Visit a large hospital in the Western world, and the first thing you have to do is battle to find a parking space. Then, when you’ve nabbed a spot, you’ll probably walk past smokers – patients, healthcare staff and visitors alike, popping outside to get a nicotine hit. And once you get inside, the first thing you might see, dotted through the lobby, are fast food outlets and shops selling high-sugar snacks and soda.
It’s a common scenario – and it’s one that illustrates the unsustainability of our current approach to healthcare.
The issue isn’t that our hospital car parks aren’t big enough. It’s more that the Western approach to healthcare is based on thinking about “health” and “illness” as two separate concepts. Hospitals aren’t usually places of remaining well. They’re hubs where sick people go to be treated.
Prevention, rather than cure
This focus on illness makes the job of healthcare providers to cure, rather than to prevent illness. Indeed, in parts of the world where healthcare is run by private business, doctors may even be rewarded for carrying out more treatments. Or in other words, we have unwittingly created a system which relies on people getting sick – but that doesn’t have the capacity to treat growing numbers of elderly and ill people.
Because as Western populations live longer – and more treatments for more things become available – this focus on cure, rather than prevention, isn’t sustainable. Growing numbers of people getting older and sicker means hospitals just don’t have the capacity – and changes have got to be made.
There are already signs that the focus is shifting towards a preventative approach in some areas. In a report to US Congress last year, The Medicare Payment Advisory Commission (MPAC) urged a shift towards value-based care. This would see providers rewarded not for the number of treatments they carry out, but on the overall impact they have.
Value-based care is about efficiency at all levels – from making sure heart attack victims get angioplasties quickly, through to creating healthcare systems that probably reduce the numbers of people having heart attacks in the first place.
It means that hospitals and healthcare providers shouldn’t think in blinkered terms about delivering treatments (and therefore ignore the ironies of sharing their building with fast food outlets). Instead, value-based care steers healthcare providers towards more holistic approaches that seek to reduce chronic illness.
Value-based care – and the efficiencies it introduces – is being embraced by institutions as well as insurers. The US-based Cleveland Clinic is an $8bn operation that treats more than seven million people a year, in hospitals and family health centres in the USA, Canada and Abu Dhabi. It’s due to open a hospital in the UK this year.
Placing data at the centre of care
Its move to value-based care, under former CEO Dr Toby Cosgrove, saw widespread changes to its approach. In an interview in 2019, Dr Cosgrove said the Cleveland Clinic realigned everything towards “health” rather than “cure”. This included visible measures such as banning smoking and processed foods from all its campuses. And at a deeper, organisational level, it meant incorporating data into strategy, planning, policy and care provision.
Dr Cosgrove said this “paradigm shift” also meant making full use of data, and thinking as a team, rather than in individual, siloed specialisms.
He said: “Medicine isn’t traditionally driven by data – but it’s an opportunity… We can store a huge amount of data in the cloud and analyse it with AI and machine learning. This will bring us realisations about people that we had no idea about… predictions about where people’s health is going to go and how you can prevent problems. As we analyse this data, we’re coming to all kinds of realisations we didn’t know… it’s going to improve our efficiency and keep a lot of people healthier than they have been in the past.”
The data, said Dr Cosgrove, is going to allow us to, “get ahead of avoidable diseases.”
Data breaking down silos
Just as importantly, the data will break down the silos in traditional healthcare. Doctors still learn their profession based on anatomy. But for medicine to become more preventative – and to accommodate emerging fields like genetics, genomics and metabolism – healthcare specialists are going to need to work together around the data.
For years, he points out, ulcers were thought to be caused by stress. But when a pathologist and microbiologist got together, they realised the problem was bacterial. This meant more cost-effective, non-invasive treatments could become available – freeing up hospital time and making the life of patients more tolerable.
If specialists came together around data, this kind of brilliant meeting of minds would no longer be down to serendipity. Instead, the data would pull them together and demand an answer.
Where is the data coming from?
But these new ways of working – that would make us all healthier and that would reduce the cost of healthcare – depend heavily on the availability of robust, timely data.
And this is where mass testing and lateral flow technology have an important role to play – especially when results can be seamlessly flowed to the cloud.
As the world looks increasingly to a future where mass testing is the norm, there is the potential for medicine to garner unprecedented insights from the data this generates.
Currently, however, the majority of lateral flow test results – including results from Covid-19 rapid antigen tests – are recorded manually. The person carrying out the test records results in a database or spreadsheet – and may or may not log a photograph of the test window. This approach takes time and is vulnerable to human error. It also limits the data that can be gathered.
Testing has to be seen as data gathering, rather than an end in itself
By integrating a data management platform like Transform® into lateral flow testing, thousands and millions of results can be flowed effortlessly to the cloud, from where they can be analysed easily via intuitive dashboards. On top of this, more data can be gathered and uploaded than when test results are recorded manually. This additional data can include geo-tagging, shift patterns in workplaces, self-reported symptoms – and countless other factors.
This is exactly the kind of rich data that public health and healthcare teams of the future will work from.
Integrating testing with this kind of digital management doesn’t have to be difficult or expensive. But it does require a shift in mindset.
We have to stop thinking about a test result as the conclusion of a process – and instead, start thinking of testing as a conduit for life-saving, knowledge-enhancing data gathering. This change in mindset would add significant value to the lateral flow test itself – and it would also heighten its significance in the healthcare landscape.
The future of healthcare is digital – so testing has to keep pace
As we re-evaluate our healthcare systems across the world, making them more efficient and effective, all health manufacturers should be looking to evolve their digital capability.
Toshiba, for example, is creating wearable, biometric technology that sends heart rate and oxygen saturation data to the cloud. This will give doctors a more accurate overview of their patients’ health. And smart alerts will allow interventions to take place swiftly.
If we want to live in societies where healthcare is truly about nurturing health, rather than scrabbling for a parking space in a hospital, we need to think data.
This will inform our healthcare policies and practices of the future. But to achieve it, the testing industry will have to embrace the idea of testing as a means of building data sets, rather than just giving results.