The start of a very exciting decade.

Digital health is on the rise, and oh boy it looks like the next few years will be interesting.

The convergence of technology and healthcare is looked upon with promising eyes. Digital transformation is progressively regarded to be the savior of many of our increasingly complex healthcare challenges. A growing ageing population, increased multimorbidity of chronic diseases, healthcare professionals’ shortages, soaring costs and squeezed budgets are all at the center of today’s conversation. Challenges that desperately require a holistic and integrated approach.

When talking about the most disruptive forces in the industry, artificial intelligence seems to be seizing most of the attention. From cancerous tumor screenings to patient scheduling and from hospital supply chain management to note-taking, AI will play a major role in the development of predictive algorithms to increase overall efficiency and assist in superior care delivery. By providing our healthcare IT infrastructure with artificial intelligence, we’re basically providing our care professionals — and patients — with augmented intelligence.

Besides AI, technological developments such as robotics, 5G, wearables, Internet of (Medical) Things, extended reality, chatbots and blockchain will all continue to push boundaries in the next few years. And at the same time, we’re on the cusp of a biotechnology revolution, in which the intersection between biology, computer science and engineering is creating an entirely new industry. One where we might even be able to program cells with whatever capabilities we’re looking for.

Let’s take a look at some of next decade’s healthcare trends.

Consumerism is creeping in

By spoiling us with persistent connectivity, hyperpersonalization and instant gratification, big tech companies have made it possible to consumerize — and democratize — almost anything. Now healthcare is clearly their next target. People will soon start to behave like typical consumers when it comes to their health and wellbeing, because they’ve become so used to this level of convenience that these expectations have started to flow towards the heatlhcare industry. We’ll see some of last years’ huge aquisitions — such as Google acquiring Fitbit — play a crucial role in fueling the consumerization process during this new decade.

Supported by the increasing uptake of wearable and hearable devices, the decreasing cost of sensors and the growing availability of open-source API’s, we’ll witness the amount of connected devices to keep expanding at an exceptional rate. At the same time, these technological advancements will be enhanced by deep-learning algorithms, allowing for ‘real-time’ to really become real-time. Adding to our current digital behavior, digital therapeutics — which are digital solutions to augment or replace current pharmacological and traditional treatments — are expected to become the norm rather than the exception. Advancements in voice technology will bring down barriers by allowing AI-powered voice recognition to replace our current interfaces for a broad range of services. And in the realm of hospital IT infrastructure, EMR’s (Electronic Medical Records) will continue to be a big driving force in the technological evolution of the industry, as it’s still difficult to grasp the magnitude of the impact an integrated form of this technology could have on the patient journey. The sheer size of the pile of data that will be collected through all of these connected devices increases the potential for interaction with the EMR’s beyond what we think is currently possible. Advanced algorithms will feast on complex and ever-growing sets of data, allowing for an interplay that transcends the interpretation of just medical and health-related data, all the way to socio-economical and population data.

The importance of Social Determinants of Health

A recent PwC Health Research Institute report brings attention to an escalating modern health crisis, even though we currently have the most advanced medical technologies the world has ever known. That’s because the social determinants of health are often-ignored social factors that have a massive impact on one’s health, such as employment, safe housing, access to clean water, access to food, education and transportation. In fact, 80% of one’s health is attributable to socioeconomic status, physical environment and health behaviors, whilst only 20% is attributable to one’s actual clinical care. So even the most advanced medical interventions are rendered ineffective when people struggle with social isolation, income inequality, poor nutrition and pollution. In the next decade, more and more innovators and regulators will realize the impact social factors have in counteracting medical best practices. At least if they remain focused on creating solutions at the wrong interaction point: when people are already sick.

That’s why we’ll see a massive shift towards preventative efforts in the next decade. Policy makers have so far been able to get away with tackling problems on a short-term string, but they’ve come to realize that it’s no longer viable to ignore prevention. We’ll start to hear a lot more about the concept of population health, which is defined as “the health outcomes of a group of individuals, including the distributions of such outcomes within the group.” Population health data will be an extremely valuable asset to streamline efforts in the pursuit of one’s health and wellbeing. A recent example shows that sleep and heart rate data from a large group of wearable device users can be used to identify a possible influenza outbreak, both on a population level as well as on an individual level.

The race between regulators and innovators

It’s critical — and evident — for healthcare technology to be safe and clinically effective. And rightfully so, as the potential impact of wrong and inaccurate healthcare interventions could simply be fatal. That’s exactly the rationale behind the new European Medical Device Regulation, which will be mandatory for every EU-member from May 26, 2020 onwards. As more and more software becomes a medical device, there’s additional complexity in categorizing and specifying these new technologies. Even more so when these technologies are enriched with self-learning algorithms, as these devices trigger new ethical discussions in which to consider the use of sensitive and — more importantly — evolving data sets. Privacy, confidentiality and cybersecurity will have never been more important.

