Counting the cost of healthcare

Nuala Moran, News Editor

The Future Delivery of Medicine: technology is delivering huge potential to improve treatments, but we can we afford it?

We are already at the point where healthcare is not affordable in any developed economy. Now payers are facing a huge bolus of extra cost as, building on advances from a range of fields – biology, materials, microelectronics, microfluidics, imaging, nanotechnology and others – medical technology delivers putative new treatments and diagnostics.

The challenge for academe and for industry is not only to develop and commercialise these technologies, but also to demonstrate how, if correctly applied, they have the potential not only to improve treatment but also to reduce cost.

As ever, technology is running far ahead – both of the processes and budgets – of the medical organisations through which it is deployed, as was forcefully demonstrated at the University College London and Science|Business joint conference on how converging technologies will change healthcare, held in London, last week.

Many significant new technologies such as point-of-care diagnostics, low-cost genome sequencing and improved imaging techniques, are poised for action. But it makes no sense to apply such technologies on a case-by-case basis. There needs to be a strategic view of how they can all come together to change the current paradigm – of treating people once the pathology is well established – to prediction and prevention.

Currently, there is huge complexity in moving a patient through a healthcare system, from when she or he first reports to a general practitioner with chest pain, or a skin lesion say, to referral, scans or biopsies, performing an operation and completing follow-up.

What is required is a process of interdisciplinary innovation to promote the adoption of novel medical technology for early and non-invasive diagnoses, supported by e-health systems – electronic patient records, networks for secure transmission of diagnostic tests or centralised analysis of MRI scans or X-rays, and underpinned by end-to-end healthcare management systems.

In all of this there are huge implications for policy makers and healthcare administrators with their silo budgeting. Point-of-care diagnostics will increase the cost of primary care, but will lead to subsequent savings on hospital time performing biopsies or running centralised pathology labs, while reducing the economic burden of ill health.

Because of course, the true cost challenge to healthcare systems in developed economies comes from the increasing incidence of chronic disease that confronts ageing populations. The afflictions we need the means to deal with better are heart disease, diabetes, musculo-skeletal conditions, neurodegenerative disorders.

The convergence of new medical technologies holds the promise that a new paradigm of prediction and prevention can take hold. But first it is necessary to understand the individual potential of each technology, and for academics, industrialists, and clinicians to work with those involved in healthcare policy to apply them in an integrated way.