In this Tech Flix film David Savage, Nash Squared's Group Technology Evangelist, explores how technology can help work with the medical community to improve patient outcomes and foster innovative ideas.Watch The Future of Healthcare Film here
David Savage: Collaboration is key across the technology sector, helping to break through bias and foster innovation. One area where we can see this inaction is MedTech. Health is a sector technology can transform, yet despite investment in technology, health services are struggling to meet the needs of patients. Obesity, heart disease, chronic pain are all rare conditions that remain a huge drain on time and resources. So how can technology help to provide better patient outcomes?
Take liver disease as one case study. It's a global top 10 killer with one estimate by the National Library of Medicine placing the hospitalization cost estimate at a staggering $81 billion in the US in 2020.Finding new treatments for these largely preventable diseases could have huge benefits for the provision of healthcare, as well as the wider economy.
However, bringing about real change is going to be based on two things, understanding the challenges of those striving to find a solution, as well as the concerns of some of those affected by these conditions. In 2020, I received a diagnosis for a chronic disease very few people have heard of primary sclerosing cholangitis. When a condition is rare, most doctors struggle to answer the barrage of questions that you have, and frankly, it's scary.
Paula Hanford: PSC is a immune-mediated liver disease. It affects the liver and the bile ducts. It's not a heterogeneous disease, it doesn't affect everybody in the same way. It's very diverse, but it can be very debilitating. For some people the symptoms are not there, they don't have many symptoms and they can go throughout their life with that. But for others, they might need a liver transplant. They might get a really serious cancer. One of the problems with the disease is the emotional impact. People don't know what the future looks like for them.
David Savage: What do you think the barriers are to finding treatments, beyond it being rare?
Paula Hanford: I mean, being rare is a really important point to a barrier though, because what you have is a really small patient pool. So when you have clinical trials, you have a very small pool of people in order to goon these clinical trials. And if you are available for the trials, because you might not be, because they are quite taxing some of these trials. Infusions every six weeks, being in a hospital for six hours at a time. These are the things that some of the clinical trials are asking patients to do. Now that's difficult, isn't it, if you've trying to hold on a job, you maybe you've got a family, you're feeling very fatigued. You might think, "Do you know what, that's just one step too far for me."
David Savage: Paula stressed the difficulty in progressing treatments, but technology can offer new solutions. Robotics and bleeding edge tech can revolutionize previously invasive procedures, and data can promise the ability to harness new treatments. The annual technology festival, Web Summit, dedicated an entire track to health tech and that emphasized the evolving relationship between health and technology.
Dr. Atul Gupta, Chief Medical Officer for Image-Guided Therapy at Philips and a practicing physician in the USA, was one of the keynote speakers. You might be in a image-guided therapy suite as opposed to a traditional operating theater. Can we dive into that in a bit more detail and talk about some of those innovations and what else patients might be begin to see.
Atul Gupta: To understand what innovations are going to have the biggest impact on your care and on my care in the next decade, let's first take a step back and figure out what are we trying to fix. What are the challenges that hospitals, caregivers, even governments across the world are facing? There's no question that hospital systems around the world are under increasing pressure.
Patients are getting older, they're getting sicker. And so what that means is the workloads are intensifying for physicians and also for the staff. I don't need to tell you, healthcare funds are shrinking, no matter where you are in the world. So we have more patients, sicker patients, staff shortages, less money, and we desperately need to use technology to increase efficiency.
One in 10 patients in England, for instance, are now on a waiting list for non-emergency treatment, like for instance a hip transplant. So that is the problem that we're trying to solve for. And I think innovations like telehealth, augmented reality, artificial intelligence, robotics, automation, these are the types of things that are going to revolutionize care. Why? Because they're going to help seasoned physicians do even more, take care of more patients more efficiently, more easily, maybe even remotely.
David Savage: What to you is the most telling thing when it comes to the patient's experience of care? Because I get the feeling that everything we've covered so far, you're looking at it very much through the lens of the physician, the hospital, looking at how we can provide better care. But I suppose the impact on the patient as well is part of that, that's increasingly important to manage.
Atul Gupta: Lung cancer kills one and a half to two million people every year. That's more than breast cancer, colon cancer and prostate cancer combined.
In the UK alone, 36,000 patients every year die from lung cancer. And so early diagnosis is critical for survival, just like with most cancers, because if you can diagnose these cancers at the earliest stage, when they're just a couple of millimeters in size before they spread, that's when you have the best chance for cure. And so we have technology that's in the works, it's a new lung cancer solution. It's a revolutionary 3D imaging and a navigation platform that supports high-precision diagnosis at the earliest stage, but also the minimally invasive treatment. And it all takes place in one room.
So now as a patient, that holds the promise for one-stop shop. Diagnosing and treating that tiny little cancer, destroying it all at the same time, all in one room, all without surgery.
David Savage: I mean, what could be preventing progress? Because let's be honest, what you're talking about sounds on the fantastical side I'd imagine to most people's experience at the moment.
Atul Gupta: Yeah, but it's coming, and it's going to come in the next decade. And so what's preventing progress?
