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  • How are people staying healthy proactively?
  • How are people staying healthy proactively?
    Ben Duchac (2017) ©
REPORT

2018 Expert Outlook on Health

How is technology changing people’s approach to wellbeing? What will be the role of doctors in the future? And how is medicine being personalised? In this part of the 2018 Expert Outlook series, we speak to three experts about the ways in which our relationship with health will evolve.

Location Global

Scope
With troves of medical information at their fingertips and access to countless health apps and wearables, people are feeling empowered to not only to manage their wellbeing, but to take an active part in personalising their own care based on genetic testing and a better understanding of bodily functions. Experts predict this will gradually redefine the industry, moving it away from reactive care and towards a more preventative and holistic approach. Remedies will become more varied, facilitated by companies that offer alternative solutions and peer-to-peer initiatives, both online and face-to-face.

In the 2018 Expert Outlook on Health, Canvas8 speaks to Dr. Trudi Edginton, a clinical psychologist and lecturer at City University; Mansal Denton, founder of Nootropedia; and chronic illness blogger and journalist Ilana Jacqueline.

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Dr. Trudi Edginton is a clinical psychologist and lecturer at City University. She is an expert in stress, and is currently working with the Economic and Social Research Council to explore the cognitive basis of people’s sense of direction and navigation.

The more technology is available, the more we’ll see the rise in precision-based healthcare, including the use of genetics. There will be more options for each individual, and companies will offer a range of remedies, therapies and different types of medicine. It will be a two- or three-tiered healthcare system that will allow people to explore all alternatives. There could be a number of different treatments that work for some but not for others. It’s about tailoring treatments to best fit the individual.

I expect to see a rise in social prescriptions. Medical professionals might prescribe exercise, an art course, or a course in learning to respond to and encourage the link between mental and physical health. Universities, healthcare providers, big tech companies, pharmaceutical firms, and start-ups are starting to create partnerships to really harness this potential. It’s exciting and forward-thinking. They’re introducing schemes to get people more engaged, like game theory and rewards-based schemes. Health insurance companies are rewarding their clients if they reach a certain weight or level of fitness. Gyms are actually the companies doing most of the work – like Virgin and Vitality. They’re linking with other companies and working together to foster proactive health, which is really influential.

Holistic healthcare seeks to improve both the body and mind Holistic healthcare seeks to improve both the body and mind
Roya Ann Miller (2017) ©

There will be more information-sharing among health professionals and a more integrated sense of care. It’ll be a soft, collaborative approach to health. You could be wearing technology that monitors your blood pressure, heart rate, blood glucose and then you’d be contacted if things are detected. Telemedicine will be really important in terms of providing greater access to doctors outside of working hours, providing consultations by phone, Skype, or apps.

What’s really lacking is social care. Homelessness and mental health issues – these are the things that have the heaviest impact on health. The NHS is excellent in terms of responding to emergencies, but there are cracks in the system when it comes to chronic health issues.

The mind/body literature has been helpful in influencing some of the mindfulness-based interventions. Talking about the link between mind and body was considered almost a weakness before. Now, it’s considered quite scientific and therefore up for conversation. It’s more evidence-based. There’s a real focus on reducing stigma in mental health.

Personal technology could become a crucial part of modern medicine Personal technology could become a crucial part of modern medicine
Crew (2015) ©

Mansal Denton is the founder and manager of Nootropedia, a site that provides supplement details and features articles about what to do to be your optimal self. He also offers one-on-one coaching and is working to create immersive experiences.

We’re going to see true healthcare flourish, versus what we have now, which is sick care. It’s getting people who are healthy to feel even better. It’s being pushed by devices, which are becoming more sophisticated, and also the dissemination of free medical information, which makes self-study and research and a lot easier.

Tools like 23andMe give us a more personalised experience. They’ve been around a while, but they haven’t really been able to provide individualistic tweaks. We’re going to start to see a rapid rise in personalised medicine, which relies on people taking responsibility for themselves on a psychological, spiritual and psychological level.

In two to three years, people will have more responsibility in their conversations with their doctors, instead of being told what to do. They’ll be able to research and discuss specific ailments and be more informed. However, the information is often contradictory and it can be challenging to discern what’s real and what’s not. It can be overwhelming and confusing.