There’s two sides of the regulation coin. On the one hand, it has the ability to build public trust into new use cases of data. According to Eleonora Harwich, 2020 will be the year where we’ll be defining what a fair partnership looks like between patients and the healthcare stakeholders around them, especially when it comes to their data. Patients are increasingly capable of understanding how their data is being used — and unfortunately also misused — which has allowed them to be the driving voice at the center of some of the data privacy discussions we’ve had recently. But on the other hand, regulation can also stiffen innovation. And even though these are incredibly difficult discussions, time is very much of the essence for start-ups and innovators.

We’ve started to see the economic impulse to be greater than the political impulse, as private companies won’t wait until policy makers have fought it out. In Belgium, we’ve seen examples such as Partena Insurance Fund to (partly) reimburse health apps such as MoveUp, Fibricheck, Skinvision and emma.health, as well as AXA Belgium to be the first to launch teleconsulation services, allowing patients to schedule an online consulation from the comfort of their own living room, at a time that’s convenient for them.

And if we take a look at our neighbours, it’s Germany that has sent a powerful signal towards the rest of Europe — and the world — by introducing their new Digital Supply Legislation. A legislation that allows doctors to prescribe digital health apps to patients that are then reimbursed by the country’s statutory health insurance. We can expect other countries to follow Germany’s footsteps in 2020, as this will likely cause similar considerations to pick up speed around Europe. And since Berlin will take over the rotating presidency of the Council of the European Union in July 2020, who knows whether they’ll be able to further facilitate the dialogue around this topic.

Luckily, more and more interesting initiatives are springing to life. The creation of the European Health Data Space might be instrumental to channeling vast flows of data into the discovery and delivery of care on a massive scale. And together with this movement, we’ll likely see more cross-border initiatives, of which Finland serves as a first bold example when it became the first country worldwide to exchange e-prescriptions together with Estonia.

Standardization and benchmarking will be a huge industry focus throughout the next decade, and we’ll probably see these ethical considerations being fed by the first concrete use-cases that will force policy makers to establish the right regulatory framework, global healthcare AI benchmarks and interoperability standards. It’ll be very interesting to witness how the relationship between regulators and innovators will evolve over the next few years.

Higher accountability to give rise to new reimbursement models

As health consumerism will enter into a new phase, we’ll start to experience the evolution of the healthcare interface. And as a byproduct of this evolution, we’ll witness the growing accountability of the patients — and health consumers — themselves. New ways of monitoring adherence, whether it’s for medication or rehab exercises, will allow quantification of treatments and follow-up interventions, giving rise to new reimbursement models of which 2020 will likely be an important piloting year. A shift from one-off consultations towards a system built for frequent follow-up and continuous monitoring, which will enable better quality relationships and shared responsibility, ultimately leading to better participation and better outcomes.

2020 will mark the year where the importance of zero-party data for insurance companies and other healthcare stakeholders becomes clear. Zero-party data is the information a consumer shares directly and intentionally with a specific organisation. Instead of first-party and third-party data, zero-party data offers companies and brands the ability to communicate their commitment to transparency, turning their customers into loyal ambassadors. Consumers won’t just freely share all of their data with healthcare organisations, but when given the right incentives, a new type of relationship will exist that is above all mutually beneficial. These organisations will have to ask themselves the question on how to become their customer’s life partner by helping them to achieve superior health. It’s those new ways of monitoring health and wellbeing — through the use of apps, trackers, wearables and platforms — , combined with an evolving business model in both the healthcare and the insurance industry, that will lead to new incentives so that people are actually held accountable for their behavior.

Exciting things to look forward to

Next year will mark the beginning of a decade filled with data-driven, digital and personalized healthcare, diagnostics and treatment, which will go hand in hand with big investments in prevention, huge collaborations between the private — both corporates and start-ups — and the public sector, as well as the rise of a digital health ecosystem platform that will form the basis of value creation and shared responsibility within the industry.

This new decade will be about removing barriers. The barriers between our current world and a virtual one and the barriers that are responsible for our current siload hospital IT infrastructure and interoperability issues. But maybe most of all, the barriers between biology, computation and engineering, together with a magnitude of ethical discussions these new technologies bring with them.

And just like Julie Yoo describes: the first generation of healthtech start-ups started selling into the system, but quickly — and painfully — found out that the system was nowhere near ready for adoption. The second generation of healthtech start-ups bypassed the system and started building around it by going direct-to-consumer and launching full-stack companies for people that agreed to pay more for higher convenience. Whereas now, in the third generation of healthtech start-ups, we’ll see both playing out at the same time, as healthcare systems start to disrupt themselves and realize that things should urgently be done differently.

But most importantly, the next decade is going to be the decade where digital health simply becomes health. The hype is over, it’s time for the first level of maturity. One that is fueled with the first successful real-world use cases.

Let’s get excited!

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As a disclaimer, the views or opinions expressed in my blog articles are personal and do not reflect upon those of the people or organisations I’m associated with.