Disruptive Forces Of The Healthcare Industry - 2016 And Beyond

Industry : Healthcare    

There are three major disruptive forces that will shape the healthcare industry in 2016 and beyond.

Disruptive Force #1: The Shift to Value-Based Care

The Affordable Care Act of 2010 is ushering fundamental shift in healthcare delivery. This represents a seismic shift from the traditional volume based reimbursement model to a value-based system, where payments are based on the value of care provided.  From a provider perspective, physicians are incentivized to manage patients to the best possible health outcome at the lowest cost. From patient’s perspective, consumers are being empowered to take a more active role in their own health leading to increased consumerism in the healthcare space.

This shift to value-based care is giving rise to new service delivery options for consumers, increased information sharing among physicians and patients, more importance to health and wellness, and a rising focus on efficiency and cost. As a result, new business models are emerging to address these changes. For instance, telehealth is evolving toward a broader means of delivering health care services in an on-demand, consumer centric manner.

Disruptive Force #2: The Digitization of Health Data

The digitization of health data is fast exploding with a range of sources that can offer insights into clinical data and drug studies. Digitization has a direct impact on how patient care is administered and how drugs are clinically tested. 

There are several key drivers of digitization and they include (1) wearable devices, (2) electronic health records (EHR), (3) social media, and (4) genetic data.

(1) Wearable Devices: While still in early stages, wearable devices focused on health and wellness could provide a continuous stream of data on vital health parameters that can be used in both clinical studies of drugs and in overall spectrum of patient care. These data were only previously available when measured in a clinical setting, but continuous stream of data could provide valuable insights into the environmental contributors to disease. Eventually, the hope is that these data could be used to predict and flag potential health issues and contribute in the realm of preventive medicine.

(2) Electronic Health Records (EHR): EHR continues to see rising adoption. With EHR, health information can be aggregated across providers and over time offer a more holistic view of a patient’s clinical profile. However, privacy remains a key hurdle as analog data becomes digitized, accessed and finally shared but the potential benefits are very promising.

(3) Social Media: Social media is increasingly being viewed by healthcare stakeholders as a way of assessing customer opinion and feedback. In evaluating the effectiveness of a drug, for example, social media could be explored for patient views and complaints thereby resulting in effective therapy management and side effect profile of drugs.

(4)  Genetic data: The rise of precision medicine and sequencing of human genome are revolutionary forces driving the health care industry. In the past, much of these data were housed in standalonecomputers, making them difficult and time consuming to analyze and share. Now, with the power of cloud computing, researchers are able to tap these and other sources of genetic data to gain insights that would have otherwise been not possible.

Disruptive Force #3: Rise of Precision Medicine

In recent years, rapid progress has been made in the areas of screening, diagnostic testing and precision medicine. Precision medicine is a ground-breaking therapeutic approach that takes in to account disease prevention and treatment based on individual differences in genes, environments and lifestyles.

President Obama announced in his State of the Union Address in January 2015 to allocate $215 million in 2016 to accelerate biomedical discoveries in curing diseases like cancer and diabetes. The major components of this initiative include: (1) using cancer as a model for precision medicine, with acceleration in the design and testing of tailored treatments and (2) creating a national research cohort of more than one million volunteers to generate a knowledge base for precision medicine.

The FDA advances Presidents Obama’s Precision Medicine Initiative (PMI) by issuing updated draft guidance on NGS (Next Generation Sequencing) based tests in early July this year. The FDA’s NGS draft guidance documents aim to provide an adaptive and streamlined approach of the regulatory oversight of NGS tests looking at the rapidly evolving genomic testing market. This, combined with research that has been conducted since the HGP (The Human Genome Project) should continue to accelerate discoveries in genomic research and precision medicine.

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