding of disease and its progression is needed. The sharp line that is drawn today between being sick and healthy will become blurred in a health/disease continuum which allows for better differentiation between different health/disease states. The regular flow of data between the health system and individuals will allow for automated monitoring and decision support services with personal advice on suitable measures (coaching, medication and intervention). In this scenario, health or disease will increasingly be understood in an individual setting, and the outcome of intervention will therefore be significantly less defined in terms of one size fits all, opening the field for new ways of medical practice and reimbursement schemes.
Healthcare innovation in precision medicine as outlined above will lead to radical changes. The technical revolution in data science, sensors and wearables, the evolution of more and more human/patient-centric healthcare services and interventions, as well as a better understanding of different states in the health/disease continuum could bring about a paradigm shift in biomedical science and a rethink on the common definition and classification of diseases themselves. The research and development of therapeutics for rare disorders could serve as a model: Continuous improvement of the molecular definitions of different disease states will eventually allow them to be stratified into clusters just like “rare disorders” enabling them to be treated or even cured with greater precision and efficacy.
It is our understanding that the future of health as described in this vision will follow a more evolutionary path with some disruptive breakthroughs along the way. The current system will not be completely replaced, but transformed and enhanced. At DayOne we believe that the future of health can only evolve if advances in the field of new technologies go hand in hand with innovation at the level of a given ecosystem, creating the openness and the right environment for their implementation. This is where DayOne, as a dedicated healthcare innovation hub situated in midst of one of the world’s leading life sciences clusters can and will make a difference.