Well, quite frankly, I think healthcare, it's a team sport. It is way too big, is way too important for anyone stakeholder, any one company, to go at it alone. I think we need collaboration. And that means collaboration between physicians, between hospitals, between governments, between the consumer technology companies, and then also with the leading health technology companies, like Philips for instance.
I think it's that collaboration that's going to lead to the best innovation.
David Savage: The advancements Atul describes are exciting, but the world of technology innovation provides little comfort when you find yourself sat in the transplant wing of a hospital.
I wanted to find examples of companies pushing the boundaries of medical science right now, something that suggests new patient outcomes are possible. And to do that, I return to liver disease.
Due to modern lifestyles and diet, a huge number of potential livers are simply not suitable for organ donation. Now whilst heart disease and cancer mortality rates have leveled off in the last few decades, liver-related deaths have increased by almost 400% since the 1970s.
But can away be found to make unsuitable donor organs viable again? I took a trip to Oxford Science Park to meet an ambitious health tech business working on that very question.
Jack O'Meara: We used AI and digital technologies throughout the discovery process. Before we actually test anything in here, we did a lot of work to amass a lot of genomic data and histology data, and tried to mine that in combination with clinical variables on the patients who we sourced that data from, to come up with new hypotheses around the genes that were driving the disease.
Everything we're doing in here is basically screening or testing out, if we knock down this gene, does it reverse or improve the disease?
David Savage: I wanted to understand what might prevent Jack's business and others in the space from developing treatments.
Jack O'Meara: Ochre Bio are an RNA medicines company with a focus on chronic liver diseases.
The biology of liver disease is still pretty poorly understood, which is why we use a lot of new technologies, sequencing, imaging, AI, tools to really try and understand what's going wrong and find better ways to treat the disease. A way to analogize it is really this, it makes us smarter, faster, and ultimately cheaper, which is of big importance.
David Savage: No, look, I was about to say, because smarter and faster, but cheaper?
Jack O'Meara: But cheaper too.
David Savage: Significantly cheaper?
Jack O'Meara: Significantly cheaper. If you think you know what the gene is that's driving the disease, you can very, very rapidly design an RNA and then test it out and see if your hypothesis was right. That ability to move really quickly kind of is a bit like how the tech world works in that you iterate.
You can iterate and fail fast, fail fast. "That gene might be driving it. Let's try it, let's try it. Oh, it didn't work. Back to the drawing board. Let's try another product. Didn't work." And we think that's going to really dramatically improve the probability success when we go into human testing, because we won't have spent three years working on a gene that we don't really know is going to work or not. We actually can iterate through different hypotheses very quickly.
We know that if you are of a certain BMI you are dramatically at a higher risk of having a heart attack. It literally will reduce your life expectancy quite significantly. And yet we're still stigmatizing medical innovation that helps to prevent the development of obesity, even though it will ultimately save a lot of people's lives. And as a society, we view it in a negative way, but I think that needs to change.
David Savage: Is that societal stigma a tangible challenge for your business?
Jack O'Meara: I would say yeah. And it plays backwards. So if you think about our business, what do we need to succeed?
We obviously need great innovation, great science.
We also need great funding, because it's an expensive game to be in. And if you're putting yourself in the shoes of an investor, an investor evaluates a whole host of different industries, from tech to real estate to biotech. And if they're looking at biotech, they're looking at different disease areas where they think there'll be people who will ultimately pay for the products that companies like us hope to develop. And if you're working in a space that's stigmatized more generally, there's a concern that governments and payers and insurance companies won't reimburse treatments for disease, like obesity, which has radically shifted over the last three to five years.
But obesity was always seen as a lifestyle disease.
So investors assumed, even if you had a treatment, payers wouldn't reimburse it because they would assume doctors would say,"Just move. You don't need a drug, you need to move more and eat less. "And that's changed quite substantially.
Now we're seeing actual medical treatments for obesity getting approved. And they're having this huge interest from the wider public because it's not only making us all look better, which we all like to do, but also improves healthcare outcomes more generally and reduces a whole lot of other side effects that come with obesity.
David Savage: Liver disease is not the only illness to suffer from negative perceptions of the disease.
Obesity has seen hundreds of policies fail due to the belief that diet and exercise can solve the problem. Unless we think differently about the challenges that we face, we aren't going to find effective solutions. The potential for benefits that can ease pressure on the whole health system is huge.
What could that future look like?
Atul Gupta: David, if I have to predict the future of healthcare, I am confident technology's going to make it faster. It's going to be more precise.It's going to be more personalized. It's going to be one-and-done, first time right. And care is going to be more accessible.
It's going to take place closer to you, not just in the hospital.So the future of healthcare, it's extraordinarily exciting. These emergent technologies, things like image-guided therapy, AI, AR, robotics automation, telehealth, they are just now starting to mature. And so we're going to see them unleashed over the next decade. I would say hang onto your seat, David, the next decade in healthcare, it is going to be a fantastic ride.
David Savage: Technology can reduce barriers, it can bring costs down, bring people together, and work through prejudice.
Collaboration is key to finding new treatments and an improved patient experience. However, as with technology in any sector, courageous leadership is key to bringing about change.
We have to build and maintain our relationships with both our partners and our community. And as a member of that community, I really hope that the potential for change can be realized.