The future of healthcare is personal
In what’s been called the Fourth Industrial Revolution, massive advances in technology are changing healthcare systems at an unprecedented rate. This revolution is driven by the availability of new kinds of health data and the rapidly falling costs of storing and processing that data. Forecasts suggest that by 2025, the “global datasphere” will grow to 163 zettabytes (ZB) or 163 trillion gigabytes — 10 times the 16.1ZB of data generated in 2016. This staggering data collection is bringing unprecedented opportunity for better, cost-effective and more personalised healthcare.
Currently, wellness and healthcare are based on a “one size fits all” approach. We recommend similar nutrition and exercise approaches for most individuals. Most patients with high blood pressure receive similar medicines at similar doses, and the same is true for cancer and most other diseases.
But the data now available makes it possible to predict individual disease risk, responses to nutrition, exercise and medical treatments. We are fast approaching the era of personalised medicine and healthcare, in which our own data will determine our unique wellness, disease-prevention and treatment needs.
A vast amount of health and fitness data is produced by wearable devices such as the Apple Watch and smartphone apps which track exercise, movement and sleep. Soon these devices will measure numerous other important health parameters as well.
There is also dramatic progress in genetic sequencing, the process of mapping our genes for disease-risk prediction and treatment. Mapping the first human genome took 15 years, and cost as much as $1-billion (about R13.6-billion). Rapid advances in sequencing technology mean it is now possible to sequence an entire genome within a few hours, at a cost of well under $1 000. These costs will continue to drop, making it feasible to perform genetic sequencing to predict responses to exercise, diet and disease risk, and to tailor treatments.
How might all of this impact on our approach to wellness, prevention and treatment of disease? In terms of wellness, the science is still maturing, but it should not be too far in the future before it will be possible to do a low-cost gene test to assess what type of dietary recommendation, or fitness regimes, would benefit each of us most. At that point, we will truly be able to design highly personalised wellness recommendations for each individual.
Similarly, there are genetic test panels that can accurately predict the risks of certain diseases, allowing those at risk to undertake more active surveillance or even preventive surgery. Perhaps best known is the BRCA test, which identifies individuals at high risk of breast and other cancers. Soon, we will be able to identify the risks of a much wider range of diseases, allowing doctors to intervene earlier, often long before disease manifests.
Further, genetic tests can predict individual responses to particular medicines. A particular “pharmacogenetic profile” explains why some individuals respond more sensitively than the average person to specific medicines. This field of pharmacogenomics is developing rapidly.
Currently, most cancer patients are treated with a few standard approaches. However, the genetic profiles of patients are unique, and so are the genetic profiles of their tumours. And, to make matters more complex, oncologists now know that tumours’ genetic profiles may evolve over time, even during treatment. In future, genetic profiling of patients and their tumours will allow doctors to tailor an individual treatment approach for each patient, and to change treatment if necessary as the tumour’s genetic profile evolves.
Most of these advances are still in development and require rigorous testing before becoming widely available. Still, this trend towards more personalised treatment is undoubtedly under way. It will mean more effective wellness recommendations, more accurate risk prediction, and more effective treatment for patients, leading to better outcomes, fewer sideeffects and reduced waste, driving down costs and making quality healthcare sustainable over time.
In next week’s column, I will review the exciting potential of artificial intelligence, or AI, another area in which data and computing power are set to revolutionise health and wellness for the better.
Dr Broomberg is the CEO of Discovery Health