The Need for Revolution
Over the last two decades, the digital revolution has profoundly reshaped the world. Very little has been immune to its impact: its scope is far beyond what was experienced during the Industrial Revolution, which dramatically altered life across the world. And the scale of it has been laid bare by the current crisis.
With nearly 2 billion under lockdown at one point, the vestiges of life that were still functioning were those that were online.
As a result, many businesses and operations which were not fully digital immersed, abruptly pivoted, trying to keep themselves afloat as the economy was put on life support.
Parts of the state and service delivery, which has always been historically slow to make such manoeuvres also had to recast itself. A meme circulated, asking what drove your digital transformation: your Chief Technology Officer or Covid?
In the UK, this pushed forward the technological progression of the health service in ways that may have taken years, if not decades. GPs shifted to telemedicine, data platforms at the centre of the NHS have been developed, while remote monitoring has been rolled out via Facebook Portals. Open source and open data have also accelerated innovation and research across a number of areas, including the rush to understand Covid-19.
As societal and health paradigms have shifted in this pandemic, however, it has raised questions about the limitations of our model of health delivery, which should be far more advanced than it is.
The predominant barriers to reform have been institutional and political, and this period should give great pause to why, we as a public, tolerate or even play our part in holding back advances that will improve our health?
In many ways our country has now been in stasis for too long, and our inability to deal with crisis effectively is a wider sign of stagnation. Even before the current crisis we should not have accepted our lot: more than 15 million people today have a long-term health condition, while nearly a quarter of deaths each year are avoidable.
Revolutionising health should therefore be at the heart of revival; a collective grand challenge that we should all pursue. Because the reality is, breakthroughs in our understanding of the bigness of biomedicine have put us at an inflection point.
Trends in Innovation
Since the Human Genome was sequenced in 2001, our understanding of biology and the human body has advanced dramatically. In genomics and the other omics, such as epigenomics, we now have the potential to understand biology on systems level, as well as the determinants that both nature and nurture have on disease onset and progression.
The gene-editing toolbox is greatly expanding, opening up further avenues to both cure and diagnose disease, while developments in wearables and in robotics raise the possibility of greater individual autonomy over one’s health.
Artificial Intelligence is also helping us to make sense of this data, leading to ground-breaking discoveries such as Halicin, a molecule which can be an effective antibiotic. Algorithms have out-performed radiologists in identifying cancerous tumours, while exceptional work between Moorfields and Google Health/DeepMind has been able to analyse eye conditions and how they might deteriorate.
It can be an essential component of how we transform the practice of medicine as well as biomedical science itself, giving health professionals more options and more time with patients, improving the depth and quality of our care.
Together, these technologies form the locus for a radical overhaul of our current health system and improve the health for millions of people around the world.
Our collective endeavour should be on accelerating innovation, but also its application. Research needs to be translated into real-world use, with stronger partnerships developed between universities, research institutions, medical practitioners and investors.
New Principles
A new coalition should be aiming to build a new set of principles around medicine, so that it is predictive, providing early warnings about the onset of infection, as well as the risk of disease onset.
From this, preventive action can be taken, whether through therapeutics and treatment, or through lifestyle changes.
It should be personalised, so that treatment is based on individual profiles, rather than on population-based assessments.
Lastly, it should be participatory. One of the lessons of the current crisis has been a need to take on greater responsibility as an individual, particularly when the limitations of the state has been so starkly revealed.
Part of this will be through wearables and Digital IDs, which can provide individuals with the ability to monitor their own physical parameters as well as control their records. For example, those suffering from type-1 diabetes can continuously monitor their blood glucose levels via wearables and automate insulin delivery to always keep this in a target range.
Under such principles, patients have far greater harmony with healthcare providers. They know what problems they might be at risk of, are provided with steps to take to prevent it, but if they do get ill, treatment is far better targeted and far more attentive to personal needs.
Healthcare should not be a transaction, whereby doctors, who are facing ever increasing strains, have little time and potentially low levels of information about a patient.
Shift from Healthcare to Health
But ultimately this is about shifting the focus from healthcare to health. Illness of any kind is such a degrading experience, not only felt by the individual, but by the web of pain and difficulty it can create.
This crisis has revealed that in the strongest possible terms. It has showed us that, above all else, our primary aim as a society should always be to maintain a positive state of being for as many of us as possible. Treatment should be a last resort.
To revolutionise medicine in such a way, with technology and human care working in tandem at the heart of the model, will require deep changes to be made.
Over the coming months we will be exploring these in more depth, but change will only come through common collective will. There has been an abundance of this in recent times, but it needs to be channelled into effective action.
We therefore welcome ideas, points of debate as well as potential partners to help us in this human grand challenge.