Is it too big a challenge?
We are experiencing a transition from our health model. The system as it was designed in the 1950s no longer works. But there are ways to break the deadlock.
We are facing great changes. The first concerns what we could call the enlightened patient or augmented patient, the second focuses on new health technologies, connected health or e-health, and the third on epigenetics, the science that demonstrates how human behavior affects gene expression. These three elements create a new possibility of measurable prevention and making people responsible for their health, which the pharmaceutical industry is beginning to understand.
Enlightened patients are people who are increasingly connected to social networks and who can find information about their health on search engines. They discuss together, exchange and are more and more informed and concerned. Many doctors today assure that they appreciate dealing with patients who ask them the right questions, even if they can go as far as contradicting their prescriptions.
Digital plays a decisive role in the evolution of health models. The health applications available on smartphones are increasing exponentially today. The tools are not only portable, but also wearable. Like watches, for example, which measure a certain number of parameters on the skin, making it possible to visualize the results or the alerts on a personalized health dashboard, the screen of your smartphone for example, results that you can download elsewhere or send to your doctor.
Towards new models of health through subscriptions
Our behaviors will change and especially the relationship with our doctor. The latter will increasingly become a life counselor and not just a prescriber of prescription drugs.
To maintain good health, five behaviors must be respected: exercise, nutrition, stress management, pleasure, social and professional harmony. These five behaviors influence the expression of our genes and cause some to slow down, inhibit, or express themselves even more. We can somehow become the conductors of our own body, keep it in good health and slow down aging.
Prevention is not deprivation, it is a pleasure to do good!
The pharmaceutical industry has already become aware of this development. Some Big Pharma companies are already moving towards health maintenance programs. Even today, these companies live on the margins made by pharmacy sales of drugs prescribed by doctors and reimbursed by health insurance. However, we are starting to see that pharmaceutical groups associate with insurance companies and offer pharma-insurances: that is to say subscriptions to programs that ensure good health. This is what I call the health maintenance program or abbreviated PMS.
In this way some believe that the pharmaceutical industry will make more profits by subscriptions than by margins made on drugs sold in pharmacies. Besides, we can check on the Internet that the most successful companies are those that have many customers subscribed to their service and their products. Whether it’s music, subscriptions to renewable energy production systems, transportation, or housing.
It is in these new health models, possibly by subscription, that what is called 4P medicine comes into play, which means: Personalized, Predictive, Preventive, and Participative medicine. It is not only a question of curing when one is sick, but above all of not getting sick.
But these new practices risk creating a form of uberization of health. Companies have created the disintermediation of traditional structures by offering more personalized services and products, more quickly, in the face of systems that are too heavy, too expensive, too complex. Thanks to digital, we can reconcile supply and demand. These disintermediation companies, like GAFA, are disruptors who reverse the classic and traditional model that we know. In health too. This risk exists.
The doctor of tomorrow can be assisted by digital or AI tools.
Predictive medicine thanks to AI
With artificial intelligence (AI), which some now prefer to call auxiliary intelligence, we can increase human intelligence. No doctor can read and assimilate all the scientific reviews, all the studies, suitable for treating a pathology. On the other hand, who can correlate all the information already published to make predictions or improve diagnoses? Watson, IBM’s artificial intelligence program, does it in minutes.
Google is developing an AI usage support program, Kubeflow. The doctor of tomorrow can be assisted by digital or AI tools, to devote more time to his patients. Many are already experimenting with it, since you can download Watson on your smartphone.
The most important question for the future is the role that individuals will play in the prevention of their health, thanks to an improved knowledge of the fundamental principles of nutrition, of the fight against pollutants that we inflict on ourselves like cigarettes, or which are present in the environment due to a lack of efficient waste management systems.
The ministries of health of many countries realize today that the biggest savings on the health insurance system will be made thanks to the participation of people in improving their health capital and the permanent investment in this capital thanks to the basic rules of good living that are nutrition, exercise, or stress management. Hence the importance of education and especially of co-education in families and schools to make young people understand the fundamental bases of balanced nutrition and permanent reinvestment in their health capital.
We can already see that the major magazines, in addition to specialized magazines, and even the daily newspapers devote more and more important spaces to the explanation of these fundamental principles of balanced nutrition and moderate exercise. These trends will only get stronger in the future, given the economic challenges represented by healthcare systems around the world and the transition to more economic and more democratic models.