People want to discover more about their bodily make-up People want to discover more about their bodily make-up
Drew Hayes (2017) ©

Doctors are going to become important points of human connection. Let’s take the extreme where all our metrics – heart rate, blood flow, etc. – are tracked. Machines will feedback, saying, “Hey, you’re stressed today. My suggestion based on your previous reaction is x, y, z.” It would completely bypass a medical professional, but it’s cold. When it comes to health and trust, it’s going to be imperative for people to have an empathetic relationship with their doctor. We need to rethink their education. Most academia is stuck in an old paradigm. The new generation of doctors is taught by the old generation, who continue to pass on an antiquated idea of healthcare. It’s very narrow and should encourage self-study and empathy.

Nootropics are nothing new – supplements have been around a while – but the industry in a sense is new. Instead of taking a regular multivitamin, I can find out specifically what I might be deficient in, what I have problems with genetically, and I’ll go based on that. The Neurohacker Collective is looking to bring human optimisation to a wider audience in a meaningful way.

Broad strokes aren’t working. People are realising that they have to be very inwardly focused when it comes to their health and how they react to things. It’s going to create more opportunities for the placebo effect. People might believe that a certain supplement or lifestyle is better for them when there is no real change if you look at bio-markers. You have to balance objective data with the subjective feeling. My job with Nootropedia is to make sure they have all the information and distil what’s important for them and help them to strip away the noise.

All signs in healthcare point towards more tailored treatment All signs in healthcare point towards more tailored treatment
Paul Bence, Creative Commons (2017) ©

Ilana Jacqueline manages patient advocacy at FDNA, which specialises in helping healthcare providers as they work to diagnose diseases through artificial intelligence. She was previously the managing editor of The Rare Daily at Global Genes and runs the blog Let’s Feel Better. Her book, Surviving and Thriving with an Invisible Chronic Illness, will be published in 2018.

The main change we’re looking at is access to patient education in ways we’ve never had before. In the past, we’ve really relied on our doctors to do the grunt work for us; the patients didn’t want to do it for themselves and doctors didn’t have the time. Now, technology is stepping in. We’re able to add crucial biometrics that give us signals for disease, tracking devices, precision medicine that uses our genetic background to focus on treatments – these are the change-makers and they’re stepping in where time and education is lacking.

We’re collecting more data than ever – not just for sick patients but for healthy people too. It’s becoming an even more accurate control group, which is going to help us more carefully pinpoint predictors of disease with a wider variety of lifestyle information being collected.

Fifteen years ago, if you posted about a health issue on the web, you maybe didn't get a real response. Now, a patient can go online and say, “I have this,” and 20 other people are going to come to that thread and say, “Oh, I've had this, and this is what happened.” You have that ability to share that information. It gives patients a little more awareness of what’s normal.

Doctors can expect more demanding patients due to tech Doctors can expect more demanding patients due to tech
Sebastiaan ter Burg, Creative Commons (2017) ©

We are in a new era of patient responsibility. They’re going to be educated to the point where they’ll have all the pieces of the puzzle. It doesn’t mean that doctors are going to become irrelevant, but it means that they’re going to be held really accountable. Patients are going to be a little more empowered to say something like, “Well, I don’t think that’s normal” or “I think it could be something else.” Doctors are going to have to either find a way to allay those fears or they’re going to have to agree to more testing, which in most cases needs to happen. They’re going to have to meet demand.

There are a lot of concierge practices popping up within healthcare. Patients are willing to pay that premium so that they can get answers faster to make sure they’re always making the right medical choice. However, the only way to allay the fears of patients who are concerned about issues is with more information and better healthcare management. It’s the same trend with nutritional information. Studies pop up and we’re terrified of eating something. But we become a little bit more educated along the way. It’s going to take some time.

Technology is a way to get patients to monitor their health more often, more accurately. We’re in an era of experimentation and the information gained changes everything. In a couple of years, home testing technology will become the everyday norm.

Maud Carette is a senior behavioural analyst at Canvas8, with a political science background. Born to be a researcher, she spends a lot of time asking questions and can be found wandering around feeding her curiosity.

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