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Mainstreaming new technologies

  

Standing in the way of progress

History is littered with legends of scientific advances that took root at inexplicable speeds. For example, the importance of handwashing has been recognised as an important hygiene practice since the mid-1850s and yet, according to the World Health Organisation, up to 37% of people admitted in intensive care units become infected due to a lack of washing hands.

 

Compared with this simple practice, today’s technologies face even greater barriers to mass adoption. Notwithstanding the early state of readiness for some—such as gene therapies and immunotherapies—implementing today’s new technologies involve high costs, new and more robust training, and a reimagining of how medicine could be practiced.

 

“The challenges will be for doctors to catch up with the exponential growth in technology and information, for healthcare systems to evolve to benefit from this, and for healthcare reimbursement systems to be able to support cost-effective and sustainable implementation,” says Dr Seet.

 

Ethical questions around new technologies can also prove to be significant barriers, “One of the issues around doing precision medicine,” says Dr Fakhro, “is the ethical side. You have such a high burden of diseases. Should you focus on a few people who you could treat really well or spend that money to treat more people not quite as well.”

 

For example, in the past five years European regulators approved two gene therapies but only three patients have been commercially treated with them, in part because of extremely high costs. One treatment, Glybera, which is used for a rare blood disorder, costs about US$1m per patient and has been taken off the market due to a lack of demand.

 

Ethics also extend to data sharing and patient privacy. Questions around how much data and how widely it should be shared for the sake of patient health, and how to prevent abuse, are hotly debated across medical systems. One company, Nebula Genomics, is trying to creatively break down that barrier by allowing patients to monetise their data—something novel for an industry that still largely assumes that sharing personal data for the greater good should be incentive enough. The company also uses blockchain solutions to protect data, a viable model for future data ecosystems.

 

Finally, training and resourcing issues cannot be ignored. New technologies require healthcare practitioners to change and incorporate new tools into their daily habits. As seen in the case of handwashing, behaviour can often be the factor that is the last to change.

 

Combining the old and the new

New healthcare technologies circulate in tandem with other more traditional solutions and opinions about healthcare. When asked about their own mix of personal healthcare practices, the majority of survey respondents indicated they seek a range of therapies from both conventional and nonconventional sources.

In addition, notable variation exists across age groups, particularly with regard to the use of conventional medicine. Older people (41 years and above) tend to use conventional medicine more for treatment of chronic diseases, acute illnesses and surgery than younger people. Much of this can be attributable to differences in health challenges faced at different ages. However, it also suggests a high level of receptivity to conventional medicine in older HNWIs. This is a group that can also lead experimentation in new treatments.

 

Survey respondents also seek a mix of in-country and out-of-country specialists to care for their health; 28% either always travel or frequently travel outside their home country for medical care and about a third do so infrequently or plan to.

 

Those who travel the most are the most optimistic about connective technologies such as telemedicine. Of those who said they always travel outside their country, 51% expect telemedicine to be “very impactful” in terms of improving preventative healthcare’s personalisation and medical treatments, compared with only 25% for those who never travel out of their home base.

 

According to Josef Woodman, CEO of Patients Beyond Borders, this could be because those who do not travel may be limited by cultural or language barriers. “After all, it’s not convenient to travel for care. You must be able to understand what your doctor is saying to you or your companion.”

 

Seeing into the horizon

Given the challenges ahead, where does the future healthcare horizon lie? On a personal level, the survey respondents are quite confident about the future of their health, with a significant proportion expecting to live well past the average life expectancies in their respective regions.

Survey respondents also seem to expect that this good health will come from a variety of digital technologies—wearables, mobile apps, AI and big data and analytics—and new diagnostics and treatments—precision medicine, advanced screenings, gene therapies, immunotherapies, 3D printing and others.

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