The Future Delivery of Medicine: how and where should industry invest?

This is the second of three reports from The Future Delivery of Medicine, a conference held at University College London on 5 and 6 November 5. The first report can be found here, and the third report will be published next week.

Converging technologies are changing the face of healthcare. What is the role of industry in driving this change, how and where should it invest, and how can the public and private sectors work together?

“Today we can’t work alone,” said Leonard Fass, Director of Academic Relations, GE Healthcare. “The first rule is to be outward looking in making relationships with academe, but also other types of companies,” Fass told delegates at the second session of the conference on The Future Delivery of Medicine: Industry and Investment, held at University College London, last week.

The glue that will integrate and hold a broad array of converging technologies together in an operational sense is information technology. As Mark Treleaven, Strategic Business Manager of Microsoft’s UK National Health Service (NHS) Resource Centre, put it, “The role of technology is to support consumers in managing their own healthcare.”

He told delegates Microsoft has set up a specialist division with a brief to change the way healthcare is delivered. One of its products is HealthVault, which aims to allow people to monitor and manage their own health, including connecting up monitoring devices, feeding in data to a personal computer and deciding with whom to share the data. Through a relationship with the US National Heart Association people can take their own blood pressure and then get advice if there is a problem.

“This is going down extremely well,” said Treleaven. The system has been in operation in the US for over a year, and on the basis of experience there, it is planned to launch HealthVault in other countries.

This example highlights some of the huge opportunity, and also the disruptive change, that can be expected. As one example, Fass said, “Hospitals won’t exist as they do now.” Paper will disappear and all data will be communicated over wireless networks. Embedded RFID sensors will be used to control and manage expensive medical equipment, which will be moved to the patient, rather than vice versa.

The role of hospitals will change and they will become centres for major trauma, with most healthcare delivered at home or in the community.

But can how products like HealthVault, and a myriad of others, be integrated into the healthcare environment in Europe in a productive and effective manner? As Treleaven said, “Microsoft entered healthcare with a very different product. We have created a platform – not a healthcare application.”

The Internet and wireless broadband communications will have a huge impact and a huge role to play, believes Gerhard Engel, Senior Director of R&D at Accelrys Ltd, a specialist in business intelligence software. “New technology trends are shaping healthcare,” he said. Web 2.0 applications that are being deployed offer the potential to link people together in a new fashion, and they are easier to develop.

Increasing computer power and better algorithms are making it possible to simulate more and more processes. Monitoring devices can be linked to the Web for people to check their own health status.

The increasing prevalence and sensitivity of diagnostics will lead to “a more preventative that curative approach,” said Alain Parthoens, Founder and Partner, Vesalius Biocapital Partners and President of the Belgian Venture Capital and Private Equity Association.

The precision and specificity of molecular diagnostics is paving the way to the development of theranostics, or combined diagnostics and treatments. “I don’t believe blockbuster [drugs] will be here forever. In future you will have to prove efficacy. A specific disease profile [as uncovered by the diagnostic] will lead to a specific solution,” said Parthoens.

All of which raises the question of who pays for what. “Will the hospital pay you to wear a monitor that keeps you out of hospital?” asked Fass. And who pays to transmit data, or for the decision support systems?

While there is huge opportunity in the “tsunami of knowledge” the problem is in squaring the circle between opportunity and cost, believes Ed Byrne, Vice Provost, (Health) at UCL. “Currently, only half of serious illness can be treated and we have an ageing population. The current 10 – 12 per cent of GDP that the UK spends on health is just about manageable” said Byrne. “But how will all the new technology be paid for?”

For Bryne the answer is to develop a culture of open innovation, linking all partners. “To solve the vast problems, the boundaries have to disappear between universities and universities, and between universities and companies, and we have to out our common shoulder to the wheel.”

This rallying call drew comments from delegates and panellists who highlighted the significant challenges for the private sector of working in an academic environment and trying to impose business disciplines.

A particular problem is handling intellectual property. While it was agreed that there needs to be some mechanism for rewarding universities for the outputs of speculative research, Fass noted, “Universities are getting more and more interested in [intellectual property].” As a result it can take years of negotiation when setting up collaborations.

Engel agreed, saying there is often a lack of awareness of the pressures business faces. “It takes a long time to go from a new algorithm to a commercial product.”