New digital health opportunities for personalized healthcare
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ore than 75 years ago, WHO defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” In these 75 years, almost all major aspects of human society have been transformed, but healthcare remains the same as it used to be before the above definition – healthcare remains disease-care. Healthcare approaches adopted in different countries are varied, but they all suffer from several fundamental debilitating problems. A major problem in many so-called developed countries is the legacy problem: entrenched socio-technical systems and business models on the parts of healthcare providers (e.g., hospitals and physicians), the health technology and services industry, and even public health agencies, all combine to maintain their complex, expensive, inequitable, inefficient, and often mediocre health, wellness, and healthcare status quo. The push to implement national electronic health record systems in many countries has brought some improvements in care quality and efficiency; however, they remain rooted in disease care and not in improving and perpetuating true health and wellness.
There is a great opportunity today in several countries like India where healthcare approaches do not have this deep-rooted legacy problem as described above. A great example was seen at the beginning of this century when countries without extensive telephone landline infrastructure were able to leapfrog the technology gap and empower the masses through mobile communication technology. Interestingly, later many of these countries also developed new perspectives on internet technology and accordingly were able to similarly transform several aspects of their societies. We believe that such an opportunity is right here and now in empowering health to even the poorest people living in the remotest parts of the world. This era is even more conducive for the leapfrogging empowerment of health, wellness, and healthcare, transforming the lives not only of individuals but potentially of entire societies.
Progress in biology, multimodal sensors, mobile devices, computing, intelligent / knowledge-driven systems and related technologies are rapidly enabling the realization of the definition of health as proposed by the WHO. The fact that chronic diseases are the major cause of death and cost in modern society justifies the emerging idea that health is a perpetual personal data system rather than the current population-based episodic probabilistic approach that believes in suppressing diseases rather than curing and even preventing them. Old as well as modern health systems all know that lifestyles that support health and wellness are quite often more important for improving and maintaining health than medical care, contributing over 80% to a person’s health state. In other words, maintaining good health and avoiding diseases is much more efficient – and satisfying – than trying to repair failing health after the damage has been done.
Visionary researchers like Dr Eric Topol are seeing a clear need for the creative destruction of traditional healthcare approaches and replacing them by developing what Prof. Bernd Blobel has described as a personalized, preventive, predictive and participative precision (P5) medicine approach for maximizing health and wellness. These approaches advance a data-driven digital health paradigm that considers each individual as a unique system. By building digital health models of a person, even a “digital twin”, it is possible to predict and use a personalized and precise approach to guide individuals away from a disease or to control it effectively. Technology now allows us to perpetually measure lifestyle and key biomarkers and analyze them to build personalized models and estimate health states. P5 approaches such as the Personicle are designed to support the optimization of health, living a healthier lifestyle (wellness) and better healthcare. Digital health apps and wearable sensors (also known as personal/consumer health devices) can enable personalized health navigation that is genuinely under the control of the individual and their caregivers (family, friends, community), and not solely the established healthcare system.
These emerging perspectives and technologies are proactive, rather than reactive; continuous rather than episodic, and use lifestyle and wellness rather than suppress diseases using chemicals that have unknown side effects. Social necessities and advances in technology have brought us to a tipping point:
Society is ready for a new perspective to bring the required transformation in health leading to better health for all individuals, and hence for global health.
